Extent of community pharmacists' care of clients with depression in Enugu, Nigeria: a cross-sectional survey.

BACKGROUND: Community pharmacists play a crucial role in the care of people with depression. This study aimed to evaluate the level of care provided by community pharmacists for clients with depression in Enugu, Nigeria. METHODS: A cross-sectional survey was conducted among randomly selected community pharmacists in Enugu, Nigeria. The data obtained were analysed descriptively. KEY FINDINGS: Approximately 25% of pharmacists perform depression screening, and 14.4% refer clients to psychiatrists. Pharmacists rarely provide information on antidepressant dosage, side effects, frequency, and duration. CONCLUSION: Community pharmacists in Enugu are not providing effective care to depressed patients. Thus, appropriate interventions are recommended.

A cross-sectional study on the knowledge, attitude, and practice of pregnant women regarding medication use and restriction during pregnancy.

Background: The use of medication during pregnancy is a complex issue that requires careful consideration to avoid potential harm to the developing fetus. Despite the existence of guidelines and restrictions on medication use during pregnancy, pregnant women in Nigeria often have limited access to information regarding drug use and may rely on their own judgment or the advice of non-professionals when making decisions about medication use. Objectives: To assess Nigerian pregnant women's knowledge, attitude, and practice toward the use of drugs and restriction/contraindications in pregnancy. Methods: A descriptive cross-sectional study was conducted among pregnant women who visited the Federal Medical Center, Umuahia, from January to February 2023. A self-administered questionnaire was answered by conveniently sampled participants. Data were collected about their sociodemographic characteristics, knowledge, attitude, and practice. Descriptive statistics and inferential statistics utilizing the Pearson's chi-Square test were used for data analysis. The level of significance was set at p < 0.05. Results: One hundred and fifty-two pregnant women completed the questionnaire (60.8% response rate) and were mostly married (n = 148; 95.0%). Majority were between the age of 25 to 35 years (n = 107; 70.4%), had a university/bachelor's degree (n = 94; 61.8%), and were business women (n = 85; 56.0%). About 35.5% of the respondents had good knowledge of medication restrictions in pregnancy. The majority of the respondents had a positive attitude (n = 98; 64.5%) and good practice (n = 139; 91.4%). Conclusion: The findings established that a substantial proportion of the women had a positive attitude and good practice of medication use and restrictions in pregnancy. However, the level of knowledge was surprisingly poor among the study group. There is a need to educate pregnant women on safe medication use and avoidance during pregnancy.

Predictors of fertility awareness among selected married women of childbearing age in Nigeria: a cross-sectional survey.

Background: Increased fertility awareness can help infertile couples to achieve pregnancy. Objectives: This study aimed to determine both the predictors and levels of fertility awareness among married Nigerian women of childbearing age. Methods: A nationwide cross-sectional survey. Data were collected via online and face to face questionnaires. Descriptive and inferential analysis were done with SPSS 25. Results: Most respondents married between ages 24-29 years old (40%) and just over half had good fertility awareness (53%). The associated factors were age at menarche (X2 = 9.962, p = 0.007), geopolitical zone of residence (X2 = 17.301, p = 0.008), level of education (X2 = 64.843, p < 0.001), employment status (X2 = 9.319 p = 0.025) menstrual cycle charting (X2 = 66.392, p < 0.001), use of internet to increase awareness (X2 = 39.849, p < 0.001) and books (X2 = 58.855, p < 0.001). Fertility awareness was lower for those with secondary education than postgraduates (AOR=0.213, 95% CI 0.116-0.390, p < 0.001). Moreover, the odds of having good fertility awareness were less in those who did not chart their menstrual cycle (AOR=0.363, 95% CI 0.245-0.538, p < 0.001). Conclusion: Menstrual cycle charting and level of education were predictors of fertility awareness.

Risk and protective factors associated with depression in young people: what do Nigerian university students know?

