Health Care In Nigeria Research Articles

Integrated Primary Palliative Care in Nigeria- Perspectives of Patients, Families and Providers.

Palliative care should be integrated into primary healthcare systems within low- and middle-income countries to achieve Universal Health Coverage goals. We aimed to identify preferences and expectations for primary palliative care among people living with serious illness and their families and the readiness of primary healthcare providers to deliver primary palliative care in Nigeria. Qualitative descriptive interview study with 48 participants: people living with serious illness (n=21) and their family caregivers (n=15), healthcare providers (n=12). Data were analysed using thematic analysis. Three major themes were identified. 1.) Engaging patients and families. 2.) Managing patients and families' expectations and preferences. 3.) Addressing staffing-related issues. Patients and families have existing trust and bonds from using primary healthcare but lack individual agency necessary for person-centered care decisions. They expect an easily accessible service, opportunities for social interaction and adequate communication. Development of healthcare providers is needed to ensure an appropriate clinical response, manage interprofessional trust and ensure clear role delineation. Our findings have identified specific approaches to implement the WHO policy on integrated primary palliative care. Palliative care integration within primary healthcare in Nigeria can be achieved through building information and communication skills of healthcare providers, engaging and empowering patients to exercise their agency in care decisions, and adequately delineating healthcare providers' roles to ensure staff work within their competencies and training.

Practices and perception of healthcare workers towards infection control measures during the COVID-19 pandemic: a cross-sectional online survey from Nigeria.

This study investigated the practices and perceptions of Health care workers (HCWs) in Nigeria towards infection control practices during the COVID-19 pandemic. This cross-sectional study was conducted among HCWs in Nigeria healthcare facilities using a 25-item validated online questionnaire. The hyperlink of the questionnaire was shared with the various professional associations/societies and hospitals in June 2020. A total of 426 HCWs completed the questionnaire with pharmacists (28.8%), nurses/midwives (22.7%) and medical doctors (20.1%) being the highest respondents. Less than 50% of the HCWs had previous training on COVID-19 and how to use personal protective equipment (PPE). Only one in five HCWs had access to adequate PPE during the COVID-19 pandemic. Overall, the HCWs had good infection control practices with better practices observed among those who attended training on COVID-19 infection and those trained on how to use PPE. Lack of funds to purchase PPEs (55.3%), lack of access to PPE (52.5%) and lack of training on how to use PPE (44.0%) were the most common barriers to adherence to infection control guidelines. HCWs in Nigeria have limited access to adequate PPE and lack adequate support from health authorities. Attendance of training on the use of PPE and COVID-19 infection were associated with access to adequate PPE and better infection control practices. Training of HCWs, provision of adequate PPE, and support are recommended to improve compliance with infection control guidelines.

"I don't like to be seen by a male provider": health workers' strike, economic, and sociocultural reasons for home birth in settings with free maternal healthcare in Nigeria.

Ending maternal mortality has been a significant global health priority for decades. Many sub-Saharan African countries introduced user fee removal policies to attain this goal and ensure universal access to health facility delivery. However, many women in Nigeria continue to deliver at home. We examined the reasons for home birth in settings with free maternal healthcare in Southwestern and North Central Nigeria. We adopted a fully mixed, sequential, equal-status design. For the quantitative study, we drew data from 211 women who reported giving birth at home from a survey of 1227 women of reproductive age who gave birth in the 5y before the survey. The qualitative study involved six focus group discussions and 68 in-depth interviews. Data generated through the interviews were coded and subjected to inductive thematic analysis, while descriptive statistics were used to analyse the quantitative data. Women faced several barriers that limited their use of skilled birth attendants. These barriers operate at multiple levels and could be grouped as economic, sociocultural and health facility-related factors. Despite the user fee removal policy, lack of transportation, birth unpreparedness and lack of money pushed women to give birth at home. Also, sociocultural reasons such as hospital delivery not being deemed necessary in the community, women not wanting to be seen by male health workers, husbands not motivated and husbands' disapproval hindered the use of health facilities for childbirth. This study has demonstrated that free healthcare does not guarantee universal access to healthcare. Interventions, especially in the Nasarawa state of Nigeria, should focus on the education of mothers on the importance of health facility-based delivery and birth preparedness.

