Economic Cost of Asthma and Psychiatric Morbidity in Nigerian Patients with Asthma.

BACKGROUND: Asthma is known to constitute a huge economic burden to its sufferers and their carers. There is a dearth of studies documenting this burden among asthmatics in Nigeria. OBJECTIVE: This study assessed the relationship between economic cost and psychiatric morbidity among stable Nigerian patients with asthma. METHODS: 85 patients with asthma completed a socio-demographic and illness-related questionnaire, the modified Economic Cost Questionnaire and General Health Questionnaire 12 (GHQ 12). Associations between socio-demographic characteristics, illness related variables, psychiatric morbidity and the direct, indirect and total costs in relation to asthma were assessed. RESULTS: The average annual total, direct and indirect cost were $309, $190.65 and $118.34 respectively per patient for subjects with asthma. Direct cost constituted 62.7% while the indirect cost was 38.3% of the total cost for asthma. Drugs and hospitalisation were leading contributors to direct costs for asthma. Psychiatric morbidity was found to be present in 35% of subjects with asthma, those with psychiatric morbidity had a higher economic burden. CONCLUSION: The economic cost of asthma is high, psychiatric morbidity increases this cost. The cost is largely due to drugs and hospitalisations for exacerbation. There is an urgent need to optimize means of helping to minimize this cost and increase measures for detecting and treating psychiatric morbidity.

Impact of intimate partner violence on anxiety and depression amongst women in Ile-Ife, Nigeria.

Research into intimate partner violence in the Nigerian environment has been limited. The objective of this study was to determine, amongst a sample of women attending the Enuwa Primary Health Care Center, Ile-Ife, the association between intimate partner violence and anxiety/depression. A descriptive cross-sectional study was conducted amongst 373 women who attended the antenatal clinic and welfare units of a primary health centre in Ile-Ife using the Composite Abuse Scale, the Hospital Anxiety and Depression Scale and a socio-demographic scale as instruments. Slightly over a third (36.7 %) reported intimate partner violence within the past year, 5.6 % had anxiety and 15.5 % were depressed. Anxiety and depression in the respondents were significantly associated with intimate partner violence. Women were ten times more likely to report being depressed and 17 times more likely to report anxiety if they were in violent relationships. This research has shown that the magnitude of intimate partner violence within the study population is comparable to those found in the developing countries. There are significant associations between intimate partner violence, anxiety and depression amongst the study population and this fact undoubtedly has implications for the mental health of the Nigerian woman.

Anxiety disorders among Nigerian women in late pregnancy: a controlled study.

This study aimed to investigate the rate and type of anxiety disorders among Nigerian women in late pregnancy. Women in late pregnancy (n = 172) and a non-pregnant control group were assessed for DSM-IV anxiety disorders. The rate of any anxiety disorder in the pregnant women was 39.0% compared with 16.3% in the non-pregnant population (p < 0.001). Although all the anxiety disorders were more common, only the rate of social anxiety disorder was significantly higher among the pregnant than non-pregnant population. Correlates of anxiety disorder in the pregnant population include age less than 25 years (OR 4.62, 95% CI 2.39-8.92), primiparity (OR 3.90, 95% CI 2.00-7.59) and presence of medical conditions (OR 3.60, 95% CI 1.28-10.12). More research is needed in this field to ascertain the specific association between pregnancy and anxiety disorders.

Pattern of alcohol consumption among commercial road transport workers in a semi-urban community in south western Nigeria.

OBJECTIVES: To determine prevalence and pattern of alcohol use, evaluate the level of awareness of the harmful consequences of drinking, and determine the relationship between alcohol use and some selected factors among commercial road transport workers. DESIGN: Cross-sectional survey. SETTING: All the five motor parks spread over Ile-Ife, a semi-urban community in south western Nigeria. RESULTS: out of the 403 transport workers, 400 (99.3%) agreed to participate in the study. The questionnaire of one respondent was rejected. The current prevalence rate of alcohol use was 67.2%. Forty seven percent were 'heavy' users; 15.3% 'moderate' users and 37.7% were occasional or 'mild' users. All the users were engaged in the use of commonly available alcoholic beverages in the vicinity of the motor parks. Majority of the respondents (74.5%) reported drinking after work; 13.5% in the mornings; 10.1% when off-duty and 1.9%, during work. Frustrations that are associated with their work topped the list of reasons adduced for drinking. Belonging to lower age groups was significantly associated with current drinking (chi2 = 17.46, df = 3, p < 0.001). The proportions of respondents with unsatisfactory level of awareness regarding the association of current drinking with road traffic accidents, and with physical complications were high. CONCLUSION: Current alcohol use and use in a hazardous manner is an important public health problem among commercial road transport workers in Nigeria. There is an urgent need to modify existing legislations or enact new laws on 'driving under the influence' of alcohol, and enforce them.

An assessment of aspirin use in a Nigerian diabetes outpatient clinic.

BACKGROUND: We have conducted this study to assess the use of aspirin among adult diabetic outpatients in our hospital. METHODS: The records of all patients attending the weekly Diabetes clinic of the Wesley Guild Hospital (WGH), Ilesa, Osun state, Nigeria over one month were reviewed and aspirin use evaluated in light of the American Diabetes Association position statement (2003) on aspirin therapy in diabetes. RESULTS: Eighty-two patients in all were studied. Fourty three (52.4%) were males, 39 (47.6%) were females. Their mean age was 59.1 +/- 10.7 yrs (range 31-81). All were type 2 and had been diabetic for a mean of 5.2 +/- 5.7 yrs (1-26yrs). Concurrent hypertension, another major risk factor for cardiovascular disease was found in 71.9% and 12.2% were obese. Aspirin use was contraindicated in 1.2%. All other patients had at least one indication for the use of aspirin based on the ADA criteria but only 39% were taking aspirin regularly. CONCLUSION: The results of this present study suggest that aspirin is still grossly under utilised in clinic patients with diabetes despite proven benefits. There is need to stimulate awareness amongst health care providers.