Prevalence and Factors Associated with Stress, Anxiety and Depression amongst Primary Care Patients with Hepatitis B and C Infections in Nigeria.

BACKGROUND: Globally, more than 350 million people live with viral hepatitis, out of which over 20 million are in Nigeria. The prevalence of anxiety, depression and stress among patients with viral hepatitis in the primary care setting is not well established. OBJECTIVES: The objectives of this study were to determine the prevalence and factors associated with depression, anxiety and stress among hepatitis patients in a primary care clinic in North Central Nigeria using the Patient Health Questionnaire (PHQ2), Generalized Anxiety Disorder (GAD 2) and Kessler 6 scales respectively. METHODS: This cross-sectional study was carried out among Hepatitis B and C patients attending the Hepatitis Clinic of the Family Medicine Department, Federal Medical Centre Keffi. A total of 123 participants were recruited using a simple random sampling technique. Their sociodemographic and clinical data were collected after which they were screened for depression, anxiety and stress. Data collected was analysed using IBM SPSS. RESULTS: The mean age of study participants was 38.9±11.6 years. Most of them had hepatitis B infection (89.7%) and were on antiviral medications or liver supplements (45.2%). The prevalence of anxiety, depression and stress among them were found to be 18.9%, 25% and 77.6% respectively. Illness duration and medication use were found to be significantly associated with both depression and stress among them. CONCLUSION: The prevalence of anxiety, depression and stress is high among adult primary care patients with viral hepatitis in FMC Keffi.

CONTEXTE: À l'échelle mondiale, plus de 350 millions de personnes vivent avec les hépatites virales, dont plus de 20 millions au Nigeria. La prévalence de l'anxiété, de la dépression et du stress chez les patients atteints d'hépatite virale dans le cadre des soins primaires n'est pas bien établie. OBJECTIFS: Cette étude visait à déterminer la prévalence et les facteurs associés à la dépression, à l'anxiété et au stress chez les patients atteints d'hépatite dans une clinique de soins primaires dans le centre-nord du Nigeria en utilisant les échelles du Questionnaire de Santé Patient (PHQ2), du Trouble Anxieux Généralisé (GAD 2) et de Kessler 6 respectivement. MÉTHODES: Cette étude transversale a été réalisée parmi les patients atteints d'hépatite B et C fréquentant la clinique d'hépatite du département de médecine familiale du Centre Médical Fédéral de Keffi. Un total de 123 participants ont été recrutés à l'aide d'une technique d'échantillonnage aléatoire simple. Leurs données sociodémographiques et cliniques ont été recueillies, après quoi ils ont été dépistés pour la dépression, l'anxiété et le stress. Les données collectées ont été analysées à l'aide d'IBM SPSS. RÉSULTATS: L'âge moyen des participants à l'étude était de 38,9±11,6 ans. La plupart d'entre eux étaient atteints d'une infection par l'hépatite B (89,7 %) et prenaient des médicaments antiviraux ou des compléments hépatiques (45,2 %). La prévalence de l'anxiété, de la dépression et du stress parmi eux s'est avérée être respectivement de 18,9 %, 25 % et 77,6 %. La durée de la maladie et l'utilisation de médicaments ont été significativement associées à la dépression et au stress chez ces patients. CONCLUSION: La prévalence de l'anxiété, de la dépression et du stress est élevée parmi les patients adultes en soins primaires atteints d'hépatite virale au FMC Keffi. MOTS-CLÉS: Prévalence et facteurs, stress, anxiété, dépression, patients atteints d'hépatite B et C.

Awareness, Availability and Use of Teaching Aids and Skills Acquisition Materials in Family Medicine Training Centres in West Africa.

