Risk perception and correlates of alcohol use among out-of-school youth in motor parks in Lagos State, Nigeria

Background and Aim: The prevalence of alcohol use has increased globally. Out-of-school youth are a vulnerable group who might have missed opportunities for learning healthy behaviours in a formal school environment. The purpose of this study was to determine the risk perception, pattern of use, and correlates of alcohol use among out-of-school youth in Lagos, Nigeria. Methods: A cross-sectional study was conducted among 380 out-of-school youth in motor parks in Lagos State, Nigeria, using interviewer administered questionnaires. Results: The lifetime prevalence of alcohol use was 61.1%, while 55.5% were current drinkers. Beer (57.3%) was the most consumed type of alcohol, followed by distilled spirits (29.8%). Using the CAGE scoring system, more than half (57.8%) of the current drinkers had a drinking problem. Almost three quarters (70.1%) had experienced at least one episode of alcohol intoxication within the past month. A considerable number of current drinkers (63.5%) desired to reduce their alcohol intake or stop drinking, while 45.5% had made unsuccessful attempts to do so within the past year. Only 28.9% had received assistance to quit or reduce their drinking and of these less than half (39.3%) received assistance from a professional or healthcare worker. Males were more likely to be current drinkers and to have experienced episodes of alcohol intoxication. Parental and peer drinking were associated with alcohol use but not with intoxication. Conclusions: It is important to design specific programmes to reduce alcohol use among out-of-school youth in these settings.

Distinguishing predisposing factors for enamel hypoplasia and molar-incisor hypomineralization in children in Ile-Ife, Nigeria

Aim: To determine if the prevalence of enamel hypoplasia, molar-incisor hypomineralisation (MIH) and deciduous molar hypomineralisation (DMH) is associated with the socioeconomic status of the child and to determine the prevalence of enamel hypoplasia and MIH/DMH comorbidity in the study population. Methods: Information was collected on the sex and socioeconomic status of the 1,169 study participants’ resident in Ile-Ife, Nigeria, recruited through a household survey. The children were clinically examined to assess for the presence of enamel hypoplasia, MIH and DMH. Associations between sex, socioeconomic status and the prevalence of enamel hypoplasia, MIH and DMH were determined. The proportion of children with enamel hypoplasia and MIH/DMH co-morbidity was also determined. Results: Among the 1,169 study participants, 47(4.0%) had MIH, 15 (1.3%) had DMH and 161 (13.8%) had enamel hypoplasia. One (0.09%) study participant had MIH/DMH co-morbidity, 12 (1.0%) had DMH/enamel hypoplasia co-morbidity, and 9 (0.8%) had MIH/hypoplasia co-morbidity. There was no significant association between the socioeconomic status and presence of enamel hypoplasia (p=0.22), MIH (p=0.78) or DMH (p=1.00). Conclusions: The socioeconomic status cannot be used as a distinguishing factor for enamel hypoplasia, MIH and DMH. The possibility of co-existence of enamel hypoplasia and MIH/DMH makes it imperative to find ways to distinguish between the lesions.

Does social vulnerability for caries predict caries status of children in sub-urban Nigeria?

It is important to identify groups of people vulnerable to a disease condition. Aim: To determine the association between social vulnerability to caries and caries status of children in Ile-Ife, Nigeria. Methods: A composite vulnerability index for caries was developed using data generated for 992 children. Wilks’ Lambda test to verify relationship between vulnerability and its variables. Logistic regression analysis was conducted to determine if the social vulnerability for caries index was a good predictor for caries status. Results: The social vulnerability to caries index could not predict caries status. The study found that sex, age and number of siblings were the significant predictors of caries status in the study population. Females (AOR: 1.63; 95%CI: 1.08 – 2.46; p=0.02) and children with more than two siblings had higher odds of having caries (AOR: 2.61; 95%CI: 1.61 – 4.24; p<0.001) while children below 5 years had lower odds of having caries (AOR: 0.62; 95%CI: 0.39 – 1.00; p=0.05) Conclusions: The social vulnerability index for caries could not predict the caries status of children in the study population. Sensitive tools to identify children with caries in the study population should be developed.

Assessment of the storage and disposal of medicines in some homes in Jos north local government area of Plateau State, Nigeria

Purpose: The purpose of this study was to assess the way medicines are stored and disposed in some households in Jos North Local Government Area (LGA) of Plateau State, Nigeria. Methods: A cross-sectional survey of 130 households in Jos was carried out using a questionnaire to ascertain practices associated with medicine storage and their disposal. Results: The results showed that 105 (80.8%) households had 635 medicines in their homes, 65.8% of which were unused medicines (3.2 unused medicines per household). Some households stored their medicines in bags/containers (76.2%) while others kept them in cup-boards/cabinets (21.96%), refrigerators (10.5%) or other places (3.3%). Methods for disposal of unused drugs varied among households with some disposing them in trash cans (70.5%) while other disposed them in toilets (19.0%) or burnt them (10.5%). Only 10.5% (n=11) of respondents knew how medicines were properly disposed. Conclusion: While most households store their medicines appropriately, majority of them adopt poor disposal methods for medicines they no longer need in their homes. Public health education on problem disposal of medicines is of the essence.

