Psychometric Properties of the Modified Family Affluence Scale (FAS II) among Adolescents in Nigeria: A Preliminary Report.

OBJECTIVE: Social inequalities have serious health consequences for the developing child. Measuring these disparities is challenging, and the Family Affluence Scale (version II), a proxy indicator based on material wealth, was developed as a solution. However, it has not been validated for use in Sub-Saharan Africa and may not be applicable in developing countries. This preliminary study aimed to determine the convergent validity and reliability of a culturally adapted version of the FAS II. METHODS: A cross-sectional study was carried out among 422 senior secondary school students in Calabar, Nigeria. Modified versions of the Family Affluence Scale Version II (FAS II) were tested for their psychometric properties as proxy measures of socioeconomic status among Nigerian adolescents. Cronbach's alpha was computed as a measure of internal consistency, while Spearman's rank correlation and regression analysis were done to assess convergent validity. RESULTS: The mean sample age was 14.95 (±1.53) years, with an approximately equal gender distribution. Internal consistency was 0.68 for the 4-item version of the modified scale and increased to 0.75 when the item about travelling abroad was deleted. The modified FAS II scores (4 items) had a significant positive correlation with tuition cost (r=0.48, p<0.001), paternal educational attainment (r=0.27, p<0.001), and maternal educational attainment (r=0.30, p<0.001). Similarly, the 3-item version had a significant positive correlation with tuition cost (r=0.52, p<0.001), paternal educational attainment (r=0.24, p<0.001), and maternal educational attainment (r=0.30, p<0.001). Moderate (aOR: 4.25; 95%CI 2.45-7.39) and high affluence (aOR: 11.43; 95%CI 6.36-20.55) predicted attending more expensive schools. Moderate affluence (aOR: 2.15; 95%CI 1.28-3.62) and high affluence (aOR: 5.21; 95%CI 2.76-9.84) predicted a higher paternal education. Also, moderate affluence (aOR: 2.18; 95%CI 1.31-3.63) and high affluence (aOR: 7.42; 95%CI 3.76-14.66) predicted higher maternal education. The 3-item version performed similarly in terms of its predictive ability. CONCLUSION: The modified version of the FAS II appears to have sufficient validity and reliability for measuring the socio-economic status of adolescents in Nigeria.

OBJECTIF: Les inégalités sociales ont de graves conséquences sur lasanté de l'enfant en développement. Il est difficile de mesurer ces disparités, et l'échelle d'aisance familiale (version II), un indicateur indirect basé sur la richesse matérielle, a été mise au point pour y remédier. Cependant, elle n'a pas été validée pour une utilisation en Afrique subsaharienne et pourrait ne pas être applicable dans les pays en développement. L'objectif de cette étude préliminaire était de déterminer la validité convergente et la fiabilité d'une version culturellement adaptée du FAS II. MÉTHODES: Une étude transversale a été menée auprès de 422 élèves du deuxième cycle de l'enseignement secondaire à Calabar, au Nigeria. Des versions modifiées de la Family Affluence Scale Version II (FAS II) ont été testées pour leurs propriétés psychométriques en tant que mesures indirectes du statut socio-économique chez les adolescents nigérians. L'alpha de Cronbach a été calculé pour mesurer la cohérence interne, tandis que la corrélation de rang de Spearman et l'analyse de régression ont été effectuées pour évaluer la validité convergente. RÉSULTATS: L'âge moyen de l'échantillon était de 14,95 ans (±1,53), avec une répartition à peu près égale entre les sexes. La cohérence interne était de 0,68 pour la version à 4 items de l'échelle modifiée et a augmenté à 0,75 lorsque l'item sur les voyages à l'étranger a été supprimé. Les scores FAS II modifiés (4 items) présentaient une corrélation positive significative avec les frais de scolarité (r=0,48, p<0,001), le niveau d'études du père (r=0,27, p<0,001) et le niveau d'études de la mère (r=0,30, p<0,001). De même, la version à 3 questions présentait une corrélation positive significative avec les frais de scolarité (r=0,52, p<0,001), le niveau d'études du père (r=0,24, p<0,001) et le niveau d'études de la mère (r=0,30, p<0,001). Une aisance modérée (aOR : 4,25; 95%CI 2,45-7,39) et élevée (aOR : 11,43 ; 95%CI 6,36-20,55) prédit la fréquentation d'écoles plus chères. Une aisance modérée (aOR : 2,15; 95%CI 1,28-3,62) et une aisance élevée (aOR : 5,21 ; 95%CI 2,76-9,84) prédisaient un niveau d'éducation paternel plus élevé. De même, une aisance modérée (aOR : 2,18 ; 95%CI 1,31-3,63) et une aisance élevée (aOR : 7,42 ; 95%CI 3,76-14,66) permettaient de prédire un niveau d'éducation maternel plus élevé. La version à 3 items a donné des résultats similaires en termes de capacité prédictive. CONCLUSION: La version modifiée du FAS II semble avoir une validité et une fiabilité suffisantes pour mesurer le statut socio-économique des adolescents au Nigeria. Mots-clés: Adolescent, Famille, Déterminants sociaux de la santé, Nigeria, Pays en développement, Reproductibilité des résultats.

