Wesley Guild Hospital

The objectives of this study were to estimate the prevalence of depressive disorder in late pregnancy in a group of Nigerian women and to examine the associated factors. One hundred and eighty women in late pregnancy completed a questionnaire on sociodemographic and obstetrical details. They also completed the Edinburgh Postnatal Depression Scale (EPDS). A proportion of them were then assessed for the DSM-IV diagnosis of depressive disorder. Fifteen (8.3%) women met the current (2 weeks) DSM-IV diagnosis of depressive disorder. The factors independently associated with depression included being single [odds ratio (OR)=16.67, 95% confidence interval (CI)=3.17-87.76], divorced/separated (OR=11.11, 95% CI=1.55-19.65), polygamous (OR=3.92, 95% CI=0.94-16.33), and having a previous history of stillbirth (OR=8.00, 95% CI=1.70-37.57) and perceived lack of social support (OR=6.08, 95% CI=1.42-26.04). Depression is common in late pregnancy among Nigerian women, with the significant correlates including mainly social and family factors. Such factors should be considered when planning health care services or formulating a predictive model. Interventions aimed at reducing the occurrence of antenatal depression need further research.

OBJECTIVE: To estimate the prevalence of post-traumatic stress disorder (PTSD) after childbirth in a group of postpartum Nigerian women and to examine any associated factors. DESIGN: A cross-sectional survey. SETTING: Postnatal clinics and infant immunisation clinics of the five health centres in Ilesa Township, Nigeria. POPULATION: A total of 876 women at 6 weeks postpartum. METHODS: The postpartum women were assessed for PTSD at 6 weeks. Other data collected were demographic characteristics, details of pregnancy and delivery and neonatal outcome. Additionally, the following measures were used: the MINI International Neuropsychiatric Interview to assess PTSD, the Index of Marital Satisfaction to measure the degree of problem a spouse encounters in the marital relationship, the Medical Outcome Study Social Support Survey to measure social support, the Life Events Scale to measure the life stress covering the preceding 12 months and the Labour Agentry Scale that measures the maternal experiences of control during childbirth. MAIN OUTCOME MEASURES: Prevalence of PTSD in this population of postpartum Nigerian women, and how this prevalence related to other maternal and neonatal characteristics. RESULTS: The prevalence of PTSD was 5.9%. The factors independently associated with PTSD after childbirth include hospital admission due to pregnancy complications (OR 11.86, 95% CI 6.36-22.10), instrumental delivery (OR 7.94, 95% CI 3.91-16.15), emergency caesarean section (OR 7.31, 95% CI 3.53-15.10), manual removal of placenta (OR 4.96, 95% CI 2.43-10.14) and poor maternal experience of control during childbirth (OR 5.05, 95% CI 2.69-9.48). CONCLUSIONS: The prevalence of PTSD after childbirth in Nigerian women is slightly higher than those found in western culture. An effective model for the prediction of the development of PTSD after childbirth needs to be developed and evaluated, and interventions aimed at reducing the incidence of PTSD after childbirth need further research.

AIMS: To investigate the screening properties of the alcohol use disorders identification test (AUDIT) in the detection of alcohol-related problems among Nigerian university students. METHODS: Eight hundred and ten students completed the AUDIT. A percentage of them were assessed for alcohol-related diagnosis with structured clinical interview. RESULTS: The AUDIT at cut-off of 5 and above could clearly identify participants with alcohol-related problems with sensitivity of 0.935 and specificity of 0.915. CONCLUSIONS: The AUDIT is a valid instrument for screening for alcohol-related problems in Nigerian university students.

OBJECTIVE: Studies from the Western culture have emphasized psychosocial risk factors for the development of postnatal depression (PND). In Africa, poor obstetrics practice and sociodemographic factors may contribute significantly to the risk of PND. The goal of this study was to examine sociodemographic and obstetric risk factors for postnatal depressive symptoms in a Nigerian community. METHODS: 876 women recruited at 6 weeks postpartum from the postnatal and infant immunization clinics of 5 participating health centers were screened with the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic and obstetric information were also obtained through a structured questionnaire. RESULTS: The mean EPDS score was 5.66 (SD = 4.20). Depression was diagnosed in 128 (14.6 %) of the postpartum women. The predictors of PND include hospital admissions during the pregnancy (OR 3.95, CI 2.57-6.07), female sex of the baby (OR 2.74, CI 1.87-4.03), preterm delivery (OR 4.21, CI 2.78-6.39), instrumental delivery (OR 3.32, CI 1.79-6.16), Cesarean section (OR 3.58, CI 1.72-7.48), and being single (OR 3.44, CI 2.15-5.53). CONCLUSION: Although the prevalence of PND symptoms seems to be the same across cultures, risk factors differ significantly. This study identified certain sociodemographic and obstetric risk factors for postnatal depressive symptoms in an underdeveloped community. These factors must be taken into consideration when planning intervention and preventive strategies for these women.

