A rapid situation assessment of sexual risk behaviour of alcohol users in Lagos, Nigeria.

BACKGROUND: National sentinel surveys of HIV/AIDS among pregnant women in Nigeria have shown steady rise in prevalence from 1991 (1.8%) to 2001 (5.8%), which may reflect the pattern in the adult population in the country. The roles of known potential risk factors of the HIV/AIDS scourge in Nigeria deserve elucidation. This work aims to study the relationship between alcohol use and sexual risk behaviour. PATIENTS AND METHODS: Rapid assessment technique involving qualitative and quantitative methods was employed. A multi-site design which made it possible to compare samples recruited in high and low density settings was used. RESULTS: One hundred and nine of the alcohol users were recruited in the Low Density Area (LDA), while 130 were recruited in the High Density Area (HDA). In the HDA, 49 (53%) of the beer users used alcohol before sex either most or all of the time 21 (22.6%), or occasionally 28 (29.1%). Unlike the beer users less than half, 8 (42.1%), of Palm wine drinkers drank alcohol before sex. Beer users in the HDA used beer after sex with casual partners significantly more than the Palm wine drinkers (P = 0.036). Alcohol users in the LDA were more inclined to casual sex and they (54, 56.8%) believed that it had some or major role in their desire as well as performance of sex compared with users in the HDA (P = 0.005). CONCLUSION: Irrespective of their socioeconomic class, ethnicity, religion and educational attainment alcohol users in the country indulge in high risk sexual behaviours that predispose them to infection with HIV and other sexually transmitted diseases.

Female genital tract malignancies in Uyo, South-South Nigeria.

BACKGROUND: Female genital tract malignancies cause a significant number of deaths in the developing world. These deaths are however usually overshadowed by maternal deaths from obstetric causes. STUDY DESIGN AND SETTING: A retrospective study of all histologically confirmed female genital tract malignancies seen in the histopathology department of the University of Uyo Teaching Hospital between January 2000 and December 2004. RESULTS: Sixty five female genital tract malignancies were studied. Majority of patients were in the fifth to seventh decades of life. Carcinoma of the cervix was the commonest cancer seen (49.2%) followed by ovarian cancer (21.5%). Carcinoma of the vulva was the least common cancer seen (1.5%). Squamous cell carcinoma was the commonest histological variety. CONCLUSION: Female genital tract malignancies are major causes of morbidity and mortality in Nigeria. There is thus a need for public enlightenment to increase the awareness of risk factors and the provision of regular cervical cancer screening services which should be free to encourage utilisation.

A controlled study of anxiety and depression in mothers of children with learning disability in Lagos, Nigeria.

BACKGROUND: Parents of children with learning disability have been reported to suffer great stress and frustration due to increased burden of care. The manifestation of stigmatization by familial environment and the collective effect of the children with adverse impact on mothers predispose them to mental shock or a variety of neurotic symptoms and other psychiatric conditions including anxiety and depression. The objectives of the study were: to determine the general Health Questionnaire (GHQ) score of mothers of children with learning disability. To identify sociodemographic variables and to assess anxiety and depression in them. METHODS: Using structured questionnaires between March and May 2002, 106 mothers of children with learning disability in a Mentally Handicapped Home for children in Lagos, Nigeria were assessed and compared with mothers of normal healthy children in Lagos. RESULTS: The mean age of the subjects was 40.0 +/- 6.6 years. More of the subjects (26.4%) compared with mothers of normal healthy children (9.9%) had a high GHQ score and high levels of anxiety (25.5%) and depression (10.4%). Marital difficulties were associated with learning disability. CONCLUSION: Mothers of children with learning disability are prone to emotional and psychological disorders. In order to improve the well-being of children with learning disability, there is need to look into the mental and physical health of mothers. Early and prompt treatment of associated anxiety and depression will no doubt help the children.

A controlled study of anxiety and depression in mothers of children with learning disability in Lagos, Nigeria

BACKGROUND:Parents of children with learning disability have been reported to suffer great stress and frustration due to increased burden of care. The manifestation of stigmatization by familial environment and the collective effect of the children with adverse impact on mothers predispose them to mental shock or a variety of neurotic symptoms and other psychiatric conditions including anxiety and depression. The objectives of the study were: to determine the general Health Questionnaire (GHQ) score of mothers of children with learning disability. To identify sociodemographic variables and to assess anxiety and depression in them.METHODS:Using structured questionnaires between March and May 2002, 106 mothers of children with learning disability in a Mentally Handicapped Home for children in Lagos, Nigeria were assessed and compared with mothers of normal healthy children in Lagos.RESULTS:The mean age of the subjects was 40.0 +/- 6.6 years. More of the subjects (26.4%) compared with mothers of normal healthy children (9.9%) had a high GHQ score and high levels of anxiety (25.5%) and depression (10.4%). Marital difficulties were associated with learning disability.CONCLUSION:Mothers of children with learning disability are prone to emotional and psychological disorders. In order to improve the well-being of children with learning disability, there is need to look into the mental and physical health of mothers. Early and prompt treatment of associated anxiety and depression will no doubt help the children

Oil doom and AIDS boom in the Niger Delta Region of Nigeria.