INTRODUCTION: Teaching aids and skills acquisition tools are rapidly forming an integral part of Family Medicine postgraduate training worldwide. While some training centres in West Africa have made concerted efforts to ensure their use, many still have a lot to improve on. Hence, there is a need to objectively determine its level of awareness, availability, and use in the sub-region. METHODS: This was a descriptive cross-sectional study involving all consenting Heads of Department and Training Coordinators of all centres with current West Africa College of Physicians Family Medicine accreditation. The Google link to a questionnaire comprising socio-demographic variables, questions on awareness, availability and use of various teaching aids and skill acquisition tools was sent to the respondents via WhatsApp message. Continuous variables were expressed as mean ± standard deviation and categorical variables as frequencies and percentages. Chi-square test and logistic regression analysis were used to determine factors associated with and predictors of availability and use of teaching aids/skills acquisition tools. RESULTS: The response rate was 107(84.3%) from all currently accredited West Africa College of Physicians Family Medicine training centres. Their mean age was 54±7 years; they were predominantly 93(86.9%) certified as trainers. All the respondents felt the use of teaching aids/skills acquisition materials will enhance learning in their departments. However, most were aware and used traditional resources (97.2%) and non-electronic (96.3%) resources. Only 10 (9.3%) respondents had mannequins for training Resident Doctors. CONCLUSION: Most Family Medicine Trainers in West Africa are aware and support the use of teaching aids/skills acquisition materials. However, the uptake is currently very low. There is an urgent need for the Postgraduate College and all stakeholders to look into ways of improving the use of teaching aids/skills acquisition materials in the sub-region.

INTRODUCTION: Les aides pédagogiques et les outils d'acquisition de compétences font rapidement partie intégrante de la formation postgraduée en médecine familiale dans le monde entier. Si certains centres de formation en Afrique de l'Ouest ont fait des efforts concertés pour assurer leur utilisation, beaucoup ont encore beaucoup à améliorer. Il est donc nécessaire dedéterminer objectivement son niveau de sensibilisation, sa disponibilité et sond'utilisation dans la sous-région. MÉTHODES: Il s'agit d'une étude descriptive transversale qui implique tous les chefs de service et les coordinateurs de formation consentants de tous les centres ayant une formation en cours à l'Ouest. Les coordonnateurs de formation de tous les centres ayant une accréditation de médecine familiale du médecins de l'Afrique de l'Ouest. Le lien Google vers un questionnaire comprenant des variables sociodémographiques,des questions sur la connaissance, la disponibilité et l'utilisation de divers supports d'outils d'acquisition de compétences a été envoyé aux répondants par message WhatsApp. Les variables continues ont été exprimées sous forme de moyenne ± écart type et les variables catégorielles en tant que fréquences et pourcentages. Le test du chi-deux et l'analyse de régression logistique ont été utilisés pour déterminer les facteurs associés et les prédicteurs de la disponibilité et de l'utilisation des aides à l'enseignement/outils d'acquisition de compétences. RÉSULTATS: Le taux de réponse a été de 107 (84,3 %) de tous les collèges de médecine familiale de l'Afrique de l'Ouest actuellement accrédités par le Collège des médecins d'Afrique de l'Ouest pour la médecine familiale. Leur âge moyen était de 54±7 ans ; ils étaient majoritairement 93(86,9%) certifiés en tant que formateurs. Tous les répondants ont estimé que l'utilisation d'aides à l'enseignement/de matériels d'acquisition de compétences améliorera l'apprentissage dans leurs départements. Cependant, la plupart étaient conscients et utilisaient des ressources traditionnelles (97,2%) et des ressources non électroniques (96,3%). Seuls 10 répondants (9,3 %) disposaient de mannequins pour la formation des médecins résidents. CONCLUSION: La plupart des formateurs en médecine familiale en Afrique de l'Ouest sont conscients et soutiennent l'utilisation d'aides à l'enseignement/de matériel d'acquisition de compétences. Cependant, l'utilisation de ce matériel est actuellement très faible. Il y a un besoin urgent pour le Collège Postgradué et toutes les parties prenantes d'examiner les moyens d'améliorer l'utilisation des aides à l'enseignement/du matériel d'acquisition de compétences dans la sousrégion. MOTS-CLÉS: Sensibilisation, supports d'enseignement, acquisition de compétences, Afrique de l'Ouest, médecine familiale.