Background: University students appear to experience a significantly higher rate of depression compared to the general population. However, there is limited data showing how much Nigerian university students know about the risk and protective factors related to depression. Objectives: To assess the knowledge of risk and protective factors associated with depression in young people among students of a Nigerian university. Methods: A cross-sectional descriptive survey was conducted among simple randomly selected students of the University of Nigeria, Nsukka. Two validated self-administered questionnaires were used for data collection. Descriptive statistics and multivariate binary logistic regression were used for the data analysis. Results: Out of 1591 participants, about 47% and 60% had good knowledge of risk and protective factors related to depression, respectively. The course of study, year of study, contact with a depressed person, and personal experience of depression significantly predicted students' knowledge of risk factors for depression. Similarly, course of study, year of study, and gender were the significant predictors of students' knowledge of protective factors against depression. Conclusions: The students had good knowledge of protective factors against depression, but were poor in knowledge of its associated risks. Therefore, provision of mental health services in the universities is recommended.

Prevalence of depression and anxiety, and attitudes toward seeking help among first-year pharmacy, medical, and nursing students at a Nigerian university.

INTRODUCTION: The first year of university study tends to be particularly challenging and exhausting, especially for students in health sciences. This study aimed to explore the prevalence of anxiety and depression among first-year pharmacy, medicine, and nursing students at a Nigerian university as well as their attitudes toward seeking professional support. METHODS: This study was a cross-sectional descriptive survey among all first-year pharmacy, medicine, and nursing students. Paper-based self-administered questionnaires were used, and they included the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Attitudes Toward Seeking Professional Psychological Help Scale. Descriptive statistics, Chi-square test, and Pearson correlation were used for data analysis. RESULTS: The study included 522 students (89% response rate). The prevalence of depression among participants was 71.8%, while the prevalence of anxiety was 61.7%. Only 24.9% of the participants expressed willingness to seek professional psychological help. Attitudes toward getting professional care was inversely related to the prevalence of depression (r = -0.155, P = .01) and anxiety (r = -0.098, P = .05). Age, smoking, alcohol intake, and dietary habits were associated with the occurrence of depression and anxiety. No demographic variables were related to the participants' attitudes toward seeking professional care. CONCLUSIONS: Depression and anxiety symptoms were very common among health science freshmen. However, the vast majority of students were unwilling to seek help. Students' attitudes toward seeking treatment are influenced by the prevalence of depression and anxiety. Therefore, educational interventions on mental health promotion are recommended.

Assessment of Health-Related Quality of Life Among Patients Infected With HIV Receiving Care in a Nigerian Tertiary Hospital.

OBJECTIVES: Globally, an appropriate estimate of the health-related quality of life (HRQoL) of people living with HIV/AIDS (PLWHA) is essential for the economic evaluation of antiretroviral therapy (ART) programs to ensure optimal value for money. Therefore, this article aimed to evaluate the HRQoL of PLWHA on ART and to explore its predictors. METHODS: A cross-sectional study was conducted among PLWHA in an ART clinic of a Nigerian tertiary hospital. The participants were selected through a computer-based simple random sampling technique. The study instrument used for data collection was the English-language version of the European Quality of Life (EQ-5D-5L). The participants completed the questionnaire in the waiting room of the clinic, and the patients' clinical data were retrieved from their medical records. Descriptive statistics and multivariate linear regression were used for data analysis. P<.05 was considered statistically significant. RESULTS: Out of the 352 participants, the majority were female (66.5%), and more than half (56.2%) had a CD4 count fewer than 500 cells/mm3. The EQ-5D index and utility score of the study population were 0.72 ± 4.18 and 73.05 ± 10.36, respectively. The significant predictors of EQ-5D index were the number of children (ß = -0.215, P=.026), CD4 count (ß = 0.171, P=.030), and duration on ART (ß = -0.144, P=.011). CONCLUSIONS: Our findings suggest that PLWHA receiving ART in Nigeria had good HRQoL. However, concerted efforts targeted at improving CD4 cell count and reducing the family burden of PLWHA would enhance their HRQoL.

Secondary school students' knowledge, attitude, and practices towards epilepsy in Nsukka City, Enugu State.