CONTEXT: There has been a steady rise in Nigeria's HIV/AIDS burden since the first sero-prevalence survey in 1991. Nigeria's economy is mainly dependent on oil that comes from the Niger Delta Region. The majority of the people of the Niger delta region depend on fishing and farming for livelihood. Years of oil exploration activities with frequent oil spillages have led to severe environmental degradation with resultant destruction of farmlands and aquatic flora and fauna. The situation of the people of Niger Delta is characterised by poverty, high fertility and disease. ISSUE: Oil has become, to the people of the Niger Delta region a doom that has contributed in no small measure to the AIDS boom in the region. The relationship between such a burden and poverty has been forged by years of official neglect, and the presence of foreign workers. In addition, young Nigerians are drawn to the Niger Delta region by the oil economy, searching for non-existent jobs. Within Nigeria, the states of the Niger Delta region bear the burden of the spread of HIV/AIDS, and the region's poverty amidst plenty, has a negative impact on the population. LESSONS: The article concludes that the HIV/AIDS burden of the region deserves urgent and special attention because it has far-reaching implications, not only for control efforts in Nigeria, but also for the rest of the world, as nationals of various countries find employment in its oil fields. A number of recommendations are made.

Epidemiology of childhood behavioural disorders in Ilorin, Nigeria--findings from parental reports.

We report the findings of a survey aimed at determining the prevalence, pattern and psychosocial correlates of childhood psychiatric disorders among primary school pupils in Ilorin, Kwara State. Eight hundred and forty-six parents completed the 31-item Rutter scale A2 and an additional pro-forma on the developmental and family history of their children. The most commonly reported symptoms were headache, vomiting, tempertantrums, restlessness, disobedience and fearfulness. Using Rutter's cut off point of 13, 157 (18.6%) qualified as cases: neurotic disorders (7.3%), antisocial disorders (8%) and undifferentiated disorders (3.3%). Males were over-represented, albeit non-significantly, among the neurotic and antisocial groups. Mothers of high scorers (HSs) reported significantly more physical and emotional problems during pregnancy. HSs were significantly more likely to (i) have had delayed developmental milestones (ii) have suffered a major illness during childhood (iii) come from broken homes, and (iv) attend school located in the rural area. Our prevalence rate compares well with those reported in Africa and elsewhere. To address the identified unmet needs of children in this environment, we suggest the need to establish a comprehensive child mental health package, which could be incorporated into the existing primary health care programme. The package should encompass the three tiers of prevention, and involve the active participation of parents, teachers, educational, as well as health professionals.

Lagos "area boys and girls" in rehabilitation: their substance use and psychosocial profiles.

We report on the psychosocial and substance use profiles of the 55 "Area Boys and Girls" (ABG) admitted to a Rehabilitation Camp in Lagos between March and May 1993 under the main auspices of the People's Bank of Nigeria. The majority were males (73%); young adults (mean age/SD: 30.6/6.3); unemployed (73%); not married (80%); of low educational standing (87%) and from low socio-economic background (over 70%). Almost all were current users of heroin (89%) and cocaine (87%), procured with a substantial amount of money and administered mainly through smoking and "chasing the dragon". None of the clients reported injecting the drug. These findings have highlighted the intricate nature of the problems of ABG and the need for a comprehensive rehabilitation package encompassing general medical, psychological and psychiatric care. Such programmes, ideally free, should be a joint venture between the government, international agencies, non-governmental organizations and the community as a whole. The key emphasis should be on equipping the clients with occupational skills for life-long economic sustenance. To curtail the growing numbers of displaced young people in the country, the government should give due attention to the root causes of the multiple social ills in the society.

Clinicopathological features of untreated fibrous hamartoma of infancy.

AIM: To study the clinicopathological features of fibrous hamartoma of infancy in Nigerian children. METHODS: Six children aged between 6 months and 10 years were studied. All specimens were stained with haemotoxylin and eosin and examined routinely. The children were followed up for between one and three years. RESULTS: In four of the children lesions were present at birth; in the other two they appeared by the age of 1 year. Some of the children had had the lesion for between three and 10 years. All lesions were located in the subcutis. They were solitary and varied in size and shape. They had grown rapidly up to the age of 5, after which growth decelerated, but did not stop or regress. The younger the child the less clearly demarcated was the tumour on the deep surface. In the older children the capsule was more developed. CONCLUSIONS: Fibrous hamartoma of infancy is rare, but it is important for clinicians to know that it is benign and readily amenable to treatment.

Familial polyposis coli: an unusual case in West Africa.

We describe a case very rare in the West African sub-region, Familial Polyposis Coli, presenting with rectal prolapse. Symptoms appeared at an unusual age of three years. Histological examination of four polyps excised at random showed all to have undergone malignant change. While the patient was being built up for surgery, she developed marked abdominal distension, hyperpyrexia, respiratory distress and vomiting. She died within 24 hours of this acute illness. This is the first reported case, to our knowledge, of Familial Polyposis Coli in the West African sub-region.

Characterization of breast cancer subgroups in an African population.

A detailed prospective study of 58 consecutive breast cancer patients and contemporaneous controls, using age, duration of tumour and presence or absence of poor prognostic signs as clinical parameters, clearly showed that the patients fell into three distinct groups. Group A accounted for 30 per cent of cancers and consisted of young women (21-45 years) with advanced cancers, a short history (3 months or less) and poor prognostic signs; these patients had fast-growing tumours. Group B, to which nearly 60 per cent of patients belonged, was made up of menopausal women (46-50 years) with advanced disease, a history of from 3 months to 1 year and poor prognostic signs; their tumour growth rate was intermediate. Group C made up slightly more than 10 per cent of cases and consisted of postmenopausal women (50 years and above) who gave a long history (1 year or more), and had resectable tumours without poor prognostic signs. Thus, although advanced breast cancer in tropical Africa is due to late presentation in the majority of cases, a small but significant proportion of women have advanced disease in spite of early presentation, attributable to fast tumour growth rate.

The Othello syndrome.

A case of the Othello syndrome is presented. In its classical form the syndrome is rare, but as with other allied paranoid states, its medicosocial implications are great. Rational management should include pharmacotherapy, conjoint family therapy after symptom remission, and long-term individual psychotherapy.