Psychiatric admissions in young people after expiration of criminal justice supervision in Australia: a retrospective data linkage study.

BACKGROUND: Mental health services are available for young people involved with the criminal justice system. However, they have unmet mental health needs after the expiration of criminal justice supervision. OBJECTIVE: To determine the incidence rate and identify predictors of psychiatric hospitalisations within 24 months after the expiration of criminal justice supervision among young people involved with the New South Wales (NSW) criminal justice system. METHODS: Retrospective data from 1556 individuals aged 14-22 years who participated in four surveys of justice-involved young people in NSW were harmonised and linked to four NSW data collections. We calculated the incidence rates of psychiatric hospitalisations within 24 months postsupervision and identified predictors of these hospitalisations using a competing risks regression analysis. RESULTS: Within 24 months postsupervision, 11.4% had a psychiatric hospitalisation compared with 3.5% during supervision. 20.7% of those admitted had a known history of mental illness and engaged with community-based and outpatient mental health services postsupervision. Predictors of psychiatric hospitalisations were: female sex (adjusted subdistribution HR (asHR) 1.84, 95% CI 1.24 to 2.73); previous incarceration (highest asHR for ≥4 episodes 1.67, 95% CI 1.01 to 2.78); head injury (asHR 1.63, 95% CI 1.20 to 2.21); personality disorder (asHR 3.66, 95% CI 2.06 to 6.48) and alcohol and substance use disorder (asHR 1.89, 95% CI 1.29 to 2.77). CONCLUSION: Justice-involved youth have higher rates of psychiatric admissions after criminal justice supervision. Engagement with mental health services postsupervision is important in addressing emerging or persisting mental health needs.

Spectrum of COVID-19 infection in children in Southern Nigeria

Background: Corona virus disease 2019 (COVID-19) is a global pandemic that affects all age groups. Infected asymptomatic children can transmit the disease to vulnerable adults with co-morbidities resulting in severe disease in the latter. There are few reports of COVID-19 in children in Sub-Saharan Africa in general and in Nigeria in particular. Aim: To determine the prevalence, symptoms and risk factors for COVID-19 in Southern Nigerian children. Methods: This was a one-year retrospective cross-sectional study between April 2020 and March 2021. Data of all children tested for COVID-19 was extracted from the Epidemiology unit of Akwa Ibom state ministry of health. All patient identifiers were omitted and data was analyzed using STATA version 13. Results: Two hundred and fifty five children (2.25%) out of a total of 11,289 people were tested for COVID-19. Fifty -four children (0.47%) of the total number of persons tested for COVID-19 were positive. Twenty one percent of the 255 children tested were positive for COVID-19. Two hundred and fifty- four (99.6%) of children that were tested had a positive history of contact with a confirmed COVID-19 case. Five (9.3%) of COVID-19 positive children were symptomatic. The commonest symptoms seen were Fever (90.9%), Anosmia (63.6%) and Aguesia (36.4%). Increasing age (15 years and above) was significantly associated with COVID-19 positivity (p=0.000). In addition, the presence of symptoms was significantly associated with COVID-19 positivity (p=0.04). Conclusion/Recommendation: The prevalence of COVID-19 in Southern Nigerian children is low. Majority of the children have asymptomatic disease. Increasing age is significantly associated with COVID-19 positivity. We recommend increased COVID-19 testing in the general children population.

Knowledge, awareness and perception of health care workers towards COVID-19 in Southern Nigeria

Context: Severe acute respiratory coronavirus disease 2019 (SARS-COVID-19) is a novel worldwide pandemic. Health care workers (HCWs) are at high risk of contacting the infection. Objective: To determine the knowledge, awareness and perceptions of HCWs towards COVID-19 in Southern Nigeria. Methods: A descriptive cross-sectional questionnaire study carried out between May 2020 and July 2020. Healthcare workers responded to questions covering their sociodemographic characteristics, knowledge of transmission, cure and outcome of COVID-19. Other questions asked were their perception about contacting the disease, and their facility preparedness to handle the pandemic. Data was analysed using Stata version 13. Results: A total of 366 healthcare workers completed the questionnaires. The mean age of respondents was 35.2 years. There were 209 (57.1%) males. Majority (44.5%) of the respondents were doctors. The top three symptoms identified by respondents were cough (97%), fever (92.9%) and sore throat (88%). Three hundred and sixty-four (99.5%) respondents had good level of knowledge of COVID -19. Two hundred and ninety (79.2%) of the respondents were worried about contacting COVID-19. Two hundred and thirty-five (64.2%) respondents said their facilities were not prepared to manage COVID-19 cases. Areas of concern were the absence of test kits and sample materials (70.5%), lack of personal protective equipment (PPE) (67.2%) and lack of dedicated intensive care units with ventilators (62%). Conclusion: There was good knowledge of COVID-19 among HCWs. However, there was a high degree of anxiety of contacting COVID-19 among HCWs and concerns about a general lack of preparedness for COVID-19 management. We therefore recommend the adequate provision of PPE and improved testing.

Assessment of Resources for Primary Health Care: Implications for the Revitalization of Primary Health Care in Akwa Ibom, Nigeria.

CONTEXT: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. AIMS: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. SETTINGS AND DESIGN: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. SUBJECTS AND METHODS: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. RESULTS: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. CONCLUSIONS: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.