Abdulkareem Jika Yusuf

Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria.

BACKGROUND Dementia has important public health implications. The magnitude of the problem remains largely unknown in the developing countries. METHODS Three hundred and twenty-two community dwelling elderly persons and their caregivers in Zaria, Northern-Nigeria were enrolled in this study. They were interviewed using Community Screening Interview for Dementia (CSI-D), Consortium to Establish Registry for Alzheimers disease (CERAD), Stick Design Test (SDT), Blessed Dementia Scale and a sociodemographic questionnaire. The data obtained were analyzed using the Statistical Package for Social Sciences version 15 for Windows. Diagnosis was based on fulfilling criteria for dementia in both the International Classification of Disease, 10th edition and the Diagnostic and Statistical Manual, 4th edition. RESULTS The mean age of the subjects was 75.5 ± 9.4 years. The prevalence of dementia was 2.79% (CI 1-4.58%). Alzheimers disease constituted 66.67% of all the cases of dementia in this community. Age was the only demographic factor associated with dementia. CONCLUSION The prevalence rates of dementia and dementia subtypes in the developing countries are similar using standard diagnostic criteria and methods.

Caregiver burden among poor caregivers of patients with cancer in an urban African setting

Objectives: The nature and magnitude of the problems facing caregivers remain largely unknown in developing countries of the world. This study addresses these issues in a group of caregivers of patients with cancer in Zaria, Nigeria.

Prevalence of HIV-Associated Neurocognitive Disorder (HAND) among Patients Attending a Tertiary Health Facility in Northern Nigeria:

Background: HIV-associated neurocognitive disorder (HAND) is a great source of morbidity in sub-Saharan African region. However, the magnitude of this problem remains largely uninvestigated despite having the largest number of population with HIV/AIDS. The aim of this study is to determine the prevalence of HAND among patients attending a tertiary health facility in Nigeria. Method: We conducted a cross-sectional study among HIV-positive patients on antiretroviral therapy (ART) for at least 1 year. They were assessed using the International HIV Dementia Scale, Word Recall Test, Stick Design Test, Subjective Cognitive Complaint Questionnaire, Alcohol Use Disorder Identification Test, Drug Abuse Screening Test, Center for Epidemiological Study–Depression Scale, Instrumental Activity of Daily Living, and neurological examination. The CD4 count and viral load were determined for all the participants. A consensus diagnosis was made on each case based on the Frascati criteria. Data obtained were analyzed using “SPSS” for Windows version 15. Results: A total of 418 HIV-positive patients participated in the study, of which 325 (77.8%) are females. The mean age (standard deviation) of the participants was 37.2 (9.3) years. The prevalence of HAND was 21.5% (95% confidence interval [CI] = 17.6%-25.4%), of which 9.6% were asymptomatic. The significant predictors of HAND in this study are duration of illness (odds ratio [OR] = 1.33 P < .001), detectable viral load (OR = 0.19, P < .001), CD4 count (OR = 0.99, P < .001), education (OR = 0.94, P = .011), stopping medication (OR = 3.55 P = .01), and severity of illness (OR = 1.24, P = .005). Conclusion: One-fifth of the HIV-positive patients in this study had HAND. Various sociodemographic and clinical features were related to the prevalence of HAND.

Suicide risk among adults with epilepsy in Kaduna, Nigeria

OBJECTIVE There is paucity of information on epilepsy and suicide in Nigeria. The objective of this study therefore was to assess the prevalence and determinants of suicide risk among adults with epilepsy (AWE) in Kaduna, Nigeria. METHOD We administered the suicidality module of the Mini International Neuropsychiatric Interview, the three-item Oslo Social Support Scale and the Hospital Anxiety and Depression Scale to 170 consecutive AWE attending the outpatient clinic of Federal Neuropsychiatric Hospital, Kaduna, between January and June 2011 to determine the prevalence of suicide risk, the level of social support and the psychological symptoms, respectively. We also recorded the sociodemographic and clinical characteristics of the subjects. RESULTS There are 99 males and 71 females. The subjects mean age was 28.7±12.1 years. The prevalence of suicide risk was 20.0%. Short seizure-free periods (χ2=4.658, P=.031), previous suicide attempts (χ2=12.216, P<.001), anxiety symptoms (χ2=5.075, P=.024) and depressive symptoms (χ2=5.093, P=.016) were significantly associated with suicidal tendencies. However, after a logistic regression analysis, none of the above variables predicted suicide risk. CONCLUSION Suicide risk is common among AWE. Poor seizure control, previous suicidal attempts and emotional distress are associated factors.

Depression in elderly people living in rural Nigeria and its association with perceived health, poverty, and social network.

