Caregivers' perception of oral health-related quality of life in a group of Nigerian children living with human immunodeficiency virus.

AIM: This study examined the caregivers' perception of the effect of dental conditions on general well-being and family life of a group of human immunodeficiency virus (HIV)-infected Nigerian children. A secondary aim was to investigate correlations between the children's sociodemographic and health-related variables and caregivers' global ratings of oral health and well-being. Study Design A cross-sectional questionnaire-based survey was conducted among parents/caregivers of 95 HIV-positive children receiving care at the Lagos State University Teaching Hospital, Nigeria. MATERIALS AND METHODS: The "Parental-Caregivers Perception Questionnaire" which included measures of global ratings of oral health and well-being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well-being, and family well-being/parental distress was used. Assessment was based on the child's oral health within the preceding 3 months of the study. RESULTS: The most affected subscale of the oral health-related quality of life was functional limitation followed by parental distress and then oral symptoms. Caregivers of older children were 2½ times more likely to view oral health as impacting their child's overall health (P = 0.034). Furthermore, caregivers of children who had not yet commenced antiretroviral therapy were 15% more likely to report oral symptoms (P = 0.024) and 11% were more likely to be distressed. STATISTICS: Data entry, validation, and analysis were done using SPSS version 17.0. Findings were considered to be statistically significant when 95% confidence intervals were not overlapping. CONCLUSIONS: According to caregivers' perceptions, oral symptoms, functional limitations, and parental distress outweighed emotional well-being in impacting a child's oral health quality of life. Oral health programs to improve the knowledge of caregivers on the importance of oral health in HIV-positive children are necessary for improvement in overall quality of life.

Factorial validation and reliability analysis of the Brain Fag Syndrome Scale.

BACKGROUND: Brain fag is an indigenous psychopathology or culture-bound syndrome formally documented in Nigeria in the 1960's by Raymond Prince. OBJECTIVE: The need for a factorial examination of the scale to ensure factorial validity and also to examine the reliability of this screening scale. METHODS: Two hundred thirty four (234) participants with ages between 11 - 20 years with a mean age of 14.20 and a Standard Deviation of 2.14 of which 114 were from a private secondary school and 120 from a public secondary school were randomly selected and administered the Brain Fag Syndrome Scale [BFSS]. The data was subjected to factor analysis using Principal Component Analysis with Oblim Rotation. RESULTS: Two valid factors emerged with items 1-3 and items 4, 5 & 7 loading on them respectively, making the BFSS a two-dimensional (multidimensional) scale which measures 2 aspects of brain fag [labeled burning sensation and crawling sensation respectively]. The reliability analysis yielded a Cronbach Alpha coefficient of 0.521, and a standardized item alpha of 0.528 estimated its internal consistency. Also, the BFSS was correlated with other tests to establish its concurrent validity [convergent and divergent]. CONCLUSION: BFSS is a valid and reliable two-dimensional instrument to assess brain fag syndrome.

Brain Fag Syndrome - a myth or a reality.

The Brain Fag Syndrome (BFS) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a culture bound syndrome. BFS is a tetrad of somatic complaints; cognitive impairments; sleep related complaints; and other somatic impairments. Prince first described this psychiatric illness associated with study among African students in 1960. There have been questions relating to the nosological status of the syndrome as to whether: BFS is an objective or subjective phenomenon; it is one phenomenon or a variant of other known disorders; it is a mental illness? These three questions pose challenges to the culture bound/depressive or anxiety equivalent approach to the condition. The scope of this paper is the scope of BFS history from its first reference in the psychological medicine to the most contemporary descriptions in transcultural psychiatry. The conceptual history of BFS is divided into four major perspectives: Traditional medicine, Psychoanalysis, Biopsychological and Transcultural psychiatry. This helps to outline some of the key issues, helps to clarify its nosological status, its present status and helps to set the stage for the future progress. From its conceptual history, BFS as a phenomenon, with its distinct presentations, is subjectively real and is best classified with the framework of psychiatry, psychology and or sociology. The existence of BFS is evidenced by case as well as epidemiological reports of the condition in different locations. However, its course, response to treatment and outcome deserve more attention than has been given.

