Prevalence and factors associated with depression among medical students in Nigeria.

BACKGROUND: Depression among medical students has been partly attributed to the nature of medical education, and may lead to poor academic and professional adjustment. The objectives of the study were to assess the prevalence of depression and its relationship to socio-demographic and clinical risk factors among medical students of Bayero University in Kano, Nigeria. METHODOLOGY: A descriptive cross-sectional study was performed. Two hundred and seventy-nine medical students were selected using a multi-stage sampling technique. The respondents were given a self-reporting questionnaire, which included sociodemographic details and 3-item Oslo Social Support Rating Scale. Depression was assessed using the Mini-International Neuropsychiatric Interview (7.0). RESULTS: The prevalence of depression among medical students was 15.1%. Depression was more in females, <22 years, those at the lower level of study, poor social support, family history of depression and history of depression. After logistic regression, only being female (P = 0.008) and history of depression (P = 0.007) differentiated medical students with depression from those with no depression with odds ratio (OR) of 2.88 (95% confidence interval [CI] = [1.31, 6.33]) and OR of 2.79 (95% CI = [1.33, 5.84]), respectively. There was no association between depression and poor financial state (P = 0.175), self-reported academic performance (P = 0.719) and use of psychoactive substances (P = 0.311). CONCLUSION: Depression is an important condition among medical students in Nigeria. There is a need to help students with mental health challenges by providing preventive measures, early identification and treatment mechanisms in medical schools in the country.

Effect of voice reminder on compliance with recommended hand hygiene practise among health-care workers in Kano metropolis.

BACKGROUND: Poor compliance with recommended hand hygiene practise by health-care workers is an emerging public health threat associated with significant morbidity, mortality and spread of multidrug-resistant microorganisms. OBJECTIVE: This study assessed the effect of voice reminder on compliance with recommended hand hygiene practise among the baseline, and post-intervention compliance with recommended hand hygiene among health-care workers using the WHO checklist for observation of 5-moments of hand hygiene of health-care workers in Kano. METHODS: Quasi-experimental study design was used. A total of 408 (204 in each arm) baseline and post-intervention observations were conducted in two hospitals in Kano, selected using a multistage sampling technique. Voice reminders were installed in the intervention hospital, and post-intervention observation was conducted 3 months after introducing a voice reminder. SPSS version 22.0 was used for data analysis. Relationship between variables was tested using χ2 and McNemar's test within the groups at 0.05 α-level of significance. RESULTS: Baseline compliance with hand hygiene in the intervention and control hospitals were 31.4% and 48.0%, respectively. Post-intervention compliance in the intervention and control hospitals were found to be 78.0% and 65.2%, respectively. Voice reminder improved compliance with hand hygiene practise when compared with baseline by +148% (P# = 0.3) in the intervention hospital compared with +36% (P# =0.1) in the control hospital. The differences were not statistically significant post-intervention when compared with the baseline. CONCLUSIONS: Voice reminder intervention improved hand hygiene compliance among health-care workers in the intervention hospital compared with the control hospital. Voice reminders should be provided in the hospitals by stakeholders. This can help in improving compliance with hand hygiene among health-care workers and reducing the burden of hospital-acquired infections due to the hands of health-care workers.

Magnitude and leading causes of in-hospital mortality at Aminu Kano Teaching Hospital, Kano, northern Nigeria: a 4-year prospective analysis.

BACKGROUND: Population based mortality data are scarce especially in developing countries including Nigeria. Despite its limitations, hospital mortality analysis assesses the quality of health-care delivery and provides a proximate measure of mortality. We reviewed the magnitude and causes of death among in-patients in a tertiary hospital in northern Nigeria. METHODS: Analysis of mortality rate and causes of death for the period 2005-2008 (inclusive) in Aminu Kano Teaching Hospital. Causes of death were prospectively entered on a database and classified according to the International Classification of Diseases (ICD- 10). RESULTS: Out of 51,975 patients admitted to the hospital, 4,029 of them died. This gives a mortality rate of 7.8% (95% Confidence Interval of 7.5% to 8.0%). Specifically, of the 15,484 males admitted, 2,361 died giving a mortality rate of 15.2% while of the 36,491 females admitted, 1,668 died giving a mortality rate of 4.6%. The median age for all patients that died was 32.4 years (range: less than 1 day to 101 years), but 36.1 years (range: less than 1 day to 101 years) for the male and 29.3 (range: less than 1 day to 87 years) for the female subsets. The ten most common causes of mortality were HIV/AIDS (8.3%), Septicaemia (6.8%), cerebrovascular disease (6.3%), chronic renal failure (3.9%) chronic liver disease (3.3%), diabetes mellitus (3.2), neonatal jaundice (2.9%), severe birth asphyxia (2.6%), prematurity (2.5%) and bronchopneumonia (2.4%). CONCLUSION: The mortality rate and causes of death are comparable to similar centres. Regular mortality audits could identify management errors and prevent recurrence of avoidable deaths.