Prevalence and Factors Associated with Depression among Resident Doctors in Nigeria: A Multi-Center Study.

BACKGROUND: Depression is a significant contributor to the global burden of disease. Several studies have shown that depression in resident doctors is more common than that in the general population. However, data on the prevalence of depression among resident doctors in Nigeria is limited. OBJECTIVES: The aim of this study is to determine the prevalence of depression as well as factors associated with depression among resident doctors. METHODS: A cross-sectional study design was employed with semi-structured questionnaires on socio-demographic and other factors associated with depression in resident doctors. The proportionate sample size in hospitals across the six geopolitical zones with multi-stage sampling and systematic random sampling technique was used to recruit resident doctors. The Beck's Depression Inventory was employed. The data was analyzed using Epi info version 3.5.3 (2011) and Stata 14. A p-value of less than 0.05 was statistically significant. RESULTS: The prevalence of depression was 18.9% among the resident doctors. Negative binomial regression used showed that depression in resident doctors was significantly associated with age (IRR=1.07, 95%CI:1.01-1.13, p=0.017), female gender ((IRR=1.75, 95%CI: 1.00-3.05, p=0.049) and being a resident in the surgical specialties (IRR=2.31, 95%CI: 1.35-3.94, p=0.002), respectively. CONCLUSION: The prevalence of depression among resident doctors showed that older age, female gender, and surgical specialties were determinants of depression.

CONTEXTE: La dépression contribue de façon importante à la charge mondiale de morbidité. Plusieurs études ont montré que la dépression chez les médecins résidents est plus fréquente que dans la population générale. Cependant, les données sur la prévalence de la dépression chez les médecins résidents au Nigéria sont limitées. OBJECTIFS: Le but de cette étude est de déterminer la prévalence de la dépression ainsi que les facteurs associés à la dépression chez les médecins résidents. MÉTHODES: Un plan d'étude transversal a été utilisé avec des questionnaires semi-structurés sur les facteurs sociodémographiques et autres associés à la dépression chez les médecins résidents. La taille proportionnelle de l'échantillon dans les hôpitaux des six zones géopolitiques avec un échantillonnage en plusieurs étapes et une technique d'échantillonnage aléatoire systématique a été utilisée pour recruter des médecins résidents. L'inventaire de la dépression de Beck a été utilisé. Les données ont été analysées à l'aide d'Epi info version 3.5.3 (2011) et stata 14. Une valeur de p inférieure à 0,05 était statistiquement significative. RÉSULTATS: La prévalence de la dépression était de 18,9 % chez les médecins résidents. La régression binomiale négative utilisée a montré que la dépression chez les médecins résidents était significativement associée à l'âge (TRI = 1,07, IC à 95 %: 1,01-1,13, p = 0,017), au sexe féminin (IRR = 1,75, IC à 95%: 1,00-3,05, p = 0,049) et au fait d'être résident dans les spécialités chirurgicales (TRI = 2,31, IC à 95%: 1,35-3,94, p = 0,002), respectivement. CONCLUSION: La prévalence de la dépression chez les médecins résidents a montré que l'âge avancé, le sexe féminin et les spécialités chirurgicales étaient des déterminants de la dépression. Mots-clés: Dépression, Médecins, Géopolitique, Beck.

EFFECT OF WORKPLACE STRESS ON THE PERCEIVED HEALTH OF RESIDENT DOCTORS IN NIGERIA.

Background: Resident doctors' health and wellbeing has recently become the focus of international concern, as they are very important members of the healthcare system. The medical workplace is a complex environment where the doctors respond differently. Objective: The objective of this study was to assess workplace stress among the resident doctors, examine their perceived health status, and determine the effect of workplace stress on their perceived health status. Methods: The study was a cross-sectional study conducted among resident doctors at University College Hospital (UCH), Ibadan, Nigeria across all the specialties over a three-month period, from 1st March to 31st May, 2019. Two hundred and thirty-two eligible and consenting resident doctors were selected by stratified random sampling and data was collected using interviewer-guided selfadministered questionnaire. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Results: The result showed that 144 (62.1%) of the resident doctors experienced workplace stress and 108 (46.6%) resident doctors perceived their health as poor. Workplace stress, years in residency program, designation, and work hours on least busy day at work were all significantly associated with perceived health status of the resident doctors, however, only workplace stress could independently predict poor perceived health status of the resident doctors. Conclusion: It is therefore important to prevent and manage workplace stress in order to improve the perceived health status of resident doctors.