Obstructed Labour as Seen in Umuahia; Southeast Nigeria

Background: Obstructed labour is one of the leading causes of maternal mortality accounting for 8% of maternal deaths globally and consuming scare resources budgeted for healthcare in Nigeria and Sub-Saharan Africa. Materials and Methods: This was a retrospective study carried out at the department of obstetrics and gynecology, Federal Medical Center Umuahia, Southeast Nigeria. The folders of all women who were diagnosed with obstructed labor in a 10-year period between January 2006 and December 2015 were retrieved and data extracted. The data was analyzed using proportions, frequencies, and percentages. Objective: To evaluate the sociodemographic profile, causes and feto - maternal outcomes of obstructed labor at the Federal Medical Center Umuahia. Results: The incidence of obstructed labor was 2.2%. Most of the women (93.7%) were between 20 and 39 years of age, (58.2%) were nulliparous while. Majority (61.1%) had secondary education though (93.7%) of the patients were unbooked. The commonest cause was cephalopelvic disproportion (61.2%) followed by malpresentation (30.5%). Commonest mode of delivery was emergency caesarean section (90.0%) and the least was symphysiotomy 3(1.2%). Hysterectomy 10 (4.2%) or uterine repair 11(4.6%) with or without bilateral tubal ligation were done for those with uterine rupture. The most frequent maternal complication was puerperal sepsis (26.2%) and there were 3(1.3%) maternal deaths. Majority (72.4%) of the babies were live births while 27.6% were stillbirths. Conclusion: Over ninety percent of the cases of obstructed labor were unbooked in this study. There is a need for education on the importance of antenatal care and skilled supervision during labor.

Comparative Analysis of the Legal Approach to Mental Health in Nigeria and Netherlands

Awareness of mental health is gradually gaining prominence around the globe as many people are beginning to speak up. Some persons suffering from these illnesses have reduced their encounters into books which have further been translated into movies and plays. Attention to mental health is now on the rise as Non-Governmental Organizations NGOs) are supporting the cause, laws, and policies are being put in place to promote mental wellbeing. The work brought about the enlightenment of the legal approach to mental health in Nigeria and the Netherlands, to ensure that more people are well-informed and aware of how the wrong attitude to mental health can pose a great challenge to the cause, and to adopt a more advanced and working system for a better mental health approach in Nigeria. The paper adopted the doctrinal method of research and made use of primary and secondary sources of materials. The legal approach to mental health in Nigeria is developing slowly as there is a considerable distance in the level of awareness, response, and treatment of mental health and wellbeing of most people in Nigeria. The paper concluded that there is a need for mental health policies in Nigeria to be in line with World Health Organization (WHO) guidelines especially the creation of mental health courts and adequate budgetary allocation for mental health facilities and service providers. It is recommended that for Nigeria to guarantee the highest standard of mental and physical well-being for its populace, the WHO guidelines must be adhered to.

Methanol Stem Bark Extract of Ficus platyphylla Protects Against Carbon Tetrachloride-Induced Liver Damage in Wistar Rats

Ficus platyphylla (Gutta percha tree) is used in Nigerian traditional medicine for treating pain and psychosis. This study evaluated the protective effect of methanol stem bark extract of Ficus platyhylla (MEFP) against carbon tetrachloride (CCl4)-induced liver injury in Wistar rats. Rats were allotted into six groups namely normal control, negative control, standard drug (silymarin) and extract treated (100, 200 and 400 mg/kg p.o. respectively) groups. Treatment was administered for 7 days. Animals in groups II-VI received a single dose of CCl4 (1:1) p.o. in olive oil at 1.5 ml/kg body weight after last treatment. Experimental rats were sacrificed after 24 hours of CCl4 administration and blood samples collected for determination of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities. Supernatant of liver homogenate was used to determine activities of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx). Results indicate increased activities (p < 0.05) in CAT, SOD and GPx in samples of MEFP treated rats while levels of ALT and AST in serum samples of treated groups differ significantly (p<0.05) when compared with negative control group (Group III). Treatment with methanol stem bark extract of Ficus platyphylla may have offered protection against CCl4 induced liver damage in experimental rats.

