Open Access Original Research Article

Psychological Morbidity among Psychoactive Substance Users in a Rehabilitation Centre in Nigeria

Dada Mobolaji Usman, Lawal Rahman, Ohaeri Jude, Oluwole Lateef, Obadeji Adetunji, Kumolalo Ferdinand

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v39i330205

Aim: The aim of this study was to determine the prevalence and correlates of anxiety and depression among psychoactive substance users in a rehabilitation centre.

Place and Duration of Study: The study was carried out in a rehabilitation centre in Lagos state, Nigeria.

Methodology: All the inhabitants of the centre who agreed to participate in the study were included in the study. However, individuals who had stayed at the centre for less than a week were excluded from the study because the effect of use or withdrawal effects of some of the drugs may mimic depressive or anxiety symptoms. The 9-item Patient Health Questionnaire (PHQ-9) and the Mini International Neuropsychiatric Interview (M.I.N.I) (anxiety modules) were used to asses for depression and anxiety disorder respectively.

Results: A total of seventy six people participated in this study. Their ages ranged from 17 to 52 years (mean= 25.9 years SD= 8.4). A high number of the subjects were males (72.4%), single (78.7%) and unemployed (64.5%). Almost all the subjects (92.1%) were introduced to the use of psychoactive substances by friends/peers. Only 4 (5.3%) subjects reported injection drug use (IDU). 53.9% of the subjects had an anxiety disorder. While 68.4% had depression. The factors associated with having anxiety disorder were female sex, older age, being divorced/ separated/widowed, unemployment, multiple substance use, long duration of use of alcohol, cocaine and heroin.

Factors associated with depression included; young age of onset of substance use, female sex, being separated or divorced or widowed, unemployment, long duration/ frequency of use of substances and multiple substance use.

Conclusion: This study has shown that there is a high rate of anxiety and depression among psychoactive substance users.

Open Access Original Research Article

Prevalence of Urogenital Schistosomiasis in Four Communities in Ogbia Local Government Area, Bayelsa State, Nigeria

J. Gbonhinbor, A. E. Abah

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2019/v39i330206

Schistosomiasis is one of the most important neglected tropical diseases in terms of morbidity and mortality and it is endemic in the Niger Delta region of Nigeria. The aim of this study was to determine the prevalence of urogenital schistosomiasis in four communities (Agbura, Otakeme, Otuagela and Otuokpoti) in Ogbia Local Government Area, Bayelsa State, Nigeria using Filtration and Sedimentation technique. Snails collected were identified by the shape of their outer shell.  Basic statistics method and ANOVA was used to analyze the data. Out of the 276 urine samples examined, 36 (13.0%) tested positive for Schistosoma haematobium. The age- related infection showed that the age-group 10-14 years (26.9%) had the highest rate of infection, followed by 5-9 years 7 (19.4%).  Age-group 50 years and above had a zero infection rate. Sex - related infection showed that an overall prevalence rate of 71.6% was recorded among males and 39.4% for females indicating that infection was higher in males than in females in all the communities; In Otuokpoti, males 8(33.3%) to females 5 (15.1%), In Otakeme, males had 6 (12.8%) than females 5 (15.6%), in Otuagela males had 7 (16.7%) than females 2 (8.7%) and in Agbura males had 3 (8.8%) than females 1 (9.1%). Primary school children had the highest 16 (21.9%) while retired civil servants had 0(0.0%). The difference was significant. Bulinus globosus was the only snail intermediate host identified in both ponds and streams. Human water contact activities observed around the water bodies were recreational activities (washing, bathing, fishing) and harvesting of freshwater snails. Variance (ANOVA) of the age- specific prevalence of urogenital schistosomiasis in the four communities showed no significant difference at P<0.05 (P=0.082) among sampled population and also no significant difference at P<0.05 (P=0.55) across the infected population in the four communities.

In conclusion, urogenital schistosomiasis is still prevalent and remains a public health challenge in Ogbia, Bayelsa state. It is strongly recommended that health education and provision of safe water should be stepped up as a control measure of the infection in the area.

Open Access Original Research Article

Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria

Modupe O. Arowolo, Elizabeth A. Awoyesuku, Chinyere N. Pedro-Egbe

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2019/v39i330207

Aims: To determine the pattern of ocular disorders in HIV-positive patients in a tertiary ospital in Nigeria.

Study Design: A cross-sectional hospital based study on confirmed HIV positive adult patients attending the HIV clinic in University of Port Harcourt Teaching Hospital.

Duration of Study:  November and December 2011.

Methodology: Consecutive patients within the inclusion criteria were recruited until the required sample size was met. The visual acuity was tested using the Snellen’s chart and the illiterate E-chart. Ocular examination of the adnexial and anterior segments were done using a pen torch and a slit lamp biomicroscope. Fundoscopy was done using a direct and indirect ophthalmoscope as well as with a 90D lens. Other information such as CD4 count and HIV serotype were retrieved from the patient’s case notes. The data was analysed using EPI-info version 7.0. Statistical methods such as the frequency and chi-square were used to test the significance of association. Level of significance was drawn at P<0.05.