KNOWLEDGE OF EMERGENCY CONTRACEPTION AND PREDICTORS OF ITS USE AMONG FEMALE UNDERGRADUATES IN TWO NIGERIAN UNIVERSITIES.

Background: Unintended pregnancies contribute to the high burden of unsafe abortion, maternal deaths and morbidities among undergraduates. Objective: To assess the determinants of good knowledge and evaluate the trends in the practice of Emergency Contraception (EC) among female undergraduates. Methods: This was a cross sectional study involving four hundred and twenty female undergraduates from two universities in Ibadan, Nigeria. Participants were recruited from their hostels and classrooms. Data collection was done using self-administered questionnaires and good knowledge was defined as three correct answers to five questions testing knowledge. The questionnaires also addressed their practices of EC. The data was stored on the computer, cleaned and analyzed using the Statistical Package for the Social Sciences (SPSS) version 22. Statistical significance was set at p <0.05. Results: Two hundred and fourteen (51.0%) participants were aware of EC and the common sources were friends (43.4%), media (42.9%) and pharmacies (42.0%). One hundred and sixty-four participants (39.1%) had good knowledge of EC. Participants in the age group 20-24 years, second year of study, those who were aware of EC and had ever used EC were associated with good knowledge. Less than half (48%) of the sexually active participants used EC in the past six months and Levonogestrel (51%) was the commonest EC used. Menstrual irregularity and abdominal pain were the major side effects of EC. Conclusion: The practice of EC is poor and with poor knowledge demonstrated among female undergraduates. There is therefore the need to improve information and access to EC in the university community.

FACTORS ASSOCIATED WITH SEXUAL DYSFUNCTION AMONG FEMALE PATIENTS IN A NIGERIAN AMBULATORY PRIMARY CARE SETTING.

BACKGROUND: Sexual dysfunction is a common but under-reported problem of public health importance among female adults in Nigeria. Empirical evidence on sexual dysfunction among female Nigerians is scarce. OBJECTIVE: To determine the prevalence and risk factors associated with sexual dysfunction among female patients presenting at the General Outpatient Clinic (GOPC), University College Hospital (UCH), Ibadan, Nigeria. METHODOS: This was a cross-sectional study of 480 married female patients who presented consecutively at the GOPC, UCH, Ibadan, Nigeria. The 28-item Sexual Function Questionnaire (SFQ-28) was used to determine sexual dysfunction. Information on their sociodemographic characteristics, obstetric and gynecological history were obtained. Bivariate and multivariate analyses were carried out and alpha was set at 0.05. RESULTS: Point prevalence of sexual dysfunction was 80.0%. The most common sexual dysfunction was problems with sexual desire (99.4%), while the least common was problems with arousal cognition (5.8%). There was a significant association between the prevalence of sexual dysfunction and age, years of relationship, number of children alive, parity, level of education, age at coitarche and family dysfunction. Age (OR=0.893; 95% CI=0.821-0.972, p=0.008), parity (OR=3.093; 95% CI=1.174- 8.151, p=0.022), having family dysfunction (OR=2.096; 95% CI= 1.129-3.891, p=0.019) and having ≥10 years of formal education (OR=4.808; 95% CI= 2.604-8.928, p<0.0001) were found to be the predictors of sexual dysfunction. CONCLUSION: Sexual dysfunction among female married adults in our setting was high. We propose that modifiable factors such as socio-demographic and gynaecological variables should be evaluated during the consultation of female patients at first contact.

Factors associated with sarcopenia among older patients attending a geriatric clinic in Nigeria.