Central nervous system depressant activity of ethanol extract of Motandra guineensis (Thonn) AD. aerial parts in mice

BackgroundMotandra guineensis Thonn AD. (Apocynaceae) is used for the management of pain and as a sedative in the treatment of insanity in Nigerian traditional medicine. The study investigated the neuropharmacological activities of the aerial parts of M. guineensis in mice. MethodsClassical models of tail suspension, forced swim, open field, hole board, elevated plus maze, and sodium pentobarbital-induced sleeping time tests were employed and the extract was administered at doses of 50,100 and 200 mg/kg, p.o. Oral acute toxicity test was done at the dose of 2000 mg/kg. The extract was also subjected to phytochemical tests and GC–MS analysis. ResultsIn tail suspension test, the extract at the dose of 200 mg/kg significantly reduced immobility time of mice compared to control while in the forced swim test, immobility time of the mice decreased in a dose-dependant manner. In the open field test, there was a significant and dose-dependant reduction in the number of lines and squares crossed compared with control. The number of head dips in the hole-board test was decreased in the extract treated groups compared to control. The extract significantly increased the time spent in the open arms of elevated plus-maze apparatus at higher doses (100 and 200 mg/kg) compared to control. The phenobarbitone-induced sleeping time was prolonged by the extract at all doses compared to control. There was no death recorded for the extract at the dose of 2000 mg/kg. ConclusionThe results indicate possible CNS depressant effect of the ethanol extract of M. guineensis, thus support the use of the plant as a sedative in the treatment of insanity in Nigerian traditional medicine.

Hura crepitans stem bark extract: A potential remedy to sub-acute liver damage

Ethnopharmacological significance and aimHura crepitans is commonly used to treat liver diseases in Nigeria and Ghana. Previous studies have supported its ethnomedicinal use in protecting the liver. The present study aimed at assessing the effect of H. crepitans stem bark on the subacute carbon tetrachloride (CCl4)-induced liver damage in rats. Materials and methodsThe protective activities of ethanolic extract of H. crepitans stem bark was evaluated in CCl4-induced subacute liver damage in rats (1:1 v/v in olive oil, intraperitoneally (i.p.), twice weekly for 8 weeks). Blood samples were obtained from the rats and used for some biochemical analysis such as liver function test (Aspartate transaminase, AST; Alanine aminotransferase, ALT; and Alkaline phosphatase, ALP), liver fibrotic indices (Aspartate platelet ratio index, APRI; AST/ALT and AST/PLT ratios) and oxidative stress markers (Malondialdehyde, MDA; Reduced glutathione, GSH; Glutathione S-transferase, GST; Glutathione peroxidase, GPx; and superoxide dismutase, SOD). Histopathological analyses were carried out to determine the expression of pro-inflammatory (NF-κB, COX-2, IL-17 and IL-23) using immunohistochemical techniques. ResultsOral administration of H. crepitans to CCl4-induced hepatic injured rats significantly decreased oxidative stress, increased the levels of SOD, GSH, GST and GPx with reduced MDA levels. The plant also mitigated liver injury as evidenced in the significantly reduced levels of AST, ALT and ALP, while it inhibited the inflammatory process via the inhibition of NF-κB, and consequently down-regulateed the pro-inflammatory cytokines COX-2, IL-17 and IL-23, respectively. Biochemical observations were supported by improvement in liver microarchitecture. ConclusionThe Hura crepitans demonstrated antioxidant, antiinflammatory and antifibrotic effect in hepatic injured rats. The study in a way justifies the traditional use of the plant for the treatment of subacute liver diseases in Nigerian Traditional medicine.

Antinociceptive and Behavioural Effects of the Leaves of Milicia excelsa (Welw.) C. C. Berg (Moraceae)

The leaves of Milicia excelsa (Welw.) C. C. Berg (Moraceae) is used in the treatment of inflammatory and painful disorders and as sedative in the treatment of insanity in Nigerian traditional medicine. The antinociceptive activity of the ethanol extract (50, 100 and 200 mg/kg, p.o.) was investigated using acetic acid-induced writhing, hot plate and formalin-induced paw licking tests while the behavioural assessment was evaluated in holeboard, elevated plus maze and phenobarbitone-induced sleeping time tests. Acetylsalicylic acid, morphine or diazepam and 1% Tween 20 (10 mL/kg) were employed as positive and negative control respectively. Acute toxicity of the extract (200-3200 mg/kg, p.o.) was also determined.