1. An investigation of measles was made in Nigeria as part of a longitudinal study of 405 village children, supplemented by observations on 1,283 children admitted to a Mission Hospital with the disease. 2. Measles was found to be the most serious of the acute infectious diseases of Nigerian children. During the Imesi village study measles played a major part in the death of 15, or 7% of the 222 children who were seen with measles. The overall case mortality in Nigeria is believed to be in the region of 5%. For children admitted to hospital with the complications of measles, a mortality in excess of 20% is not infrequent. This contrasts with the present situation in Northern Europe and America, where measles is of relatively minor public health importance. 3. Bronchopneumonia was present in nearly half the children needing admission to hospital. Of those with bronchopneumonia, 28% died. 4. Diarrhoea occurred in all stages of the disease, but was most common and severe during and following the period of desquamation. Treatment by parenteral fluid to combat dehydration was required in 55% of children admitted with this complication. 5. Extensive loss of weight was associated with the disease in the majority of children. In the village study nearly one child in four lost 10% of his former weight. The mean time taken to recover former weight was 7·2 weeks. 6. Children frequently developed marasmus and kwashiorkor after an attack of measles. 7. Striking appearances were observed in the rash and subsequently in the skin. In some children the rash darkened in colour in the manner described by Rhazes and other early writers. Extensive desquamation often appeared after the rash. The desquamation was most severe when the rash darkened. 8. The picture of measles in this study resembles descriptions of the disease to be found in the older literature. Accounts of the incidence and severity of bronchopneumonia, laryngitis, diarrhoea and weight loss before 1920 are presented to illustrate this similarity. 9. Possible reasons for differences in the frequency and severity of measles in different places and epochs are discussed. Differences in strains of the virus and host immunity seem unlikely factors, but liability to secondary infections may be of some importance. It is concluded that the severity of the disease is related to the manifestations of the rash. A dark rash, followed by profuse desquamation, is associated with equivalent changes in the larynx, bronchus, and intestines, which are likely to be responsible for the occurrence of bronchopneumonia, laryngitis and diarrhoea. Defective nutrition is a possible cause of the ‘vulnerability’ of the epithelium. The analysis of the data from Nigeria was made possible by the payment of expenses to Dr Morley by the London School of Hygiene and Tropical Medicine from July 1960 to December 1961. Subsequently the work was supported by a grant from the Medical Research Council to Prof. B. S. Platt, Head of the Department of Human Nutrition, London School of Hygiene and Tropical Medicine. The authors wish to thank Dr W. R. Aykroyd, Senior Lecturer, Department of Human Nutrition, for his encouragement and assistance in preparing the text, and Miss Allen and Miss Wise for secretarial help. They must also thank Professor Court of the Department of Child Health in the University of Durham for helpful criticism.

The tropical fruit Carica papaya and its seeds have proven antihelminthic and anti-amoebic activities. To determine the effectiveness of air-dried C. papaya seeds on human intestinal parasitosis, 60 asymptomatic Nigerian children with stool microscopic evidence of intestinal parasites received immediate doses (20 mL) of either an elixir composed with air-dried C. papaya seeds and honey (CPH) or honey alone (placebo) in two randomized treatment groups. Repeat stool microscopic examinations were conducted 7 days postintervention for intestinal parasites. Significantly more subjects given CPH elixir than those given honey had their stools cleared of parasites [23 of 30 (76.7%) vs. five of 30 (16.7%); z = 4.40, P = .0000109]. There were no harmful effects. The stool clearance rate for the various types of parasites encountered was between 71.4% and 100% following CPH elixir treatment compared with 0-15.4% with honey. Thus, air-dried C. papaya seeds are efficacious in treating human intestinal parasites and without significant side effects. Their consumption offers a cheap, natural, harmless, readily available monotherapy and preventive strategy against intestinal parasitosis, especially in tropical communities. Further and large-scale intervention studies to compare C. papaya with standard antiparasitic preparation are desirous.