False identification of other microorganisms as Staphylococcus aureus in Southern Nigeria

Purpose: Staphylococcus aureus is the causative agent of many infections and the advent MRSA has drawn much attention to it. However, some organisms have been noted to be wrongly identified as S. aureus through phenotypic identifications leading to wrong treatment of infections. This study is therefore undertaken to evaluate the rate of false identification of other organisms as S. aureus in Southern Nigeria. Methods: 507 microorganisms which have been previously identified as S. aureus in 8 States in Southern Nigeria through characteristic morphology on blood agar, Gram staining, growth and fermentation on Mannitol Salt Agar and coagulase formation were collected. All the isolates were identified in this study through sequencing of 16S rRNA and detection of spa gene. The percentages of true and false identities were determined. Results: Of the 507 isolates previously identified as S. aureus, only 54 (11 %) were confirmed as S. aureus while the rest were coagulase negative Staphylococci (85 % misidentification rate), Bacillus sp. (12 % misidentification rate), and Brevibacterium sp. (3 % misidentification rate). Conclusion: A high rate of false positive identification of S. aureus which could lead to the misuse of antibiotics in emergency situation has been identified in this study. The use of standard methods for the identification of S. aureus at all times is highly recommended.

Prevalence of AmpC β-lactamase among Gram-negative bacteria recovered from clinical specimens in Benin City, Nigeria

Purpose: Infections caused by AmpC-positive bacteria results in high patient morbidity and mortality making their detection clinically important as they cannot be detected in routine susceptibility testing. This study aim to determine the prevalence of AmpC β-lactamase among Gram negative bacteria recovered from clinical specimens in Benin City, Nigeria. Methods: A total of 256 consecutive and non-repetitive Gram negative bacteria were recovered from various clinical specimens. The prevalence of AmpC β-lactamase was determined using a combination of disc antagonism test and cefoxitin-cloxacillin inhibition test. Disc susceptibility test was performed on all isolates using standard techniques. Results: Cefoxitin-cloxacillin inhibition test detected more AmpC β-lactamase than other tests. The prevalence of AmpC β-lactamase did not differ significantly between both genders and between inpatients and out-patients (p>0.05). Isolates recovered from sputum had significantly higher prevalence of AmpC β-lactamase producers compared with isolates from other clinical specimens (p=0.0484). The prevalence of AmpC production was significantly higher among isolates of Pseudomonas aeruginosa than other isolates (p = 0.0085). Isolates that produced AmpC β-lactamase were more susceptible to the test cephalosoprins. Conclusion: An overall prevalence of AmpC β-lactamase (15.23 %) was observed in this study. Pseudomonas aeruginosa was the most prevalent producer of AmpC enzymes. Prudent use of antibiotics is advocated.

Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

Background: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.

Alstonine as an Antipsychotic: Effects on Brain Amines and Metabolic Changes

Managing schizophrenia has never been a trivial matter. Furthermore, while classical antipsychotics induce extrapyramidal side effects and hyperprolactinaemia, atypical antipsychotics lead to diabetes, hyperlipidaemia, and weight gain. Moreover, even with newer drugs, a sizable proportion of patients do not show significant improvement. Alstonine is an indole alkaloid identified as the major component of a plant-based remedy used in Nigeria to treat the mentally ill. Alstonine presents a clear antipsychotic profile in rodents, apparently with differential effects in distinct dopaminergic pathways. The aim of this study was to complement the antipsychotic profile of alstonine, verifying its effects on brain amines in mouse frontal cortex and striatum. Additionally, we examined if alstonine induces some hormonal and metabolic changes common to antipsychotics. HPLC data reveal that alstonine increases serotonergic transmission and increases intraneuronal dopamine catabolism. In relation to possible side effects, preliminary data suggest that alstonine does not affect prolactin levels, does not induce gains in body weight, but prevents the expected fasting-induced decrease in glucose levels. Overall, this study reinforces the proposal that alstonine is a potential innovative antipsychotic, and that a comprehensive understanding of its neurochemical basis may open new avenues to developing newer antipsychotic medications.