BACKGROUND: Epilepsy is the most common noninfectious neurologic disease in Nigeria and other developing African countries. Epilepsy remains a stigmatized disease. The stigma stems from the traditional African belief, which views epilepsy as a spiritual disease. A lack of information and illiteracy has been blamed as the cause of the stigmatization. AIMS: The aim of the present study was to assess the awareness, knowledge, and attitude towards epilepsy among secondary school students in Nsukka. METHODS: This was a cross-sectional survey using a validated, self-administered questionnaire comprising four sections: demographic characteristics, awareness, knowledge, and attitude towards people living with epilepsy (PLWE). Data were analyzed using the IBM SPSS Statistics 23. Descriptive analysis (frequencies, percentage, mean, and standard deviations) were used to summarize the data. The relationship between sociodemographic characteristics and knowledge score and attitude score was performed using chi-square analysis. Statistical significance was set as a p-value <0.05. RESULTS: The majority of the students (87.4%) had heard of epilepsy as a disease. The most common source of information was the electronic media (21.5%). More than half (61.6%) had witnessed a convulsion in the past, and 36.9% knew someone with epilepsy. The majority of the students (66.7%) believed that epilepsy is caused by witchcraft. Jerking (77.3%) and loss of consciousness (82.4%) were identified as the commonest manifestation of epilepsy. Regarding treatment management of epilepsy, 81.3% of the students believe the use of orthodox medicine, while 85.4% would insert a spoon in the mouth when a seizure occurs as part of first-aid treatment. Nearly half of the students had good knowledge (48.1%) of epilepsy and a positive attitude (46.5%) towards the disease. The students' knowledge was associated with their school (X2 = 23.21, p = 0.001). However, students' attitude towards epilepsy was associated with their schools (X2 = 5.93, p = 0.015) and their guardians' level of education (X2 = 14.65, p = 0.012). CONCLUSION: The findings of this study suggest poor knowledge and attitude towards epilepsy among secondary school students in Nsukka, Enugu State, Nigeria.

Development and validation of a questionnaire for evaluating knowledge of risk factors for teen depression among health care trainees of a Nigerian university.

INTRODUCTION: Increasing knowledge of factors predisposing individuals to depression appears to be an important preventive strategy. However, there is no validated instrument for evaluating knowledge of risk factors for depression among adolescents. Therefore, we aimed to develop and validate a questionnaire to assess knowledge of risk factors for teen depression. METHODS: Extensive literature search and expert consultations were carefully conducted. The content, face, and convergent validity of the prefinal Knowledge of Risk Factors for Teen Depression Questionnaire (KRFD-Q) were performed. The Cronbach's alpha and test-retest reliability of KRFD-Q were conducted. Exploratory factor analysis (EFA) was used to delineate the final items into distinct clusters. Participants' demographic characteristics were presented using descriptive statistics. All analyses were performed using SPSS version 20. RESULTS: A total of 17 items were generated after an extensive literature search and expert consultations. Two items were considered as repetitions and thus deleted. The overall Cronbach's alpha of KRFD-Q was 0.72. Test-retest reliability (r = 0.83, P < .0001) and convergent validity (r = 0.61, P = .034) were satisfactory. The corrected item-total correlation of KRFD-Q ranged from 0.13 to 0.45. The EFA identified three factors, (1) family abuse, stress, and self-criticism (7 items), (2) social/relationship factors (5 items), and (3) genetic and economic factors (3 items). DISCUSSION: The findings of this study demonstrate that 15-item KRFD-Q developed is satisfactorily valid and reliable to measure the knowledge of risk factors for teen depression among university undergraduate students.

Attitudes of pharmacy and non-pharmacy students towards mental illness in Nigeria: a comparative survey.