Two groups (A and B), each of 52 children, were selected from a study population of 405 children. Group A were the children whose weights fell below the 10th percentile at 6, 9 or 12 months of age. Group B were considered to be of satisfactory weight and were always above the 50th percentile at these ages. The children in the two groups were found to retain their relative weight position during the succeeding 4 years. A similar poor or satisfactory weight gain was also found in their younger siblings. The records of the children in these two groups and their families were examined for anthropometric, social, economic and medical factors to try and discover methods of predicting which children were liable to be underweight. Factors were examined under 17 headings. 9 of these were considered to be useful and if they are verified by other studies may be used by those caring for small children in developing countries as ‘Indications for special care.’

group. Blood films were examined in the hospital laboratory by locally trained technicians, and spot checks of

<h3>Background:</h3> The University of Queensland (UQ), Ochsner Clinical School (OCS) is a partnership between Ochsner Health System in New Orleans, LA, and UQ in Brisbane, Australia. OCS medical students are trained on both continents, receiving their didactic education in Australia and their clinical education in the United States. <h3>Methods:</h3> We review the OCS experience and compare the pediatric rotations at OCS and UQ. <h3>Results:</h3> Students in the pediatric rotations in Australia and in the United States receive their clinical instruction in the real-world learning environment of hospitals and clinics. In addition, lectures, online learning modules, case-based tutorials, and rigorous assessment at the end of the rotation help prepare medical students for future contact with pediatric patients. Sixty-nine third-year OCS students and 499 fourth-year UQ students completed the pediatric rotation in 2014. In 2015, 105 third-year OCS students and approximately 400 fourth-year UQ students completed the pediatric rotation. <h3>Conclusion:</h3> In a unique educational collaboration, OCS has used e-learning and face-to-face tutorials to produce a well-rounded curriculum that assimilates global healthcare and international medicine. This article demonstrates the feasibility of delivering a standardized curriculum across two continents using modern e-learning tools.

Objective The objective of this study is to compare the prevalence of depression in postpartum women and that of non-postpartum women. Method A total of 876 women recruited at 6 weeks postpartum and 900 matched non-postpartum women were administered the Beck's Depressive Inventory (BDI) and translated local version of the EPDS. Psychiatric diagnosis was made using the using the modified non-patient version of Structured Clinical Interview for DSM-III-R (SCID-NP). Results Depressive disorder was diagnosed in 128 (14.6%) of the postpartum women and in 55 (6.3%) of the non-postpartum women, and the difference was found to be significant (t=8.919, df=875, P<0.001). The postpartum women had higher EPDS and BDI scores than the non-postpartum women. The EPDS correlated well with the SCID-NP diagnosis with a Spearman's correlation of 0.600 (P<0.001) and with the BDI score with a Spearman's correlation of 0.461 (P<0.001). The sensitivity of the EPDS at cut-off score of 8/9 was 94% and specificity was 97%. Conclusion The prevalence of postnatal depression in Nigeria is comparable to that of the western world and the Yoruba version of EPDS is a valid instrument for screening postnatal women for depressive disorders in a Nigerian community.

PURPOSE: The study assessed the school performance of Nigerian adolescents with epilepsy compared with healthy controls and examined the variables correlating with their academic difficulties. METHODS: The school grades of adolescents with epilepsy aged 12 to 18 years (n = 73) over the past academic year were compared with the grades of their classmates of the same age and gender. Risk factors possibly associated with school performance, such as adolescent variables (age, gender, perceived stigma, attitude toward epilepsy, and psychopathology), seizure variables (age at onset of illness, years of illness, types of seizures, and frequency of seizures per month), drug variables [types of antiepileptic drugs (AEDs), number of AEDs and side effects of AEDs], and family variables (family's socioeconomic status, family functioning, caretakers' psychopathology, and caretakers' perceived stigma) were assessed. RESULTS: The mean school grades of adolescents with epilepsy are significantly lower than are those of their healthy controls (p < 0.001) in all the subjects. The variables that significantly predict poor school performance in adolescents with epilepsy include psychopathology in the caretaker (p < 0.001), adolescents' perceived poor family functioning (p = 0.002), adolescents' attitude toward the illness (p = 0.001), adolescents' felt stigma (p = 0.002), externalizing symptoms in the adolescents (p = 0.004), and duration of illness (p = 0.024). CONCLUSIONS: The determinants of poor school performance in adolescents with epilepsy in Nigeria are multivariate, with psychosocial factors most important. These should be noted for early identification and screening of those children at greatest risk for academic failure and the greatest need for appropriate educational remediation services.