Assessment of limited joint mobility of the hand in Black Africans with diabetes mellitus and in non-diabetics.

OBJECTIVE: This study is designed to further characterize Limited Joint Mobility (LJM) of the hand using quantitative goniometric measurements among Black Africans with Type 2 diabetes mellitus and non-diabetes. METHODS: Seventy-six patients with Type 2 diabetes and 63 normal controls matched for age and gender were purposively selected. Visual clinical examination and quantitative goniometric assessment of patients with DM and non-DM controls were done. The LJM was graded using the criteria of Silverstein et al. Glycaemic control and proteinuria were also assessed. RESULTS: Prevalence of LJM among Type 2 DM patients was 26.3% compared with 4.8% in normal controls. Subjects with LJM within the control group were significantly older than those with LJM within the DM group (p < 0.05). Prayer sign was 11.8% in DM patients compared with 4.8% of control. The flattening sign demonstrated by the inability to flatten their hands on a flat surface was more in patients with DM (10.5%) compared with 4.8% in the control group. Stage II LJM with 18.4% prevalence was the commonest followed by Stage III (7.9%) among patients with DM. Poor glycaemic control was found in 85%, using fasting plasma glucose and 70%, using 2-hour postprandial blood glucose (2 hpp). CONCLUSION: We conclude that Black Africans with Type 2 DM only have moderately severe cases of LJM.

Determinants of antenatal booking time in a South-Western Nigeria setting.

BACKGROUND: Utilisation of antenatal services and early booking are important factors in the reduction of maternal mortality and morbidity and these are influenced negatively by social, cultural and religions factors. OBJECTIVE: To determine factors that influence the booking time in South Western Nigeria with the intention of identifying areas needing educational intervention. METHODS: A descriptive cross-sectional study of 327 antenatal patients done between January to March 2005. Using both structured and semi-structured questionnaires information were collected on the socio-demographic and complete medical history. RESULTS: Two hundred and forty-six (90.4%) out of the 272 women who met the inclusion criteria were interviewed. The mean (SD) age of patients was 30.47 (5.52) years, of which 60% of the mothers were educated beyond secondary school level and 44.3% of the patients booked late. Late booking was thrice as common in multiparae as in nulliparae. Variables that were significantly associated with time of booking included educational level of the husband (P = 0.005), parity (P = 0.012), previous miscarriage (P < 0.001) and medical problem in the index pregnancy. Stepwise regression analysis showed the latter two factors as predictors of booking time. (Beta of -0.566 and -0.643, respectively). 57.3% of pregnant mothers felt that women should book by the first trimester but half of them actively booked late. Early detection of problems was the commonest reason for the choice of time of booking. CONCLUSION: The socio-cultural and religious determinants of health-seeking behaviours need to be researched further and unless these are modified by interventional campaigns good education may not easily translate to optimum utilisation of antenatal services.

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.

Attitude towards antipsychotics among out-patients with schizophrenia in Nigeria.

OBJECTIVE: The study aim to assess the attitude of patients with schizophrenia attending out-patient clinics in Nigeria towards antipsychotic medication and examine the factors associated with such attitude. METHOD: Out-patients with schizophrenia (n = 312) completed the 10-item Drug Attitude Inventory. They were also evaluated for sociodemographic details, illness-related and drug-related variables. RESULTS: Overall, the patients had a good attitude towards antipsychotic medication. The factors significantly associated with poor attitude towards medication include presence of symptoms, presence of side-effects like dyskinesia and sedation, lack of insight into the illness, and being employed. CONCLUSION: Special attention should be paid to patients with these factors while designing programmes to improve overall compliance in patients with schizophrenia.