BACKGROUND The relationship between late-life depression, poverty, social network, and perceived health is little studied in Africa; the magnitude of the problem remains largely unknown and there is an urgent need to research into this area. METHODS We interviewed community dwelling elderly persons of two rural areas in Nigeria using Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-30). Those who scored 11 and above on the GDS-30 were further interviewed using Geriatric Mental State Schedule (GMSS). Diagnosis of depression was based on the International Classification of Diseases 10th edition (ICD-10) and GMSS-Automated Geriatric Examination for Computer Assisted Taxonomy (GMMS-AGECAT). RESULTS A total of 458 community dwelling elderly persons participated in the study of which 57% were females. Mean age of the participants was 73.65(±7.8) years (95% CI 72.93-74.37). The mean GDS-30 and MMSE scores were 4.15(±4.80) and 21.73(±4.67), respectively. A total of 59 and 58 participants had depression based on ICD-10 criteria and GMSS-AGECAT, respectively. Agreement between ICD-10 and AGECAT diagnoses was κ = 0.931. By multiple logistic regression analysis, late-life depression was significantly associated with financial difficulties (Odds ratio 4.52 and bereavement Odds ratio 2.70). CONCLUSION Late-life depression in this cohort is associated with health and socio-economic factors that are worth paying attention to, in a region of economic deprivation and inadequate healthcare.

Poor academic performance among adolescents with epilepsy in Kaduna, Northern Nigeria: A case-control study

Adolescents with epilepsy experience significant academic difficulties. However, little is known about the effects of epilepsy on the academic performance of adolescents with the disorder in Northern Nigeria. Objective. To assess the academic performance of adolescents with epilepsy and factors associated with poor performance in this population in a Northern Nigerian setting. Methods. The socio-demographic/clinical characteristics of 77 consecutive adolescents (aged 12 - 17 years) with epilepsy attending the Child and Adolescent Clinic of Federal Neuropsychiatric Hospital, Kaduna, North-West, between March 2008 and September 2010 and the socio-demographic characteristics of 76 controls (matched for age and sex) were recorded. Information concerning school attendance and academic performance of the subjects and the controls were obtained from the adolescents and their parents or caregivers. Results. The mean ages of the subjects and the controls were 15.1 (standard deviation (SD) 2.1) and 14.7 (SD 1.7) years, respectively (p>0.05), the mean duration of illness was 6.1 (SD 4.6) years, the mean seizure-free period was 16.8 (SD15.6) weeks, and 64.9% of the subjects and 57.9% of the controls were males. Forty-six subjects (59.7%) and 12 controls (15.8%) had poor academic performance (p<0.001). Long duration of illness, short seizure-free periods and irregular school attendance were significantly associated with poor academic performance (p<0.05). Conclusions. Poor academic performance is common among adolescents with epilepsy and is associated with early onset, poor seizure control and missing school. Efforts should be made to control seizures and educate society about the illness.

Low education and lack of spousal relationship are associated with dementia in older adults with diabetes mellitus in Nigeria: Dementia in diabetes mellitus

The relationship between dementia and type 2 diabetes mellitus (T2DM) in older adults is well established in the literature. However, there have been few studies on this relationship in older adults living in low‐ and middle‐income countries, and most demographic projections predict that older adult population will increase substantially in these regions by 2050.

Emotional distress among people with epilepsy in Kaduna, Northern Nigeria

Background: Epilepsy is associated with significant psychiatric morbidities. However, little is known about epilepsy and emotional distress in northern Nigeria. Aim: To assess the prevalence and determinants of emotional distress among people with epilepsy (PWE) in Kaduna, northern Nigeria. Settings and Design: This cross-sectional study was conducted between January, 2011 and June, 2011. Materials and Methods: We administered the Hospital Anxiety and Depression Scale as well as the Oslo 3-Items Social Support Scale to 209 consecutive PWE of at least 1 year duration attending the outpatient clinic of Federal Neuropsychiatric Hospital, Kaduna in order to measure their levels of anxiety and depression, and social support. The socio-demographic and clinical characteristics of the subjects were also recorded. Results: The 209 subjects consisted of 123 (58.7%) males and 86 (41.3%) females with mean age of 28.7 (SD, 12.1) years. Majority have strong social support (56.3%) and less than 6 months seizure-free periods (82.3%). The prevalence of anxiety and depressive symptoms were 20.2% and 15.4% respectively. Older age, being a female, poor social support and short seizure-free periods were significantly associated with emotional distress (P value < 0.05) while female sex (OR = 2.201, P value = 0.024, 95% CI = 1.108 - 4.373) and poor support (OR = 0.361, P value = 0.024, 95% CI = 0.149 - 0.875) predicted anxiety and depressive symptoms respectively. Conclusion: Emotional distress is quite common among PWE and should be taken into consideration in the management of patients with this disorder.