CONTEXT: Aging is characterized by progressive and generalized loss of skeletal muscle mass and strength called sarcopenia which causes poor health and disability. There is paucity of data on this syndrome of public health importance among older Nigerians. AIM: This study determined the prevalence and factors associated with sarcopenia among persons aged 60 years and above at a geriatric center in Nigeria. MATERIALS AND METHODS: A cross-sectional study of 642 persons aged ≥60 years who attended the geriatric center between March and July 2014. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People criteria. Bivariate and multivariate analyses were carried out using SPSS 20. Alpha was set at 0.05. RESULTS: The mean age ± standard deviation of the respondents was 69.1 ± 7.2 years, and 378 (60.6%) were females. The point prevalence of sarcopenia was 5.4% which was significantly higher among the females compared with the males (7.1% vs. 2.8%) P = 0.02. Low muscle mass and low gait speed were found in 10.9% and 36.1%, respectively. Logistic regression analysis showed age (odds ratio [OR] =1.090; 95% confidence interval [CI] =1.034-1.149, P = 0.01), having no formal education (OR = 2.810; 95% CI = 1.043-7.573, P = 0.04), malnutrition (OR = 5.817; 95% CI = 1.471-23.434, P = 0.01), and female gender (OR = 3.068; 95% CI = 1.068-8.817, P = 0.04) to be the predictors of sarcopenia. CONCLUSION: Older people in this setting are at risk of developing sarcopenia, especially the females. Healthcare workers should address the social and health-related factors which could lead to sarcopenia.

Functional health of patients with knee osteoarthritis in a family medicine clinic in Ibadan.

BACKGROUND: Patients with knee osteoarthritis experience pain and functional impairment, which impacts upon activities of daily living ultimately leading to a loss of functional independence and low quality- of-life. This study therefore aimed at evaluating the functional health status of patients with knee osteoarthritis in the Family Medicine clinic, University College Hospital, Ibadan, Nigeria. METHODS: A cross-sectional study was conducted on 270 eligible respondents between January and March 2011. The Ibadan Knee/Hip Osteoarthritis Measure (IKHOAM) was administered after screening with the knee pain screening tool (KNEST). Respondents'Socio- demographic characteristics and knee pain intensity ratings were also recorded. RESULTS: The age range of respondents in the study was from 28 years to 85 years with a female: male ratio 5:1. Out of the 270 respondents studied, 146 (54.1%) reported restriction in performing duties at work. One hundred and twenty seven respondents (47.0%) needed some assistance in walking outside the house for 15 to 20 minutes, whilst 195 (72.2%) required some assistance in climbing stairs. Thirty four (12.6%) of Muslims and 77 (28.5%) of Christians could not kneel to pray. Males are twice more likely to have a better functional health than females (OR= 2.1, 95% CI= 1.0- 4.6, p=0.046). CONCLUSION: Knee osteoarthritis significantly impairs activities of daily living, especially some socio-cultural and religious practices of respondents. Therefore in addition to treating the knee symptoms, removing environmental barriers may reduce immobility within and outside the home thereby improving functionality.

Breast self-examination practices in Nigerian women attending a tertiary outpatient clinic.

BACKGROUND: The morbidity and mortality caused by breast cancer can be decreased by early detection with breast self-examination (BSE). The objective of this study was to determine the prevalence and the factors determining the practice of BSE. MATERIALS AND METHODS: The study was conducted on 140 women aged above 18 years who presented consecutively in a General Outpatient's clinic in a tertiary hospital in Nigeria. This was the baseline study from an intervention study which looked at the effect of demonstration of BSE on improving Clinical Breast Examination (CBE) among two groups of respondents. Structured questionnaires were validated and administered by an interviewer and the data were analyzed using Statistical Package for Social Sciences (SPSS) version 12. RESULTS: The overall self-reported prevalence of BSE practice was 62.1% among the respondents. Older women (16, 76.2%), married women (63, 65.6%) and women with tertiary education (51, 68.9%) had the highest prevalence of BSE practice. Prevalence rate was highest for civil servant (25, 78.1%), P = 0.04. The practice of BSE was higher among women with a previous history of breast disease (15, 68.2%) and in respondents with a family history of breast disease (7, 63.6%), Only 11 (12.6%) performed BSE as per guidelines, which was once in a month. CONCLUSION: The prevalence of BSE was found to be high, especially in those with tertiary education and in those with a past personal or family history of breast disease. In resource-constrained countries, BSE is a screening tool that can be employed to help reduce the breast cancer burden because routine mammography screening is not yet feasible. Women need to be informed about the when and how to perform BSE.