Drugs of Abuse among In-Patients Receiving Treatment for Substance Use Disorders in a Tertiary Health Care Center in South-South Nigeria: An Exploratory Qualitative Study.

INTRODUCTION: Recently, there has been an increase in the abuse of relatively newer substances sometimes in unusual combinations. Some of these drugs and their street names are unfamiliar to researchers and clinicians, hindering their identification. Our objective was to investigate current trends in drug abuse, focusing on eliciting drugs of use and their street names in Calabar, Nigeria. METHODS: Using a qualitative design, we conducted focus group discussions among 15 male in-patients of the drug treatment ward of the Federal Neuropsychiatric Hospital, Calabar. Data was collected as audio recordings and handwritten notes and was analyzed using the Nvivo software. RESULTS: Prescription drugs like flunitrazepam (street name Blueboy, Sweetnol), trihexyphenidyl, codeine and tramadol were commonly abused. Illicit substances included cannabis of various potencies (each having unique street names), vulcanizing gum (street name Solution), cocaine and heroin (street name Thailand). Some unusual substances such as soakaway fumes, formaldehyde or gammalin (lindane) mixed with cannabis were described. Few supposedly nonpsychoactive substances were reportedly potent when consumed alone (e.g., leaves of the papaya plant) or in mixtures, such as menthol candy dissolved in soft drinks. Other prescription drugs such as Benadol or D4, unfamiliar to the researchers, were volunteered. CONCLUSION: Newer substances of abuse in their various combinations are abused by Nigerian youth. More studies are needed to elucidate further the chemical composition of these drugs/mixtures and their mechanism of action.

INTRODUCTION: Récemment, il y a eu une augmentation de l'abus de substances relativement nouvelles parfois dans des Combinaisons. Certaines de ces drogues et leurs noms de rue sont peu familiers aux chercheurs et aux cliniciens, ce qui entrave leur identification. Notre objectif était d'étudier les tendances actuelles dans l'abus de drogues, en mettant l'accent sur l'obtention de drogues de consommation et leur noms de rues à Calabar, Nigeria. MÉTHODES: À l'aide d'une conception qualitative, nous avons mené des discussions de groupe entre 15 patients masculins hospitalisés du médicament service de traitement de l'Hôpital fédéral neuropsychiatrique, Calabar. Les données ont été recueillies sous forme d'enregistrements audio et d'écriture manuscrite, et a été analysé à l'aide du logiciel Nvivo. RÉSULTATS: Médicaments sur ordonnance comme le flunitrazépam (nom de la rue Blueboy, Sweetnol), trihexyphénidyle, codéine et tramadol ont été couramment maltraités. Les substances illicites comprenaient le cannabis de différentes puissances (chacune ayant des noms de rue uniques), gomme vulcanisante (nom de rue Solution), cocaïne et héroïne (nom de la rue Thaïlande). Certaines substances inhabituelles telles quefumées trempées, formaldéhyde ou gammaline (lindane) mélangés avec du cannabis ont été décrits. Peu de substances prétendument non psychoactives étaient apparemment puissantes lorsque consommés seuls (par exemple, feuilles de la papaye) ou en mélanges, tels que les bonbons au menthol dissous dans les boissons gazeuses. Autres médicaments d'ordonnance tels que Benadol ou D4, inconnus de l'chercheurs, ont été volontaires. CONCLUSION: Nouvelles substances d'abus dans leurs divers combinaisons sont abusées par les jeunes Nigérians. D'autres études sont nécessaires pour élucider davantage la composition chimique de ces médicaments/mélanges et leur mécanisme d'action. Mots-clés: Drogues psychoactives, étude qualitative, abus, hospitalisé.