Comparative assessment of the anti-diarrhoeal effects of the ethanol leaf and stem extracts of lantana camara in Wistar rats

The antidiarrhoeal effects of Lantana camara ethanol leaf and stem extracts were compared in Wistar rats. The phytochemical and acute toxicity tests were also determined. The extracts were evaluated for castor oil- induced diarrhoea and enteropooling as well as intestinal transit in rats. The ethanol stem extract produced significant (P < 0.05), while the ethanol leaf extract produced significant (P < 0.01) dose dependent protection on rats against castor oil induced diarrhoea. The stem extract inhibited intestinal transit time and caused significant (P < 0.05), while leaf extract caused significant (P < 0.01) dose related inhibition of castor oil induced enteropooling in rats, comparable to the standard drugs. The leaf and stem extracts significantly and dose dependently delayed the onset of castor oil induced diarrhoea, decreased the frequency of defecation and reduced the severity of diarrhoea in rats. The ethanol leaf and stem extracts of L. camara significantly and dose dependently decreased the volume of intestinal fluid accumulation in the castor oil induced enteropooling. The distance travelled by charcoal meal in intestinal transit time was also reduced. The oral LD50 values obtained were greater than 5000 mg/kg in rats. These findings suggest that both ethanol leaf and stem extracts of Lantana camara may contain some biologically active ingredients that are active for the treatment of diarrhoea in Nigerian herbal traditional medicine. However, the leaf extract has more antidiarrhoeal activities compared to the stem extract in castor oil-induced diarrhoeal in Wistar rats.

Promoting the Mental Health of Healthcare Workers during COVID19 Pandemic

This paper examines the influence of work-related stress, social support, fear of COVID-19, and demographics in promoting mental health (MH) amongst healthcare workers (HCWs) in Nigeria. Hence, it adopted a survey research design. The results showed that work-related stress, social support, fear of COVID-19, and demographics strongly and jointly influence healthcare workers’ mental health in Nigeria. Also, they indicated a significant independent influence of these independent factors on healthcare workers’ mental health. The results show that out of the demographics considered in this study (such as gender, age, marital status, level of education, profession, department, work experience, and state of residence), only marital status did not significantly influence the healthcare workers’ mental health in Nigeria. So, the government, health faculties, clinical psychologists, human resources managers, and medical practitioners should encourage reducing work-related stress. This should be done by increasing social support, reducing fear of COVID-19, and considering demographics while trying to promote healthcare workers’ mental health in Nigeria, especially during the current COVID -19 pandemic era. Thus, this paper has recognized work-related stress, social support, fear of COVID-19, and demographics as significant influencers in promoting mental health amongst healthcare workers in Nigeria.

Prevalence and factors associated with catastrophic health expenditure among slum and non-slum dwellers undergoing emergency surgery in a metropolitan area of South Western Nigeria.

BackgroundOut of Pocket (OOP) payment continues to persist as the major mode of payment for healthcare in Nigeria despite the introduction of the National Health Insurance Scheme (NHIS). Although the burden of health expenditure has been examined in some populations, the impact of OOP among slum dwellers in Nigeria when undergoing emergencies, is under-researched. This study sought to examine the prevalence, factors and predictors of catastrophic health expenditure amongst selected slum and non-slum communities undergoing emergency surgery in Southwestern Nigeria.MethodsThe study utilised a descriptive cross-sectional survey design to recruit 450 households through a multistage sampling technique. Data were collected using pre-tested semi-structured questionnaires in 2017. Factors considered for analysis relating to the payer were age, sex, relationship of payer to patient, educational status, marital status, ethnicity, occupation, income and health insurance coverage. Variables factored into analysis for the patient were indication for surgery, grade of hospital, and type of hospital. Households were classified as incurring catastrophic health expenditure (CHE), if their OOP expenditure exceeded 5% of payers’ household budget. Analysis of the data took into account the multistage sampling design.ResultsOverall, 65.6% (95% CI: 55.6–74.5) of the total population that were admitted for emergency surgery, experienced catastrophic expenditure. The prevalence of catastrophic expenditure at 5% threshold, among the population scheduled for emergency surgeries, was significantly higher for slum dwellers (74.1%) than for non-slum dwellers (47.7%) (F = 8.59; p = 0.019). Multiple logistic regression models revealed the significant independent factors of catastrophic expenditure at the 5% CHE threshold to include setting of the payer (whether slum or non-slum dweller) (p = 0.019), and health insurance coverage of the payer (p = 0.012). Other variables were nonetheless significant in the bivariate analysis were age of the payer (p = 0.017), income (p<0.001) and marital status of the payer (p = 0.022).ConclusionAlthough catastrophic health expenditure was higher among the slum dwellers, substantial proportions of respondents incurred catastrophic health expenditure irrespective of whether they were slum or non-slum dwellers. Concerted efforts are required to implement protective measures against catastrophic health expenditure in Nigeria that also cater to slum dwellers.