In Vitro and In Vivo Neutralizing Activity of Uvaria chamae Leaves Fractions on the Venom of Naja nigricollis in Albino Rat and Bovine Blood.

BACKGROUND: Snakebite envenomation is a global priority ranked top among other neglected tropical diseases. There is a folkloric claim that Uvaria chamae is beneficial for the management of snakebite and wounds in African ethnobotanical surveys. Besides, there are many registered patents asserting the health benefits of U. chamae. OBJECTIVE: This study aimed to investigate U. chamae's potentials and identify candidates for the development of tools for the treatment and management of N. nigricollis envenomation. METHODS: Freshly collected U. chamae leaves were air-dried, powdered, and extracted in methanol. The median lethal dose of the extract was determined and further fractionated with n-hexane, n-butanol and ethyl acetate. Each fraction was tested for neutralizing effect against venom-induced haemolytic, fibrinolytic, hemorrhagic, and cytotoxic activities. RESULTS: U. chamae fractions significantly (p<0.05) neutralized the haemolytic activity of N. nigricollis venom in n-butanol; 31.40%, n-hexane; 33%, aqueous residue; 39.60% and ethyl acetate; 40.70% at the concentration of 100mg/ml of each fraction against 10mg/ml of the snake venom when compared to the positive control. The fibrinolytic activity of N. nigricollis venom was significantly (p<0.05) neutralized in n-hexane at 73.88%, n-butanol; 72.22% and aqueous residue; 72.22% by the fractions of U. chamae. In addition, haemorrhagic activity of N. nigricollis venom was significantly (p<0.05) neutralized by U. chamae fractions at the concentrations of 100mg/ml, 200mg/ml and 400mg/ml except for n-butanol and aqueous residues at 400 mg/ml. CONCLUSION: U. chamae leaves fractions possess a high level of protection against N. nigricollis venoms-induced lethality and thus validate the pharmacological rationale for its usage in the management of N. nigricollis envenomation.

Knowledge and Attitude of PLWHA concerning oral lesions of HIV/AIDS among patients of PEPFAR clinic in Lagos University Teaching Hospital (LUTH) Lagos, Nigeria.

INTRODUCTION: Oral manifestations in Human Immunodeficiency virus/Acquired Immunodeficiency Disease Syndrome (HIV/AIDS) are associated with adverse effects on quality of life such as pain, difficulty in eating, bad breath, altered taste and sometimes altered appearance. There is also a predisposition to poor nutrition which confers an additional burden on the body's immune defences and the ability to fight off infections. Knowledge of the oral lesions will enable People Living with HIV/AIDS (PLWA) to seek dental treatment on time. AIMS AND OBJECTIVES: To assess the general knowledge of HIV/AIDS, its oral manifestations and willingness to know more about its oral lesions among people living with HIV/AIDS (PLWHA) in Lagos, Nigeria. PATIENTS AND METHODS: A structured questionnaire was administered to two hundred and thirty-five patients (235) who were randomly selected from attendees at an NGO clinic supporting PLWHA in Lagos. RESULTS: Majority of the participants exhibited poor knowledge of the oral manifestations of HIV/AIDS although many of them had fair knowledge of the general symptoms of HIV/AIDS. The high educational status of the subjects seemed to play little role in awareness of oral manifestations in HIV/AIDS as only 45(21.4%) of the participants had good overall knowledge having a range of 25-31 correct answers out of 210 participants. Many of the respondents (145, 69%) wish to know more about oral lesion of HIV/AIDS. CONCLUSION: Although there is a high awareness of the general symptoms of HIV/AIDS in the study group, there is poor awareness of the oral manifestations, their presentations and management. The study also showed that PLWHA would be willing to know more about the oral manifestations of HIV/AIDS and seek dental care for their management.