Prevalence and pattern of psychiatric morbidity among people living with human immunodeficiency virus in Kano

Background:Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.Objectives:To determine the prevalence and pattern of psychiatric morbidity among PLWHAattending Aminu Kano Teaching Hospital, Kano.Materials and methods:This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.Patients aged 18years and above who had been on ARVdrugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.Results:Atotal of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.Conclusion:Psychiatric disorders are common in PLWHA, with major depression being the commonest.

A qualitative study on the influence of COVID-19 on smoking behaviors through changing social and physical contexts.

Globally, COVID-19 has been a major societal stressor and disrupted social and physical environments for many. Elucidating mechanisms through which societal disruptions influence smoking behavior has implications for future tobacco control efforts. Qualitative interviews were conducted among 38 adults who smoked combustible cigarettes in 2020 and 2021. The majority were women (75.7%), identified as Black (56.8%), were employed (61.3%), had a smoke-free home (66.7%) and lived in a small metro or rural (79.0%) county, primarily in rural southwest Georgia. Participants reported more time at home, increased isolation and less socializing, changed work and financial situations and altered household and family contexts. The vast majority of participants smoked more at some point during the pandemic with about half of these continuing to smoke more at the time of the interview. More time at home, multiple sources of stress and boredom were the main reasons for increased smoking. Decreases in smoking were attributed to financial strain, smoke-free home rules and nonsmoking family members, concerns about COVID-19 and less socializing with friends who smoke. Future tobacco control efforts during societal stressors such as pandemics should take into account specific psychosocial and environmental influences in attempts to minimize negative changes to smoking patterns.

Epilepsy treatment gap in Sub-Saharan Africa: Meta-analysis of community-based studies.

OBJECTIVE: To evaluate the prevalence, highlight the variation and determine the trend over time, of epilepsy treatment gap (ETG) in Sub-Saharan Africa (SSA). METHODS: We systematically searched PubMed, MEDLINE, Embase, ISI databases, and African Journal Online (AJOL). We determined the pooled prevalence estimate of ETG and the degree of heterogeneity in the region. Further subgroup analysis by sub-region, settlement setting, and cutoff adopted for active epilepsy in the studies was carried out. Meta-regression technique was also used to determine the trend of the ETG magnitude over time. RESULTS: Twenty-three studies from SSA met the inclusion criteria. We found a high level of discordance among the studies that were included. Collectively, the estimated ETG was 68.5% (95% CI: 59.5%-77.5%). On subgroup analysis, the prevalence of the ETG was 67% (95% CI: 52%, 83%) in the Western, 68% (95% CI: 56%, 80%) in the Eastern, and 63% (95% CI: 53%, 73%) in the Southern Africa sub-regions. On stratified analysis based on 1-year, 5-year, and 2-year cutoffs for definition of active epilepsy, the prevalence figures for the ETG were 71% (95% CI: 56%, 85%), 55% (95% CI: 33%, 77%), and 57% (95% CI: 43%, 71%), respectively. Meta-regression result suggested that the prevalence of the ETG decreases by approximately by 0.006 per year. CONCLUSION: The study showed a high prevalence of ETG, higher than the average for resource poor countries, and twice in rural compared with urban settlements in SSA.

Activated polymorphonuclear cells promote injury and excitability of dorsal root ganglia neurons.

Therapies aimed at depleting or blocking the migration of polymorphonuclear leukocytes (PMN or neutrophils) are partially successful in the treatment of neuroinflammatory conditions and in attenuating pain following peripheral nerve injury or subcutaneous inflammation. However, the functional effects of PMN on peripheral sensory neurons such as dorsal root ganglia (DRG) neurons are largely unknown. We hypothesized that PMN are detrimental to neuronal viability in culture and increase neuronal activity and excitability. We demonstrate that isolated peripheral PMN are initially in a relatively resting state but undergo internal oxidative burst and activation by an unknown mechanism within 10 min of co-culture with dissociated DRG cells. Co-culture for 24 h decreases neuronal count at a threshold<0.4:1 PMN:DRG cell ratio and increases the number of injured and apoptotic neurons. Within 3 min of PMN addition, fluorometric calcium imaging reveals intracellular calcium transients in small size (<25 microm diam) and large size (>25 microm diam) neurons, as well as in capsaicin-sensitive neurons. Furthermore, small size isolectin B4-labeled neurons undergo hyperexcitability manifested as decreased current threshold and increased firing frequency. Although co-culture of PMN and DRG cells does not perfectly model neuroinflammatory conditions in vivo, these findings suggest that activated PMN can potentially aggravate neuronal injury and cause functional changes to peripheral sensory neurons. Distinguishing the beneficial from the detrimental effects of PMN on neurons may aid in the development of more effective drug therapies for neurological disorders involving neuroinflammation, including painful neuropathies.

Neutrophils invade lumbar dorsal root ganglia after chronic constriction injury of the sciatic nerve.

To test whether neutrophils (PMN) target lumbar dorsal root ganglia (DRG) following axonal injury leading to neuropathic pain, we visualized PMN infiltration in DRG tissue sections and estimated PMN count by flow cytometry following sciatic chronic constriction injury (CCI). Seven days after CCI, results show PMN within DRG where their count increased by three fold ipsilateral to injury compared to contralateral or sham, concomitant with peak neuropathic pain behavior. Superoxide burst in PMN isolated from rats d7 after CCI was elevated by 170% +/-18 compared to naïve and MCP-1 mRNA expression in DRG increased by 8.9+/-2.9 fold, but that of MIP-2, CINC-1, and RANTES did not change. We conclude that CCI causes PMN invasion of the DRG whereby the functional implication of their close proximity to neuronal axon and soma remains unknown.