Diagnosis of malaria parasitemia in children using a rapid diagnostic test.

AIM: This cross-sectional study was conducted to evaluate the diagnostic performance of a new rapid immunochromatographic test named "Paracheck pf" in the diagnosis of malaria in Nigerian children. MATERIALS AND METHODS: A total of 380 Nigerian children aged between 6 and 59 months who presented at the University of Nigeria Teaching Hospital (UNTH) Enugu with fever and no obvious focus of any other infection were consecutively recruited. Malaria parasitemia was determined using simple microscopy and "Paracheck pf". RESULTS: "Paracheck pf" has the following diagnostic performance characteristics: Sensitivity of 82%, specificity of 91.5%, negative predictive value of 91.5%, positive predictive value of 82%, a strong positive correlation between parasite density and test sensitivity, and a detection limit of 397 parasites/µl. CONCLUSIONS: The test is, therefore, recommended for the use in Nigerian children aged between 6 and 59 months in Enugu for the diagnosis of malaria, but negative results should be cautiously interpreted in infants because symptomatic malaria may occur in these children at parasite densities as low as 100/µl.

Effect of petroleum products inhalation on some haematological indices of fuel attendants in Calabar metropolis, Nigeria.

The Haematotoxic implications of exposure to petroleum fumes through inhalation in human subjects were investigated. A total of 400 subjects (200 males and 200 females) aged between 18-30 years participated. Each gender was further categorized into two groups of 100 each for control and test, respectively. The test group was again subdivided into test 1 (T1) and test 2 (T2) in both sexes. T1 subjects were exposed to petroleum fumes for two years and below while T2 subjects were exposed for more than two years. Samples of blood were collected daily and subjected to haematological analysis. The results obtained showed that in males and females, red blood cell counts (10(6) /mm3) was significantly [P < 0.001] decreased in T1 (4.4 +/- 0.13) and T2 (3.85 +/- 0.07) compared to control (4.76 +/- 0.01). White blood cell counts, haematocrit, haemoglobin concentration and mean corpusclular haemoglobin concentration (MCHC) were significantly [P < 0.01] decreased in both sexes of test groups when compared with control. There was also a significant [P < 0.001] decrease in mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) in test 2 males compared with control. Most subjects exposed for longer than two years (T2) had significantly [P < 0.001] lower values of red blood cell count, haemoglobin concentration and haematocrit than those exposed for less than two years. The odds/odds ratio that a subject would become anaemic progressively rose from less than 1 in the control to greater than 1 or infinity on exposure to petroleum fumes. These results indicate that the petroleum fumes cause a reduction in haematological indices which worsens with prolonged exposure.

Severe alopecia areata treated with systemic corticosteroids.

BACKGROUND: Treatment of severe alopecia areata is difficult, and most efforts to successfully treat this condition have been disappointing. Systemic corticosteroids have been demonstrated as an effective treatment of severe alopecia areata. METHODS: Eighteen patients with alopecia areata (extensive patchy and totalis universalis types) were treated with systemic corticosteroids. RESULTS: Satisfactory hair regrowth was achieved in seven patients (38.9%). Hair fall subsequently occurred in all of these patients on discontinuation or tapering of corticosteroid therapy. CONCLUSIONS: Systemic corticosteroid therapy does not prevent the spread or relapse of severe alopecia areata and, when complete regrowth is obtained, it is rarely maintained off therapy.

Epidermolysis bullosa in the eastern province of Saudi Arabia.

BACKGROUND: Epidermolysis bullosa is recognized to be rare, but its prevalence in the Eastern Province of Saudi Arabia had not been previously established. METHODS: We reviewed 49,902 dermatology cases seen in our clinic over a 7-year period (1984 through 1990) and carried out a therapeutic trial of oral phenytoin in three severe cases of epidermolysis bullosa dystrophica (Recessive dystrophic type). RESULTS: Sixteen cases of epidermolysis bullosa were found in this series, ten (62.5%) of which were of the dermolytic type (epidermolysis bullosa dystrophica), and four (25%) of the epidermolytic type (epidermolysis bullosa simplex). Parental consanguinity was established in fourteen (87.5%) of these cases. All ten cases of epidermolysis bullosa dystrophica developed complications. Three severe cases were treated with oral phenytoin and managed with meticulous nursing and nutrition with blended foods and protein and vitamin supplements and responded satisfactorily. CONCLUSIONS: This study confirmed the rarity of epidermolysis bullosa in this province (population 3,000,000), and demonstrated the usefulness of oral phenytoin therapy, meticulous nursing, and good nutrition in the management of epidermolysis bullosa dystrophica.