Assessment of Healthcare Institutions and Socio-Economic Welfare: A Survey of Secondary and Tertiary Hospitals in Rivers State, Nigeria

The purpose of this paper is to access healthcare institutions and the welfare experience of patients and workers in public Secondary and Tertiary Hospitals in Rivers State, with ownership across Federal Government, State Government and the Military. From a stratified sampling technique, a representative survey sample of 90 respondents was involved. Our findings shows that Tertiary hospitals in Rivers state relies on funding by Federal Government, State Government, internally generated funds and grants, in their decending order. Budgetary cut on health institution is perceived to reduce service delivery and health workers motivation, though a cut in funding is expected by few, as a result of the prevalent fall in global oil price. The analysis also shows that the price of health services and medicines have increased in recent times, but we could not establish the symptom of inflation on the prices of healthcare consumption. It was established that the level of qualified health workers without gainful employment has slightly increased, owing to low absorptive capacity of government owned hospital, low renumeration from non-public-owned hospitals. The study found that the populace prefers public hospitals over private hospitals, mainly because of affordability and availability of specialists. Although there is evidence of inadequate workforce, bureaucratic holdup and poor ambience. The study concludes that the government is the provider of very affordable and quality healthcare in Nigeria. It was therefore recommended that there should be proper accountability by the hospital management on the proceeds and expenses. Efforts should be made to strenghten internally generated revenue, while a public-private partnership, improved efficiency and quality of service delivery will attract funds.

Mental health in Nigeria: A Neglected issue in Public Health

In Nigeria, the disparity between available healthcare services and need for mental health services is palpable. Although, the country has made significant advances on challenging public health problems, health-related policy development and legislation in trying to achieve health for all policy, there have been challenges with regards to mental health services including that of policy development and legislation, financing, research, training and integration of mental health care into primary health care. We consulted relevant publications, official document, policy statement, blueprints, working plans of the relevant organizations responsible for mental care and services locally and globally. We identify and highlight challenges faced in mental health services implementation and provide recommendations as way forward and call for urgent action to government, non-governmental organizations (NGOs), policy makers and legislatives which are urgently needed to reform and implement them for a better, accessible, and affordable mental health services for the mental well-being of the populace.

Therapeutic Plants Used for Typhoid Fever Treatment in Kaduna State Nigeria

For ages, medicinal plants play a significant role in the effective, affordable, and safe healthcare system. Medicinal plants continue to play an important role in Nigeria's healthcare system, which serves more than 70% of the country's population. For pharmaceutical exploration and conservation, it is important to document the use of medicinal plants in a specific region across time. The study's goal was to find out which plants were used to treat typhoid illness in Kaduna state. The in-depth interview guide was utilized in conjunction with an expert method and non-random probability sampling. The study discovered and recorded 31 plant species from 25 families that are used by Kaduna residents to cure typhoid diseases. Plants with a 0.45 value of relative frequency citation were documented. The highest relative frequency of citation (0.9) and fidelity level (90%) are found in Garcinia mangostana, Senna alata, Moringa oleifera, and Hibiscus sabdariffa, respectively. In Nigeria, traditional medicinal knowledge is guarded by elderly people. The study discovered plant species that could be used as a potential source of anti typhoid in Nigeria.