Antimicrobial activities of Garcinia kola on oral Fusobacterium nucleatum and biofilm

The extracts from the root, bark and seed of Garcinia kola are currently used in traditional medicine in Nigeria. The aim of this study was to evaluate the inhibitory activity of crude extracts of G. kola on Fusobacterium nucleatum isolated from the oral cavity. Methanol and aqueous extracts were prepared from the seed and the minimal inhibitory concentration was evaluated by the agar dilution method, using a Wilkins-Chalgren agar supplemented with horse blood (5%), hemin (5 mu g/ml) and menadione (1 mu g/ml). Antimicrobial activity of plant extracts on microbial biofilms was determined in microtiter plates. The seed of G. kola demonstrated significant inhibitory action on F. nucleatum isolates at a concentration of 1.25 and 12.5 mg/ml for amoxicillin resistant strain. It was able to inhibit the microbial biofilm formed by the association of F. nucleatum with Porphyromonas gingivalis ATCC 33277, Aggregatibacter actinomycetemcomitans ATCC 33384 and Prevotella intermedia ATCC 2564 at a concentration of 25 mg/ml. The in-vitro inhibitory effect of G. kola on F. nucleatum population suggests a potential role for its use in oral hygiene.

Transport of North African dust from the Bod,l, depression to the Amazon Basin: a case study

Through long-range transport of dust, the North-African desert supplies essential minerals to the Amazon rain forest. Since North African dust reaches South America mostly during the Northern Hemisphere winter, the dust sources active during winter are the main contributors to the forest. Given that the Bod,l, depression area in southwestern Chad is the main winter dust source, a close link is expected between the Bod,l, emission patterns and volumes and the mineral supply flux to the Amazon. Until now, the particular link between the Bod,l, and the Amazon forest was based on sparse satellite measurements and modeling studies. In this study, we combine a detailed analysis of space-borne and ground data with reanalysis model data and surface measurements taken in the central Amazon during the Amazonian Aerosol Characterization Experiment (AMAZE-08) in order to explore the validity and the nature of the proposed link between the Bod,l, depression and the Amazon forest. This case study follows the dust events of 11-16 and 18-27 February 2008, from the emission in the Bod,l, over West Africa (most likely with contribution from other dust sources in the region) the crossing of the Atlantic Ocean, to the observed effects above the Amazon canopy about 10 days after the emission. The dust was lifted by surface winds stronger than 14 m s(-1), usually starting early in the morning. The lofted dust, mixed with biomass burning aerosols over Nigeria, was transported over the Atlantic Ocean, and arrived over the South American continent. The top of the aerosol layer reached above 3 km, and the bottom merged with the boundary layer. The arrival of the dusty air parcel over the Amazon forest increased the average concentration of aerosol crustal elements by an order of magnitude.

Soil organic carbon and fertility interactions affected by a tillage chronosequence in a Brazilian Oxisol

No-till (NT) adoption is an essential tool for development of sustainable agricultural systems, and how NT affects the soil organic C (SOC) dynamics is a key component of these systems. The effect of a plow tillage (PT) and NT age chronosequence on SOC concentration and interactions with soil fertility were assessed in a variable charge Oxisol, located in the South Center quadrant of Parana State, Brazil (50 degrees 23`W and 24 degrees 36`S). The chronosequence consisted of the following six sites: (i) native field (NF); (ii) PT of the native field (PNF-1) involving conversion of natural vegetation to cropland; (iii) NT for 10 years (NT-10); (iv) NT for 20 years (NT-20); (v) NT for 22 years (NT-22); and (vi) conventional tillage for 22 years (CT-22) involving PT with one disking after summer harvest and one after winter harvest to 20 cm depth plus two harrow disking. Soil samples were collected from five depths (0-2.5; 2.5-5; 5-10; 10-20; and 20-40 cm) and SOC, pH (in H(2)O and KCl), Delta pH, potential acidity, exchangeable bases, and cation exchangeable capacity (CEC) were measured. An increase in SOC concentration positively affected the pH, the negative charge and the CEC and negatively impacted potential acidity. Regression analyses indicated a close relationship between the SOC concentration and other parameters measured in this study. The regression fitted between SOC concentration and CEC showed a close relationship. There was an increase in negative charge and CEC with increase in SOC concentration: CEC increased by 0.37 cmol(c) kg(-1) for every g of C kg(-1) soil. The ratio of ECEC:SOC was 0.23 cmol(c) kg(-1) for NF and increased to 0.49 cmol(c) kg(-1) for NT-22. The rates of P and K for 0-10 cm depth increased by 9.66 kg ha(-1) yr(-1) and 17.93 kg ha(-1) yr(-1), respectively, with NF as a base line. The data presented support the conclusion that long-term NT is a useful strategy for improving fertility of soils with variable charge. (C) 2008 Elsevier B.V. All rights reserved.

Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.

Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys

Background Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.