OBJECTIVE: To clinically compare the healing of abscess wounds dressed with either crude undiluted honey or Edinburgh University solution of lime (EUSOL). DESIGN: A prospective clinical randomized study. LOCATION: The Isolation Children's Ward of the Wesley Guild Hospital, Ilesa, an affiliate of the Obafemi Awolowo University, Ile-Ife, Nigeria. SUBJECTS: Thirty-two (32) Nigerian children with 43 pyomyositis abcesses. INTERVENTIONS: All subjects had fresh surgical incision and drainage of the abcesses and a 21-day course of ampicillin plus cloxacillin (Ampiclox) and gentamicin; the wounds were left to close spontaneously with twice-daily wound dressing with packing of the abscess cavity with either honey- or EUSOL-soaked gauze in two randomized treatment groups. OUTCOME MEASURES: The clinical conditions of the wound sites were documented on days 1, 3, 7, and 21 as either clean or dirty, dry or wet, granulation tissue present or absent, and epithelialization present or absent; the length of hospital stay was also measured. RESULTS: Honey-treated wounds demonstrated quicker healing and the length of hospital stay was significantly shorter in patients with honey-treated wounds than those treated with EUSOL (t = 2.45, p = 0.019). CONCLUSIONS: Honey is a superior wound dressing agent to EUSOL. Honey is recommended for the dressing of infected wounds, more so in tropical countries, where it is most readily available.

One hundred and fifty cases of typhoid in infants and young children are reported. In children over 5 years of age the features resembled those in adults, but in those under this age they were often nonspecific including fever, convulsions, diarrhoea, and vomiting. Attention is drawn to the importance of a blood culture in anaemic afebrile children who develop rigors and high fever after blood transfusions.

Journal Article A medical service for children under five years of age in West Africa Get access David Morley, M.D., D.C.H. David Morley, M.D., D.C.H. formerly Paediatrician Department of Human Nutrition, London School of Hygiene and Tropical Medicine UKChild Health Unit, West African Council for Medical Research, Wesley Guild Hospital, Ilesha, Western Nigeria Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 57, Issue 2, March 1963, Pages 79–88, https://doi.org/10.1016/0035-9203(63)90019-1 Published: 01 March 1963

OBJECTIVE: This report explored early postpartum mood changes and their correlation with postnatal depression in African women. METHOD: Scores on the Maternity Blues Scale and the Edinburgh Postnatal Depression Scale for 478 women on the fifth day postpartum were compared with the women's Research Diagnostic Criteria diagnosis at 4 and 8 weeks postpartum. RESULTS: The Maternity Blues Scale and the Edinburgh Postnatal Depression Scale scores at day 5 postpartum were found to reliably predict the diagnosis of depression at 4 and 8 weeks postpartum. CONCLUSIONS: African women at risk of postnatal depression can be identified in the early postnatal period by incorporating simple screening methods.

This study sought to investigate the relationship between parental psychopathology and health-related quality of life in a group of Nigerian adolescents with epilepsy. The participants were 86 adolescents with epilepsy (50 males, 36 females; mean age 14y 5mo [SD 2y 1mo]; age range 12-18y). There were 54 (62.8%) adolescents with complex partial seizures, six (7.0%) with simple partial seizures, 14 (16.3%) with generalized tonic-clonic seizures, four (4.7%) with absence seizures, and eight (9.2%) with other types of seizure. They completed the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48). Parents also completed the General Health Questionnaire, Zung's Self-Rating Anxiety Scale, and Zung's Self-Rating Depressive Scale as measures of their psychopathology. Factors correlating with poor overall quality of life in the adolescents include longer duration of illness, large number of antiepileptic drugs, more severe medication toxicity, and psychopathology in the parents. General psychopathology in parents is significantly associated with QOLIE-AD-48 subscales of Epilepsy Impact (r=0.527, p<0.001), Attitude (r=0.214, p=0.047), Physical Function (r=0.417, p<0.001), Stigma (r=0.305, p=0.004), Social Support (r=0.365, p=0.001), and School Behaviour (r=0.220, p=0.042). There is a possibility of a cross-cultural difference on the effect of epilepsy on the quality of life of adolescents. Psychopathology in parents is significantly associated with poorer quality of life of these adolescents. Physicians should consider this, therefore, when planning intervention strategies in improving the quality of life in adolescents with epilepsy.

