How large is the burden of depression in a medical school? A cross-sectional study among medical students in Nigeria.

INTRODUCTION: mental health of students deteriorate when they begin studies in a medical school. The study aimed to determine the prevalence of depression and associated factors among medical students in a university in Nigeria. METHODS: a cross-sectional study design was used. All matriculated medical students of Ebonyi State University Abakaliki, Nigeria were included in the study. Information was obtained using a self-administered structured questionnaire. Beck´s depression inventory was used to determine the prevalence of depression. Chi square test was used to ascertain association between variables. Level of statistical significance was determined by p value of <0.05. RESULTS: the mean age of the students was 23.2 ± 3.3 years and majority, 60.2% were males. Prevalence of depression was 17.4%. Third-year class (major examination class) had the highest proportion of students who were depressed, 24.2% while final year class had the least, 8.8%. Coping mechanisms for low moods included sleeping, 50.4% and having interactions with colleagues, 46.9%. Factors associated with depression included being <25 years, (p=0.008), being in the pre-clinical school, (p=0.023) and being afraid some students may not graduate from medical school (p=0.030). CONCLUSION: burden of depression was high among the students and most pronounced among third year students. There is need for proper orientation of newly admitted medical students on the medical curriculum by authorities of the university. Efforts should be made to decrease undue anxiety among students especially during examination. Adequate measures should be put in place for early detection and prompt management of cases of depression among the students.

The role of the Deki Reader™ in malaria diagnosis, treatment and reporting: findings from an Africare pilot project in Nigeria.

BACKGROUND: The Deki Reader is a diagnostic device used with rapid diagnostic tests (RDTs) and linked to an online database for real-time uploads of patient information and results. This is in contrast to visual interpretation of malaria RDTs recorded on the District Health Information System (DHIS). This paper compares records for use of the Deki Reader with DHIS records of visual interpretation of RDTs. RESULTS: A total of 4063 patient encounters/tests were recorded on the Deki Reader database between June 1st and December 31st, 2016. These tests were for 2629 persons who presented with fever and had RDT done. In comparison, data from DHIS 2.0 for same period recorded 7201 persons presenting with fever. 2421 out of the 2629 persons (92.1%), received RDT using Deki Reader compared to 6535 out of 7201 persons (90.4%) recorded on DHIS (p = 0.04). From DHIS records, malaria positivity rate was 51.6% (3375 out of 6535 persons) compared to Deki Reader records of 23.6% (572 out of 2421 persons). The difference between these two rates was significant (p < 0.001). The odds ratio (95% CI) for the association between use of Deki Reader and having a positive malaria result was 0.29 (0.26-0.32). DHIS showed that 4008 persons received Artemisinin-based combination therapy (ACT) while 3989 persons tested positive with RDT or microscopy, compared to 691 out of 705 persons (98.0%) using Deki Reader. Finally, Deki Reader identified 618 processing and manufacturers errors with an error rate of 15.3%. CONCLUSION: The Deki Reader is likely a useful tool for malaria diagnosis, treatment, and real-time data management. It potentially improves diagnostic quality, reduces wastage in ACT administration and improves data quality.