An open non-comparative pilot study of the safety and efficacy of oral fluconazole in the treatment of dermatophyte infections in Nigeria

In an non-comparative study to assess the efficacy and safety of oral fluconazole in superficial fungal diseases of the skin; 82 adult Nigerian patients (58 males and 24 females) with clinical and mycological diagnosis of dermatomycoses were enrolled for the trial. Sixty-five patients completed the trial and each of them received a daily dose of 50mg fluconazole for a period of 4 weeks. An overall 90 per cent cure rate was observed in patients with other forms of dermatomycoses and 80 per cent for patients with pityriasis versicolor. The drug was well tolerated by all the patients and very few side effects were noticed

Recessive dystrophic epidermolysis bullosa treated with phenytoin.

Three patients with severe recessive dystrophic epidermolysis bullosa were treated with oral phenytoin and palliative and supportive measures for variable periods. Their progress was compared with that of three milder cases managed only with palliative and supportive measures. The phenytoin-treated group showed marked decrease in blister count, increase in trauma tolerance, a rise in hemoglobin level, and considerable weight gain. The results support earlier reports that collagenase inhibitors are useful in controlling blister formation in recessive dystrophic epidermolysis bullosa.

Albinism in Nigeria with delineation of new recessive oculocutaneous type.

Seventy-nine Nigerian oculocutaneous albinos were investigated. Fifty-six had typical tyrosinase-positive albinism (TPA) and 23 had brown albinism (BA), a new oculocutaneous type. The TPA were characterized by localized but no generalized skin pigment, yellow hair, blue to brown irides, nystagmus, and reduced or absent retinal pigment. Localized skin pigment included freckles and lentigines. The iris and skin pigment were the result of the slow accumulation of pigment with age as both were found in older individuals. The most severe skin changes were premalignant keratoses and squamous cell carcinoma of the skin, and the skin malignancies were the major factor in limiting the lifespan for TPA. The BA were characterized by generalized light brown skin pigment, light brown hair, blue to brown irides, nystagmus, and reduced retinal pigment. There was little accumulation or change of pigment in the eyes or skin with age. The generalized light skin pigment was effective in reducing sensitivity to solar radiation and very few BA had premalignant keratoses. Pedigree analysis for BA suggested on autosomal recessive inheritance pattern.

Chromosome breaks and sister chromatid exchanges in albinos in Nigeria.

The prevalence of squamous cell carcinoma of the skin in albinos reaches approximately 90% in patients over 20 years of age in the vicinity of Enugu, Nigeria. Chromosome breaks and sister chromatid exchanges (SCE) were evaluated in tyrosinase-positive oculocutaneous albinos and pigmented controls of Ibo extraction who were life-long residents of Nigeria. No difference in the frequency of chromosomal breaks in 14 albinos compared to 6 pigmented controls, and no differences in the frequency of SCE in 9 albinos compared to 3 controls could be detected. Increased chromosomal abnormalities in lymphocytes do not appear to be assoicated with albinism or fulminating skin cancer present in albinos in the tropics.

African histoplasmosis in Eastern Nigeria: report of two culturally proven cases treated with septrin and amphotericin B.

Two cases of African histoplasmosis culturally proven to be caused by Histoplasma duboisii are reported from Eastern Nigeria. One case had cutaneous papules and subcutaneous nodules all over his body while the other patient had cutaneous papules, an abscess over the right scapula, enlarged cervical, axillary and inguinal lymph nodes, and possible lung involvement. None of the 35 soil samples collected from the environment of the two patients were found positive for H. duboisii. In the first case, most of the lesions cleared with Septrin given orally. The 2nd case responded very well to treatment with intravenous Amphotericin B except for persistance of swellings in the inguinal lymph nodes. The effect of intralesional injection of Amphotericin B on this residual lymph node infection is now being assessed.

Chromomycosis caused by Philaphora pedrosoi in eastern Nigeria.

Three cases of chromomycosis from Eastern Nigeria are described. The aetiological agent was identified as Phialophora pedrosoi. Amphotericin B cleared most of the lesions in one case while 5-fluorocytosine gave a complete cure in another case.