Socio-economic implications of the management of HIV positive pregnant women--a review of four cases in Ile-Ife, Nigeria.

AIDS constitutes a major public health problem in developed and developing countries. The experience at Obafemi Awolowo University Teaching Hospitals Complex (O.A.U.T.H.C.), Ile-Ife, Nigeria has shown that HIV/AIDS is not uncommon. Screening of pregnant women with symptoms and signs suggestive of HIV/AIDS revealed 5 cases in three years (1996-1998). Four of these cases were reviewed to highlight the socio-economic implications and the burden of the disease on maternal and child health in our environment. It was shown that the socio-economic status of the women could not support adequate management of their conditions resulting in poor outcomes namely abortion, increased risk of infection to the baby and debts from hospital bills among others. Improvement in the socio-economic conditions of the populace and community health education on HIV/AIDS will enhance the outcome of management in pregnancy. In addition to emphasising preventive measures, research into appropriate mode of management of HIV/AIDS in pregnancy is urgently needed in our environment.

Infant feeding practices in a deprived environment: a concern for early introduction of water and glucose D water to neonates.

The main objective of this study was to inquire from lactating mothers whether they were fully or partially practising exclusive breastfeeding in the first six months postnatally. Time of initiation of breast and complementary feedings, types of feeds and reasons for giving other feeds to infants apart from breast milk were also examined. The data were collected by structured pretested questionnaire. Of the 200 nursing mothers interviewed, 103 (51.5%) and 77 (38.5%) reported to have given water and glucose D water to neonates respectively within the first week of life. Sieved cornpap was the popular weaning diet. Time of introducing complementary feeding to infants, and nursing mothers' educational levels, were highly significantly related (P = 0.005). Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. It is concluded that there is a strong need to correct this unnecessary practice of giving water and glucose D water to neonates to prevent thirst and Jaundice respectively. The correction should commence with health workers and then the nursing mothers.

PIP: This paper examines the practice of exclusive breast-feeding in the first 6 months after birth among lactating mothers in Ile-Ife, Osun State, Nigeria. The study also determines the time of initiation of breast-feeding and complementary feedings, type of feeds, and reasons for giving water and glucose D water to neonates. The investigation was carried out among 200 nursing mothers using pre-tested structured questionnaire. Of the 200 nursing mothers interviewed, 103 and 77 reported to have given water and glucose D water to neonate respectively within the first week of life. Mothers usually used sieved cornpap as a weaning diet. The time of introducing complementary feeding to infants were significantly related to the nursing mother's educational levels. Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. This study suggests that there exists a wrong practice in the timing of starting complementary feeding to neonates. The practice of giving water and glucose D water to neonates to prevent thirst and jaundice, respectively, is unnecessary. Therefore, necessary corrective measures are needed.

Blood pressure distribution of Nigerians in the first two decades of life.

The systolic and diastolic blood pressures of 2301 Nigerian boys and 2017 Nigerian girls were measured. Their ages, which were in the range 1-20 years, heights and weights were also recorded. The relationship between these variables are discussed. Selected percentiles of systolic and diastolic pressures for different ages and weights are given.

Electron contamination in 60Co gamma-ray beams.

All radiotherapy photon beams are accompanied to some extent by secondary electrons which originate in interactions with source hardware, collimator, shadow tray, and/or the air through which the beam passes. Skin sparing, the shape of the dose buildup curve, and the depth of the dose maximum are all influenced by this electron "contamination." The present study of a 60Co source employs a flat ion chamber to measure dose buildup curves in polystyrene at source distances of 72 to 200 cm, with an open beam or a filter of Lucite, Cu, Pb-loaded acrylic, or Ba- or Pb-loaded nonbrowning glass placed 57 cm from the source, using 5 X 5, 20 X 20, and 35 X 35-cm2 beams as defined at 80 cm SSD. The effect of electron generation in the air was studied by placing a He-gas-filled plastic bag in the beam. A value of about 12% is estimated for the lowest relative dose obtainable with a polystyrene phantom in a "clear" 60Co gamma-ray beam of 1-cm diameter.

Electron contamination in 60 Co gamma-ray beams.

All radiotherapy photon beams are accompanied to some extent by secondary electrons which originate in interactions with source hardware, collimator, shadow tray, and/or the air through which the beam passes. Skin sparing, the shape of the dose buildup curve, and the depth of the dose maximum are all influenced by this electron "contamination." The present study of a 60 Co source employs a flat ion chamber to measure dose buildup curves in polystyrene at source distances of 72 to 200 cm, with an open beam or a filter of Lucite, Cu, Pb-loaded acrylic, or Ba- or Pb-loaded nonbrowning glass placed 57 cm from the source, using 5×5, 20×20, and 35×35-cm2 beams as defined at 80 cm SSD. The effect of electron generation in the air was studied by placing a He-gas-filled plastic bag in the beam. A value of about 12% is estimated for the lowest relative dose obtainable with a polystyrene phantom in a "clear" 60 Co γ-ray beam of 1-cm diameter.