Results: A total of 411 patients were enrolled in this study. The age range was between 18-69 years with a mean age of 36.9 years. There was a female preponderance with a male to female ratio of 1:2. Ocular disorders were seen in 37.1% of patients studied. The commonest manifestation was the ocular adnexial manifestation and conjunctival microvasculopathy ranked highest (15.6%) in this group. Herpes zoster ophthalmicus was seen in 5 (1.2%) patients, presumed squamous cell carcinoma in 12(2.9%) and Kaposi sarcoma in 3(0.7%). Chorioretinitis was found in 12(2.9%), retinal microvasculopathy in 19(4.6%) and maculopathy in 15(3.6%). There was no case of CMV retinitis.

Conclusion: Ocular findings seen in HIV- positive patients were mostly adnexial and occurred in 37% of the study population.

Open Access Original Research Article

Pfcrt K76T and Pfmdr 1 Resistance Genes in Post Chloroquine Era in South-South Region of Nigeria

Tolulope Alade, Ewaoche Sunday Itodo, Ebidor Lawani, Gloria Adie, Mirabeau Youtchou Tatfeng

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/ijtdh/2019/v39i330208

Malaria, a global health problem especially in the sub-Sahara region has been posing a recurrent problem due to the resistance of the parasites to the available antimalarial drugs despite the preventive measures provided by WHO.

Aims: This study is aimed at determining the prevalence of resistance markers in four Niger Delta states of Nigeria, a decade after withdrawal of chloroquine.

Methods: Eight hundred and forty six (846) subjects participated in the study and were distributed as follows, 192(22.7%)  Bayelsa; 218(25.8%) Rivers; 196(23.2%) Edo and 240(28.4%) Delta respectively. Malaria parasite identification was carried out using standard parasitological techniques. Genotyping of the resistance markers Pfcrt K76T and Pfmdr 1 was carried out by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP).

Results: Our findings revealed that the prevalence of malaria infection in the four Niger Delta states were 78.1%, 68.8%, 62.8% and 58.8% in Bayelsa, Rivers States, Edo and Delta respectively. There was no statistical difference in the prevalence of malaria within the four Niger Delta states. (P>0.05). Children below the age of 5 years recorded the highest infection rates when compared to subjects in other age groups (P< 0.01). Our findings also revealed that the distribution of mutant Pfcrt K76T and Pfmdr 1 genes across the four states were 12.0% and 28.6%, 4.0% and 22.0%, 14.6% and 29.3%, 10.6% and 25.0% in Bayelsa, Rivers, Edo and Delta state respectively. However, the prevalence of Pfcrt K76T in Rivers State was statistically lower when compared to other states (P < 0.01) while no statistical difference existed in the distribution of Pfmdr 1 mutant genes (P>0.01).

Conclusion: Prevalence of Pfcrt and Pfmdr 1 remained elevated in the Niger Delta states despite the withdrawal of chloroquine over a decade ago. Hence, Nigeria is far from an eventual re-introduction of chloroquine as its resistance markers still persist in our communities. Furthermore, the root cause of the persistence of these resistance markers needs to be investigated.

Open Access Original Research Article

Socio-demographic Determinants of Vaccine Coverage for Pneumococcus and Rotavirus among under Five Children in Busolwe Town Council, Butaleja District, Eastern Uganda: A Cross Sectional Study

Brenda Wafana Nabwana, Sylvia Sidney Namayanja, Collette Kemigisha, Erina Kisakye, Amos Kuddiza Kusetula, Silvester Wakabi, Ivan Wambi, Innocent Musiime, Rebecca Nekaka, Yahaya Gavamukulya

International Journal of TROPICAL DISEASE & Health, Page 1-13
DOI: 10.9734/ijtdh/2019/v39i330209

Background and Aims: There is a high burden of vaccine-preventable diseases in the children under five years of age, particularly pneumonia diarrhea and which is greatly affected by low immunization coverage despite the existing efforts and policies. This study was carried out in Butaleja district and was aimed at establishing the socio-demographic determinants of vaccine coverage for pneumococcus and rotavirus among under five children (U5C) in the district.

Study Design: This was a mixed methods cross-sectional study.

Place and Duration of Study: Busolwe Town Council, Butaleja District, Eastern Uganda.

Methodology: Structured researcher administered questionnaires were administered to 434 caregivers of U5C in different parts of Butaleja district. In-depth interviews with key informants and focused group discussions with Village Health Teams and community members were conducted. Review of Health Management Information Systems records was done. STATA 15 was used to analyze the data.

Results: The study found that there is a declining trend in completion of the doses of Pneumococcal vaccine (PCV) and Rotavirus vaccine. For example, in quarter 1 of 2019, out of the 312 children who started immunization, only 2 completed Rota virus immunization and only 117 completed PCV vaccinations a trend that has been observed since 2016. The factors that showed a significant association with the the fact that they gave their child at least one dose of  the vaccine were having been sensitized on the current immunisation schedule(P-value = <0.001), misunderstanding that vaccine is harmful for child (P-value = 0.007), willingness to take children to vaccination (P-value = <0.001), and social factors such as family (P-value = <0.030). Gender also played a key determinant role where the children’s fathers lacked knowledge on significance of immunization and thus discouraged the mothers from taking the children for immunization. Inadequate funding was also highlighted from the Focus Group Discussions.

Conclusion: Vaccine coverage for pneumococcus and rotavirus is still low in Butaleja district mainly due to the attitudes and perceptions of caregivers as well as the knowledge gap. There is need for extensive sensitization of all community members to enable them understand the significance of immunization. It would further be important to increase the funding of the immunization programme to intensify and ensure effectual outreaches as well as the establishment and enforcement of a policy for immunization compliance.