BACKGROUND: Epilepsy is a chronic disorder marked by intermittent, often unpredictable seizures which may be embarrassing and disruptive to the normal activity of daily living. This review was undertaken to provide information / data on the prevalence, seizure types, treatment issues and psychosocial impact of epilepsy in Nigeria. METHOD: We searched the PUBMED database with emphasis on studies conducted in Nigeria using a combination of the following words: epilepsy, seizure, convulsion, prevalence, epidemiology, psychiatric morbidity, social issues, quality of life, cognition, school performance, treatment issues and Nigeria. RESULT: 48 relevant studies that met the criteria were reviewed. The point prevalence of epilepsy varies from 5.3 to 37 per 1000 in Nigeria. Most studies showed a predominance of generalized tonic-clonic seizures. Nigerian patients with epilepsy suffer social deprivation and discrimination in education, employment, housing, marital life as well as associated psychiatric morbidity. CONCLUSION: Epilepsy, a stigmatizing disorder in Nigeria, has a significant impact on the day to day functioning of those with the condition.

The COVID-19 infection has been a matter of urgency to tackle around the world today, there exist 200 countries around the world and 54 countries in Africa that the COVID-19 infection cases have been confirmed. This situation prompted us to look into the challenges African laboratories are facing in the diagnosis of novel COVID-19 infection. A limited supply of essential laboratory equipment and test kits are some of the challenges faced in combatting the novel virus in Africa. Also, there is inadequate skilled personnel, which might pose a significant danger in case there is a surge in COVID-19 infection cases. The choice of diagnostic method in Africa is limited as there are only two available diagnostic methods being used out of the six methods used globally, thereby reducing the opportunity of supplementary diagnosis, which will further lead to inappropriate diagnosis and affect the accuracy of diagnostic reports. Furthermore, challenges like inadequate power supply, the method used in sample collection, storage and transportation of specimens are also significant as they also pose their respective implication. From the observations, there is an urgent need for more investment into the laboratories for proper, timely, and accurate diagnosis of COVID-19.

The serum protein patterns of groups of Nigerians including 98 children partially protected by "daraprim" against malaria, and 113 unprotected children, have been studied. The protected children have a significantly lower concentration of serum gamma globulin than the unprotected children from the age of 12 months onwards. In children, sicklers have a significantly higher serum gamma globulin than non-sicklers. It is suggested that sickling protects against malaria by enhancing the antibody response against the malaria parasite.

1. Approximately 1000 Nigerian children between the age of 6 months and 2 years were given Enders ‘B’ meásles vaccine, combined with gamma globulin in all except 120 children. A control group of similar numbers received gamma globulin alone plus inert material. 2. In a preliminary village study the 26 vaccinated children remained free of measles, 19 of the 27 control children developed measles and 2 of these children died. 3. In a blind study among children attending the large child out-patient clinic at the Ilesha hospital, a follow up was also attempted but was more difficult. In all, 272 cases of ‘measles-like’ illness were seen, 192 in control children, and 80 in the vaccinated group. The number in the vaccinated group is believed to be a reflexion of the difficulties under which this diagnosis was made, rather than a failure of the vaccine to immunize. Eleven children are known to have died from measles. All these 11 were in the control group who had not had vaccine. 4. The control children showed a smaller mean gain in weight than the vaccinated in the months following inoculation. The difference may have been due to poor weight-gain among the control children who developed measles. This work was supported in part by the Health Research Council of the City of New York under contract U 1056 and by the office of the Surgeon General, Department of the U.S. Army, sponsored by the Commission on Viral Infection Armed Forces Epidemiological Board. We wish to thank Dr W. J. Martin, Ph.D., D.Sc. and Miss I. Allen of the Medical Research Council's Statistical Unit for Statistical help. The vaccines and gamma globulin were supplied by Dr Maurice Hilleman, Director, Merck Institute for Therapeutic Research.