OBJECTIVES: Globally, persons with mental illness are victims of stigma, even among healthcare professionals and trainees. However, in Nigeria, little is known about the attitudes of pharmacy students towards people with mental illness. Therefore, the objectives of this paper were to assess and compare the attitudes of pharmacy and non-pharmacy students towards mental illness and explore its associated demographic factors. METHODS: A cross-sectional survey was conducted among pharmacy and selected non-pharmacy students of a Nigerian university. The Attitude Scale for Mental Illness was used for data collection. The survey instrument was distributed to and completed by selected students in batches after normal class lectures. Descriptive statistics, chi-square test and Student's t-test were used for data analysis. P < 0.05 was considered statistically significant. KEY FINDINGS: The key findings showed that pharmacy and non-pharmacy students generally demonstrated positive attitudes towards mental illness. Pharmacy students had more positive, less stigmatizing attitudes compared with students of non-pharmacy courses. Students' attitudes towards mental illness were significantly influenced by gender, age, a previous visit to a mental hospital and knowing a family member or friend with a mental illness. CONCLUSIONS: Our findings suggest that students' attitudes towards mental illness were positive but sub-optimal. Student pharmacists demonstrated more positive attitudes towards mental illness compared with non-pharmacy students. However, the major contributors to positive attitudes were male gender, older age, a previous visit to a mental hospital and having a close associate with a mental illness. Therefore, educational interventions addressing students' misconceptions of mental illness are recommended.

The participation of community pharmacists in the case management of malaria in Enugu metropolis, Nigeria: a cross-sectional survey.

Background: Nigeria accounts for approximately 25% of the global malaria burden. Malaria is a major cause of morbidity and mortality, especially in children and pregnant women. Pharmacists play vital roles in the fight against malaria. However, in Nigeria, the role of the community pharmacist in managing cases of malaria has received very little research attention. This study aimed to evaluate the level of participation of community pharmacists in the management of malaria cases in Enugu metropolis and to explore factors associated with such participation. Methods: A cross-sectional survey was conducted among community pharmacists in Enugu metropolis using a modified and re-validated 16-item self-administered questionnaire. The questionnaire was distributed to participants in selected pharmacies for completion. Descriptive statistics and the chi-square test were used for statistical analysis. Results: Out of the 103 participants, more than half (55.3%) were male. More than half of the pharmacists satisfactorily provided preventive (57.3%), pharmaceutical (62.1%), and curative (51.1%) services for patients with malaria. Overall, 57% of the pharmacists satisfactorily participated in the management of malaria cases. The number of years of practice was significantly associated with the pharmacists level of involvement in preventive (P=0.003) and curative (P=0.018) services. However, the provision of pharmaceutical care services for malaria patients was significantly associated with the sex of the respondents (P=0.023). Conclusions: Our results suggest that more than half of the community pharmacists in Enugu metropolis were satisfactorily involved in the management of malaria cases. However, the number of years of practice and sex were factors associated with the extent of pharmacist involvement in the management of malaria cases.

Willingness to pay for pharmacist-provided home telemonitoring among patients with chronic diseases in Enugu metropolis.

Home telemonitoring is a promising approach in the management of patients with chronic diseases. However, no study has assessed its acceptability and possible service charge in Nigeria. Therefore, this study aimed to evaluate willingness to pay for pharmacist-provided telemonitoring among patients with chronic diseases and to explore its determinants. Hence, using the contingent valuation method, a cross-sectional study was conducted among eligible patients visiting 15 selected community pharmacies in Enugu metropolis, over a period of 3 months. Of the 335 patients who participated in the study, about 40 percent (i.e. 39.4%) were willing to pay an average monthly fee of ₦915.91 ± 485.49 (US$2.99 ± 1.59) for home telemonitoring services. Significant predictors of willingness to pay for home telemonitoring were perceived insufficient income (odds ratio = 0.20, 95% confidence interval = 0.07-0.60, p = 0.040) and health insurance status (odds ratio = 0.39, 95% confidence interval = 0.18-0.86, p = 0.019). Our findings suggest a promising potential for adopting home telemonitoring services among patients with chronic diseases in Enugu metropolis.

Assessment of the steps taken towards avoidance of medication errors among hypertensive outpatients attending a tertiary health care facility in Nigeria: a cross-sectional study.

