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.

Discordant rapid HIV tests: lessons from a low-resource community.

OBJECTIVES: HIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community. METHODS: A cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine™ HIV 1/2 and Uni-Gold™ HIV assays, plus plasma HIV-1 antigen testing with the COBAS® Ampliprep/COBAS® Taqman® HIV-1 assay, followed by western blot in those with detected HIV-1 antigen. RESULTS: Of 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60). CONCLUSIONS: When the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations.

Clinical profile, knowledge, and beliefs about diabetes among patients attending a Tertiary Health Centre in Lagos: A cross-sectional survey.

INTRODUCTION: Diabetes affects 347 million people worldwide; more than 80% of the affected live in low- or middle-income countries. Patients' beliefs about their medical conditions are important in helping physician focus on beliefs that needed to be changed or reinforced. The overall aim of this study was to improve the standard of care of patients with diabetes. METHODS: The study designed was a cross-sectional survey; adults with diabetes attending diabetic clinic of LASUTH took part in the survey. Participants were asked to fill a structured questionnaire which was used to assess clinical patterns, beliefs, and practice about diabetes. RESULTS: One hundred and fifty patients with diabetes took part in the study. This study showed that more females presented with diabetes compared with males, type 2 diabetes is commonerthan type 1 and there is a highassociation of the disease with hypertension or being overweight. More than half of the participants do not know the cause of diabetes, 13% believed that disease is curable, and 30% admitted to use alternative medications in addition to the anti-diabetic medications prescribed by the physicians. CONCLUSION: Knowing patients' beliefs and knowledge about diabetes is important to impart overall care for them. Health education about a disease should be planned to address beliefs and knowledge of patients about their medical condition to address misinformation and misconceptions about their disease conditions.

The influence of socioeconomic and nutritional status on menarche in Nigerian school girls.

A study of 352 randomly selected secondary school girls in an urban population in Southern Western Nigeria revealed a mean menarcheal age of 13.94 +/- 1.31 years and that 76.8% of girls attained menarche between ages 13 and 15 years. Age-matched pre- and post-menarcheal girls did not differ significantly in biophysical measurements, however, nutritional status was strongly and positively associated with attainment of menarche. School girls from the upper socio-economic class reached menarche 11 months earlier than the lower socio-economic counterparts. A significant finding of this study is that the declaration rate in age at menarche was slowest in girls from high socio-economic households. This deceleration was not influenced by body mass suggesting that socio-economic factors play a unique role in the secular trend widely reported in menarcheal age.

Effect of suxamethonium, pancuronium, neostigmine and halothane on serum cholinesterase activity.

Serum cholinesterase (Ch E) estimations were done in 30 healthy Nigerians scheduled for elective surgical procedures and were studied in two groups. Half of the patients were given general anesthesia using a muscle relaxant technique and the other half had halothane as the main anesthetic. Suxamethonium reduced Ch E by 9%, pancuronium by 25% and neostigmine by 58% compared to preinduction levels. Halothane reduced Ch E by 7% and 15% at 10 minutes and 24 hours postanesthetic respectively, compared to preinduction levels. The normal control value of Ch E in 30 healthy Nigerians was on the lower side of the normal range, observed mostly in Caucasians.