Improving the quality of life of people living with HIV/AIDS: A cross-sectional study of the role of religion.

Background: Previous studies have found religion as a useful tool in coping with chronic medical conditions including HIV/AIDS. Aim: This study assessed how religiosity and religious coping are associated with quality of life (QOL) among people living with HIV/AIDS (PLWHA). Patients and Methods: This was a cross-sectional study of 140 HIV clinic attendees of a Nigerian tertiary health facility. Religiosity, religious coping and QOL were measured with religious orientation scale-revised (ROS-R), Brief Religious Coping (Brief RCOPE) and World Health Organization Quality of Life-Bref (WHOQOL-BREF), respectively. Correlation analysis assessed the relationship between ROS-R, Brief RCOPE and WHOQOL-BREF. Results: : Intrinsic religiosity (IR) scores had a moderate positive correlation with psychological health domain of QOL (r = 0.4, N = 140, and P 0.001), and a weak positive correlation with physical health domain of QOL (r = 0.2, N = 140, and P 0.05). Extrinsic religiosity (ER) scores moderately correlated positively with the psychological health domain of QOL (r = 0.03, N = 140, and P 0.002), but weakly correlated positively with the physical health domain (r = 0.2, N = 140, and P 0.02). Positive religious coping (PRC) scores moderately correlated positively with the psychological health domain (r = 0.03, N = 140, and P 0.05) and weakly correlated positively with physical health domain of QOL (r = 0.2, N = 140, and P 0.02). Extrinsic religiosity social (ERS) scores had a moderate positive correlation with the social relationships domain (r = 0.4, N = 140, P 0.001). Conclusion: Increased ER, IR orientations and Positive Religious Coping appear to improve the psychological and physical health domains ofQOL QOL Therefore, religiosity should be encouraged among PLWHA to improve QOL.

Partnership for the implementation of mental health policy in Nigeria: a case study of the Comprehensive Community Mental Health Programme in Benue State.

BACKGROUND: 71% of countries in the World Health Organisation's (WHO's) African Region have a stand-alone mental health policy or plan, but only 14% have fully implemented it. In Nigeria, integration of mental health into primary care has been a stumbling block to the implementation of the 1991 National Mental Health Policy, 2013 Policy on Mental Health Services Delivery and the National Mental, Neurological and Substance Use Programme and Action Plan. A partnership between public and private not-for-profits in Benue State, the Comprehensive Community Mental Health Programme (CCMHP) has successfully integrated mental health into primary care in alignment with the national mental health policy and the WHO's mental health Gap Action Programme Intervention Guide (mhGAP-IG). There is a need to document such examples in order to inform policy implementation in Nigeria and other low- and middle-income countries (LMICs). METHODS: We followed the Case Study Methodology to Monitor and Evaluate Community Mental Health Programmes in LMICs. Four field visits were conducted between 2013 and 2017 to document the first phase of activities of CCMHP, covering the period of January 2011 through June 2016. RESULTS: In its first phase, CCMHP trained 19 community psychiatric nurses and 48 community health extension workers in mhGAP-IG, establishing 45 new mental health clinics in primary care facilities across Benue, a state more populous than many countries. As a result, 13,785 clients (55% male, 45% female) were enrolled in mental health services either in primary care or in one of two pre-existing community-based rehabilitation facilities. Most are adults over age 18 (82.75%), and present to services with epilepsy (52.38%) or psychosis (38.41%). CONCLUSION: The case of CCMHP demonstrates it is possible to rapidly scale-up mental health services in line with national mental health policy using the mhGAP-IG, even in a challenging, low-resource setting. Multi-sectoral partnerships may help to overcome some of the barriers to successful integration of mental health into general healthcare by capitalising on the resources and expertise of both state and non-state actors. However, a difficult political context could threaten the sustainability of the programme if funder requirements force a rapid transition to full government ownership.

Prevalence and correlates of cigarette smoking among patients with schizophrenia in southeast Nigeria.

OBJECTIVE: To determine the prevalence of cigarette smoking among patients with schizophrenia and to explore their sociodemographic and clinical characteristics. METHOD: A cross-sectional descriptive study of 367 patients with schizophrenia. Instruments administered included sociodemographic questionnaire, Present State Examination: schizophrenia section to confirm schizophrenia diagnosis and Present State Examination: tobacco section to those that smoked. RESULTS: A total of 189 females (51.5%) and 178 (48.5%) males were studied. The mean age of the participants was 34.1 ± 9.94 years. Two hundred and forty-one (65.7%) had never being married. Two hundred and three (55.3%) had secondary school education. A lifetime prevalence of 25.9% and a current smoking rate of 20.4% were reported. Ninety five (53.4%) of the males had smoked at least once in their lifetime. None of the females smoked. Among those that smoked, being unmarried (Ï°² = 6.51, P < 0.01) and unemployed (Ï°² = 5.11, P < 0.02) were associated with prescription of high doses of antipsychotics. Of those that smoked, the managing psychiatrist identified or documented only twenty-five (26.3%) of them (kappa = 0.80, P < 0.00). CONCLUSION: The rate of smoking in Nigerian patients with schizophrenia is considerably less than is reported for their Western counterparts.