Joseph D. Adeyemi

Psychiatric disorders in Nigerian nursing home residents

Background. The prevalence of psychiatric disorders in nursing homes, which has not been studied before in Nigeria, is the subject of this cross‐sectional study.

A Case Control Study of Psychiatric Morbidities among Subjects with Leprosy in Lagos, Nigeria:

Objectives: To determine the pattern of psychiatric morbidity prevalent among leprosy patients and to compare it with two control groups; those suffering from Tinea vesicolor and Normal subjects. Design: Eighty-eight leprosy patients were matched for age and sex with those suffering from Tinea vesicolor as well as normal subjects. The subjects were assessed for psychiatric morbidity through a clinical interview with PSE-9. Results: The prevalence of psychiatric morbidity among leprosy patients (580/1000) was significantly more than those with tinea vesicolor patients (182/1000) and normal subjects (148/1000) (p < 0.05). Depressive illness was the most common diagnosis in the three groups. Conclusions: Leprosy patients are more likely to manifest with psychiatric illness than those suffering from Tinea vesicolor and normal subjects.

Attitude to Aging among Different Groups in Nigeria

Attitude to aging and the aged was surveyed in three groups of Nigerians, 1) caregivers living at home with the elderly, 2) various categories of hospital workers, and 3) the general public. Based on scores of an eleven-item questionnaire the best attitude was in caregivers, and the poorest in hospital workers. Years of education had an overall negative effect on attitudinal measurement. An inference from this study is that the elderly are still valued, but caregivers could be under some stress and would appreciate assistance. It is important for developing countries like Nigeria to begin to think seriously of what types of public assistance the elderly and their families would need.

Clinical profile and containment of the Ebola virus disease outbreak in two large West African cities, Nigeria, July-September 2014.

INTRODUCTION The Ebola virus disease (EVD) outbreak in Nigeria began when an infected diplomat from Liberia arrived in Lagos, the most populous city in Africa, with subsequent transmission to another large city. METHODS First-, second-, and third-generation contacts were traced, monitored, and classified. Symptomatic contacts were managed at Ebola treatment centers as suspected, probable, and confirmed EVD cases using standard operating procedures adapted from the World Health Organization EVD guidelines. Reverse transcription PCR tests confirmed EVD. Socio-demographic, clinical, hospitalization, and outcome data of the July-September 2014 Nigeria EVD cohort were analyzed. RESULTS The median age of the 20 EVD cases was 33 years (interquartile range 26-62 years). More females (55%), health workers (65%), and persons <40 years old (60%) were infected than males, non-health workers, and persons aged ≥40 years. No EVD case management worker contracted the disease. Presenting symptoms were fever (85%), fatigue (70%), and diarrhea (65%). Clinical syndromes were gastroenteritis (45%), hemorrhage (30%), and encephalopathy (15%). The case-fatality rate was 40% and there was one mental health complication. The average duration from symptom onset to presentation was 3±2 days among survivors and 5±2 days for non-survivors. The mean duration from symptom onset to discharge was 15±5 days for survivors and 11±2 days for non-survivors. Mortality was higher in the older age group, males, and those presenting late. CONCLUSION The EVD outbreak in Nigeria was characterized by the severe febrile gastroenteritis syndrome typical of the West African outbreak, better outcomes, rapid containment, and no infection among EVD care-providers. Early case detection, an effective incident management system, and prompt case management with on-site mobilization and training of local professionals were key to the outcome.

Interplay of Anxiety and Depression With Quality of Life in Endstage Renal Disease

BACKGROUND Endstage renal disease (ESRD) is increasingly being recognized as a major public health issue globally. Planning of intervention measures is preferably hinged on what is known about outcome parameters. OBJECTIVES This study investigated the influence of anxiety with depression and psychosocial- and treatment-related correlates on quality of life (QOL) in ESRD. METHODOLOGY Overall, 100 eligible individuals with ESRD were recruited by systematic random sampling technique. They were initially interviewed using the sociodemographic/clinical profile questionnaire, followed by assessment with the Hospital Anxiety and Depression Scale. Subsequently, subjective QOL of participants was assessed using the World Health Organization QOL-BREF. RESULTS The mean age of participants was 41.9 ± 10.9 years, and males (55.0%) were preponderant. A total of 29 (29.0%) participants had diagnosable anxiety with depression psychopathology based on Hospital Anxiety and Depression Scale scores ≥ 8. Different degrees of impairment across domains of QOL were observed. Factors like being employed, married status, younger age, and spending less on treatment correlated positively with good QOL across specific domains, whereas comorbid anxiety with depression, history of dialysis, monthly income less than ₦50,000 (

Psychiatric Treatment of a Health Care Worker After Infection With Ebola Virus in Lagos, Nigeria

300), and having up to 50 dialysis sessions correlated negatively with good outcome in specific domains of QOL (p < 0.05). However, only age, anxiety/depression, employment, and history of dialysis were independently related to QOL following logistic regression analyses. CONCLUSION The care of ESRD should be matched with need-based mental health services, and psychosocial support across important illness trajectories is indicated for best outcome. Further research among people with ESRD is also warranted.