INTRODUCTION: Active involvement of patients in the management of their health has been suggested as a major means of curtailing medication errors. This study aimed to assess the steps taken by hypertensive patients in avoiding medication errors before, during and after clinic visits. METHODS: A cross-sectional study was conducted in Enugu State University Teaching Hospital (ESUTH), Parklane, Enugu, Nigeria (June to August, 2016) using a standardized 35-item interviewer-administered questionnaire. The IBM SPSS Version 20.0 was utilized for statistical analysis with P < 0.05, considered statistically significant. RESULTS: A total of 200 questionnaires were completed and returned. Few (24.4%) of the respondents were taking non-prescribed medicines and most (61.5%) knew their names. Only 41.9% of the patients monitor their blood pressure very often. There was a statistical difference between the mean scores of steps to avoid medication errors after the clinic visit for the different occupations (F = 8.109; P < 0.001) and educational level (F = 6.182; P < 0.001). CONCLUSION: Patients that took necessary steps in avoiding medication errors before their clinic visits were likely to avoid errors at the clinic. Also, patients that avoided medication errors at the clinic were likely to avoid medication errors after the doctor's visit.

Willingness-to-Accept and Willingness-to-Pay Ratios of Prevention of Mother-to-Child Transmission Services in a Nigerian Hospital: A Cross-Sectional Contingent Valuation Study.

BACKGROUND: In Nigeria, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome treatment and care services, prevention of mother-to-child transmission (PMTCT) inclusive , are accessed free of charge by patients due to finanacial support from donor agencies. This trend may not be sustainable in the future due to the present global economic realities. Hence, there is the need to ascertain the readiness of PMTCT patients to pay for such services. OBJECTIVES: This contingent valuation study determined the willingness-to-accept (WTA), willingness-to-pay (WTP), and WTA-to-WTP ratios of PMTCT services among clients in a Nigerian tertiary hospital. METHODS: This was a cross-sectional questionnaire-based study. All adult PMTCT patients who had never paid for any component of the services participated in the study. The questionnaire measured their WTP and WTA for the following components of PMTCT: primary prevention of HIV, prevention of unintended pregnancy in HIV-positive women, follow-up treatment and support, and therapeutic interventions around delivery. The WTP and WTA for PMTCT drugs and specialized clinical pharmacy services were also measured. The WTA-to-WTP ratios, income effects, and income elasticity were determined for all services. Questions were posed using Naira (N) ($1 = N250, at the time of the study). RESULTS: Respondents aged 25 to 34 years comprised 80.8% of the population, whereas 80.8% were married. The mean amounts of WTA and WTP for services involving primary prevention of HIV was N543 000 and N18 600, respectively. Its WTA-to-WTP ratio and approximate income effect were 29.19 and -28.19, respectively. These variables were associated with WTP for some services: level of education with PMTCT follow-up treatment and support (P=.046), trimester of pregnancy with primary prevention of HIV (P=.002), correspondent's residence with specialized clinical pharmacy services (P=.003), and time spent to reach facility with primary prevention of HIV (P=.002). CONCLUSIONS: All services had high WTP, WTA-to-WTP ratios, and income effects, with inelastic income elasticity coefficients: patients in the Nigerian hospital attribute high value to all PMTCT services.

Evaluation of Health Status of Type 2 Diabetes Outpatients Receiving Care in a Tertiary Hospital in Nigeria.