Physical functionality and self-rated health status of adult patients with knee osteoarthritis presenting in a primary care clinic.

BACKGROUND: Knee osteoarthritis is a chronic medical condition of public health importance in Nigeria which causes disability and impacts daily activities in the sufferers. This study aimed to describe the physical functionality and self-rated health status of adult patients with clinical knee osteoarthritis presenting at the Family Medicine Department, University College Hospital, Ibadan, Nigeria. METHODS: This was a cross-sectional study of 400 respondents. Knee osteoarthritis was diagnosed clinically using the criteria of the American College of Rheumatology. Morbidities, self-rated health status and physical functionality of the respondents were also assessed. RESULTS: Knee osteoarthritis was diagnosed in 46(11.5%) respondents. Respondents with knee osteoarthritis significantly rated their health worse than those without knee osteoarthritis (p <0.0001). Experience of pain, stiffness and performance of daily activities were significantly worse among respondents with knee osteoarthritis. Those who had knee osteoarthritis had significantly higher waist (p <0.0001), hip (p <0.0001) and knee circumferences (p <0.0001) respectively. Logistic regression analysis showed increasing age (OR=1.103; 95% CI=1.022 - 1.191), self-rated health worse than six months ago (OR=12.562; 95% CI=1.178-125.243), experience of stiffness after waking up in the morning (OR=12.758; 95% CI=3.572-45.569), stiffness after sitting/lying down/resting (OR=21.517; 95% CI=2.213-209.220) and waist circumference (OR=1.225;95% CI=1.017-1.477) to be the most significantly associated with knee osteoarthritis. CONCLUSION: Knee osteoarthritis significantly impairs the health and daily activities of adult patients in Ibadan, Nigeria. Healthcare workers need to screen adult patients routinely at first-contact to detect knee osteoarthritis clinically early and manage appropriately.

Socio demographic and clinical correlates of knee pain in adult women attending a primary care clinic.

AIMS AND OBJECTIVES: The objectives of the study were to determine the socio demographic and clinical correlates of knee pain in women in a primary care clinic. PATIENTS AND METHODS: The study was a cross-sectional survey of 400 women attending the General Outpatients' clinic of the University College Hospital (U.C.H.), Ibadan, Nigeria using the systematic random sampling technique. RESULTS: The prevalence of knee pain was 42.0% (95% CI 40.0- 41.0). The radiographic findings in the knees showed mostly osteophytes in 24 out of the 28(85.7%) respondents who had radiographs done. The highest prevalence of knee pain was found in caterers and traders, 62.5% and 51.6%, respectively (p= 0.001). Multivariate analysis done using logistic regression with a backward selection showed that the odds of developing knee pain increases with age (Odds Ratio=1.585, 95% CI 1.321-1.903, p=0.000), and body mass index (Odds Ratio 1.587, 95% CI 1.295-1.946, p=0.000). CONCLUSION: The prevalence of knee pain in women seen at the primary care clinic is high. Preventive measures for knee pain need to be instituted.

Obesity: an emerging disease.

Obesity is rapidly becoming an emerging disease in developing countries due to the increasing westernization of societies and change in the lifestyle. The etiology of obesity is said to be multifactorial, with a combination of genetic and environmental factors. Literature has been extensively reviewed to provide a broad overview of obesity. Data for this review were obtained from original articles, review articles and textbooks. Internet search engines were also employed. The years searched were from 1993 to 2008. Obesity, classified in terms of the body mass index and the waist-hip ratio, has several associated co-morbidities such as diabetes mellitus, hypertension, degenerative osteoarthritis and infertility. In Nigeria, there is limited information on obesity. A literature review on obesity is necessary to improve the knowledge about obesity in developing countries, its prevention and its management.

Health risks of obesity.

Obesity is becoming of interest as a non-communicable disease. There is however a dearth of information on obesity in this environment, as literature in developing countries is limited. Review of health risks of obesity is useful in order to increase the pool of available information in Nigeria and to draw attention to obesity and its attendant health risks.