Late-life depression: Burden, severity and relationship with social support dimensions in a West African community

Abdulaziz Mohammed, M.B.B.S., M.P.H.-F.E, Taiwo Lateef Sheikh, M.B.B.S., M.S.C., Saheed Gidado, M.B.B.S., M.P.H.-F.E., Ismail Adeshina Abdus-salam, M.B.B.S., M.P.H., Joseph Adeyemi, M.B.B.S., M.Sc., Adebola Olayinka, M.B.B.S., Chima Ohuabunwo, M.B.B.S., Orina Oluwagbemiga Victor, M.S.W., Patrick Nguku, M.B.B.S., M.P.H., Erinfolami Adebayo Rasheed, M.B.B.S., Funmi Doherty, M.S.W., M.P.H., Ndadilnasiya Waziri, D.V.M., M.P.H.-FE, Faisal Shuaib, M.D., Dr.P.H., Babalola Obafemi Joseph, M.B.B.S., Idris Mohammed Bomai, D.V.M., Akin Oyemakinde, M.B.B.S., M.P.H.

Factors associated with anxiety disorders among HIV-positive attendees of an HIV clinic in Lagos, Nigeria

OBJECTIVES The occurrence of depression in old age is often linked with grave consequences. The purpose of this study is to investigate the burden of depression and its relationship with perceived social support among the elderly in a West African community setting. METHODS In this cross-sectional study, participants made up of 350 elders aged 60 years and above were selected through multi-stage random sampling technique. All participants were interviewed with designed questionnaire, multidimensional scale of perceived social support (MSPSS) and Geriatric Depression Scale (GDS) to elicit socio-demographic profile, social support and depressive psychopathology respectively. RESULTS The participants were largely females (52.9%) and their mean age was 68.8±7.3 years. A little above one-quarter (26.4%) had depressive episode, and mild severity was preponderant. Low level of social support was associated with depression (χ(2)=8.418, p=0.004); especially low social supports from significant others (χ(2)=3.989, p=0.046) and family members (χ(2)=4.434, p=0.035). Similarly, severity of depression in the elderly correlated negatively with availability of social support from significant others (χ(2)=5.495, p=0.019) and family members (χ(2)=5.149, p=0.023). CONCLUSION Considering the burden of depression in this elderly population and the influential roles of social support especially from family and significant others on depression; strengthening of informal social support and formal social support for the elders is advocated. In addition, design of community based geriatric mental health with social services and articulation of public policy to address old age needs are implied.

Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria

Anxiety disorders (ADs) occurring in people living with HIV/AIDS (PLWHA) are often poorly identified in spite of the untold consequences that may result if not diagnosed and treated promptly. This study aimed to describe factors associated with ADs among PLWHA. Three hundred participants were administered sociodemographic/clinical profile questionnaires, and diagnoses of ADs were made using Schedule for Clinical Assessment in Neuropsychiatry (SCAN) based on International Classification of Diseases, 10th edition (ICD-10) criteria. In this study, 65 (21.7%) participants were diagnosed with ADs. A lack of family support, unemployment, younger mean age and being unmarried (P < 0.05) were factors associated with ADs in PLWHA; however, lack of family support (odds ratio [OR] = 0.458, 95% confidence interval [CI] = 0.254–0.827, P = 0.010), being unmarried (OR = 1.930, 95% CI = 1.046–3.560, P = 0.035) and unemployment (OR = 0.495, 95% CI = 0.264–0.926, P = 0.028) were the only factors that remained significant following logistic regression analysis. Prompt identification with active management of ADs and their associated factors among PLWHA are advocated. Further research on the risk factors for ADs is also warranted.

Anxiety disorders in breast cancer: Prevalence, types, and determinants

Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5) were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35). Twenty-nine (34.5%) met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD), language and speech disorder, intellectual disability (8.3%) and learning disorders (9.5%). Main health concerns to caregivers were poor language development in all (100%), of which 11 (40.7%) were non-verbal; gaze avoidance was seen in 14 (48.3%) and challenging behavior in 12 (42.9%). Comorbidities included seizure disorders (3.4%) and ADHD (6.9%). Persons with autism had history of ASD behavior more often when compared to the other neurodevelopmental disorders and these findings were statistically significant. Referrals were given to caregivers to engage in services within the community. As seen in this study, community understanding of ASD is poor in such locations, in which many persons with other neurodevelopmental disorders are often presented as having autism. Caregivers in the study location are distressed by many symptoms associated with autism and their comorbid conditions. Currently there is an evident role for frequent large scale community based screening and autism awareness exercises possibly using inter-sectoral collaboration as a strategy.