OBJECTIVES: The aim of this study was to determine the health status of type 2 diabetes patients in a Nigerian tertiary hospital, and examine the sociodemographic and clinical variables that predicted the health status of type 2 diabetes patients in terms of utility valuations and EuroQol Visual Analogue Scale (EQ-VAS) score. METHODS: This was a cross-sectional study of 147 diabetes patients attending the University of Nigeria Teaching Hospital, Enugu State, Nigeria. The EQ-5D-5L instrument, version 2.1, was used to evaluate patients' self-reported health status, and patients who gave informed consent completed the questionnaire while waiting to see a doctor. Descriptive and multiple linear regression analyses were performed using SPSS version 20. RESULTS: Overall, 147 patients participated in this study, with a mean age (± standard deviation) of 56.7 years (± 10.33). Over half of the respondents were females (55.1%) and more than half were older than 60 years of age. The mean EQ-VAS and utility valuations of respondents were 72.59 ± 10.51 and 0.72 ± 0.13, respectively. The age of respondents independently and significantly predicted EQ-VAS by -2.659 per year, while the age of respondents, level of education, duration of diabetes, and presence of other illnesses independently and significantly predicted utility valuations by -0.020 per year, +0.029 per level of education, -0.008 per year, and -0.044 per illness, respectively. Less than 39% of patients experienced no problems for each of the dimensions, except self-care (68%). CONCLUSION: The results of this study revealed a relatively low health status among type 2 diabetic patients in Nigeria. Old age, duration of diabetes and the presence of other illnesses were major contributors to the negative impact on health status, while a higher level of education contributed positively to health status. Adequate family support, as well as regular and effective patient counseling and education, may be worthwhile.

Mental health literacy: what do Nigerian adolescents know about depression?

BACKGROUND: Depression is a leading cause of disability and has been projected to become the 2nd most burdensome disease by the year 2020; depression has also been found to be the strongest single risk factor for attempted or completed suicides. Adolescent-onset mood disorders are frequently unrecognized or misdiagnosed and often go untreated. While there is a growing literature on the mental health literacy of adults, there has not been a parallel interest in the mental health literacy of young people in Nigeria. METHODS: The study was a cross-sectional descriptive survey conducted among students of a Federal Government College (high school) in south-east Nigeria. All consenting students in the senior secondary classes (grades 10-12) were recruited, making a total of 285 participants. The participants were presented with the 'friend in need' questionnaire designed to elicit the participants' recognition of the disorder depicted in two vignettes and their recommendation about the appropriate source of help-seeking. One vignette was of a clinically depressed case while the other vignette was about a girl undergoing normal life crisis. RESULTS: Out of the 285 students recruited into the study, 277 questionnaires were adequately completed indicating a response rate of 97.2%. A total of 4.8% (n = 13) participants correctly identified and labelled the depression vignette. Only four respondents (1.5%) recommended professional help from a Psychiatrist or Psychologist. Insomnia was the most identified symptom of distress for depression (17.1%). Females demonstrated higher mental health literacy, in terms of their ability to correctly label the depression vignettes, their expression of greater concern over a depressed peer than males, their expectation that depression requires a longer recovery than normal teenage problems and in their ability to identify individual symptoms of depression. Family and friends were the most recommended source of help. CONCLUSION: Mental health literacy was abysmally low amongst the adolescents surveyed. There's an urgent need to increase mental health awareness in Nigeria.

Knowledge, Attitudes and Perceptions of Prostate Cancer among Male Staff of the University of Nigeria

Prostate cancer is the number one cancer in males in Africa, both in terms of incidence and mortality, accounting for 40,000 (13%) male cancers and 28,000 (11.3%) male cancer-associated deaths. In the developed world, the probability of being diagnosed with cancer is more than twice as high as in developing countries. In developing countries, most cancer victims are diagnosed at late stage, with incurable tumors, pointing to the need for education schemes and better detection programs. This study assessed knowledge, attitudes and perceptions of prostate cancer among male staff of the University of Nigeria. This cross-sectional descriptive study was carried out with 655 male staff who agreed to participate and were recruited on giving oral consent. A self-administered questionnaire, written in English was used. The mean percentage knowledge score was 71.2%. Some 57.8% of respondents had a high knowledge level of prostate cancer. The mean percentage attitude score was 69.9%. More than half (60.8%, n = 397) of respondents had a positive attitude towards prostate cancer screening and treatment. The mean percentage perception score was 60.0%. More than half (53.9%, n = 351) of respondents had a negative perception of prostate cancer screening and treatments. The staff of the University of Nigeria have appreciable knowledge and a positive attitude with regard to prostate cancer. A significant proportion of staff however, exhibited poor knowledge and negative attitudes and perceptions of prostate cancer screening and treatment.