Patterns of African Healthcare Funding: Investment Implications for Public-Private Partnerships

The Coronavirus Global Pandemic Now Poses Additional Peril To The Already Burdened Healthcare Systems With Inadequate Funding In Africa. This Paper Attempts To Present The Funding Patterns For Healthcare In Nigeria, Congo, Tanzania, Egypt, And South Africa. It Also Explored Investor Opportunities For Lowering OOPs And Increasing Investor Profits. Data Were Drawn From The WHO, The World Bank, And World Charts Databases. Government Health Expenditure Was Far Below What Individuals And Families Pay From Out-Of-Pocket Payments (OOPs) For Healthcare Services Except In South Africa, Where OOP Accounts For Only 8%. Contrary To Popular Notion, Donation Funds Or Foreign Aid For Healthcare Accounts For A Lower Percentage Of Total Healthcare Expenditure In The Countries Under Consideration. Households Mostly Bore The Healthcare Expenditure Burden (Nigeria’s OOPs Of 77%, Congo- 48%, And Egypt- 60%). Averagely, Nigeria And Congo Only Spent About 3% Of Their National Budget On Healthcare. In Comparison, Tanzania And Egypt Spent An Average Of 4% And 5% (South Africa-8%) Between 2010 And 2017, Reflecting Low-Risk Protection For Households. Specific Aspects For Investments Through Public-Private Partnerships (PPP) Reviewed In This Paper Should Include Designing Innovative Financing Models Focusing On Risk Pooling Mechanisms To Help Bridge The Funding Gap, Local Production, And Manufacture Of Pharmaceuticals And Healthcare Equipment At This Time, Instead Of Importation. Investors Can, Therefore, Take Advantage Of The Various Initiatives Outlined In This Paper To Achieve Better Health Outcomes In Africa.

The Hepatoprotective Activity of the Methanol Leaf Extract of Lasimorpha Senegalensis against Liver Injury Induced by Paracetamol (Acetaminophen) in Albino Wistar Rats

The leaf extract of Lasimorpha senegalensis is used in Nigerian traditional medicine for the treatment of liver disease. The aim of this investigation was to evaluate the hepatoprotective ability of Lasimorpha senegalensis methanol leaf extracts on paracetamol-induced toxicity in order to validate or invalidate its traditional use in the treatment of liver disease. Gas Chromatography-Mass Spectometry analysis of the extract revealed the presence of Cycloheptasiloxane tetradecamethyl- and 3, 4-Dihydroxyphenylglycol, a strong antioxidant capable of protecting the cell membrane from assaults. Thirty Wistar rats of mixed sexes were randomly assigned to six groups of five rats each. Group 1, which was the normal control received only normal saline. Groups 2-4 were pre-treated with the extract at various doses, twice daily for 4 days. Silymarin, a known hepatoprotective drug was administered in the same manner to group 5 at 100 mg/kg body weight for 4 days. One hour after the last pre-treatment on the fourth day, groups 2-6 received 2500 mg/kg of paracetamol (PCM) orally in order to induce hepatotoxicity. Eighteen hours after PCM intoxication, blood samples were collected for haematology and biochemical analyses. All the animals were sacrificed and the liver cells were harvested for histopathological examinations. The liver function markers (ALT, AST, ALP), total and direct bilirubin were estimated. This present study has shown that the extract under investigation exhibits hepatoprotective activities since they reduce cell membrane disturbances induced by PCM in the isolated liver cells of the rats. These activities were comparable with that of silymarin, a reference hepatoprotective drug.

Nigerian cultural beliefs about mental health conditions and traditional healing: a qualitative study

PurposeThis study aims to explore how cultural beliefs and traditions are integral to understanding indigenous mental health conditions (MHCs) and traditional healing (TH). However, Nigerian cultural beliefs about MHCs and TH are under-researched.Design/methodology/approachThis study adopted a qualitative design using critical realist and social constructionist perspectives to explore Nigerian mental health-care practitioners (MHCPs) and lay participants’ (LPs) views regarding MHCs and TH. Purposive and snowball sampling techniques were used to select 53 participants (MHCPs = 26; LPs = 27; male = 32; female = 21) in four Nigerian cities (Ado-Ekiti, Enugu, Jos and Zaria). Data were collected using semi-structured interviews and analysed through thematic analyses.FindingsThe data sets revealed three overarching themes, namely, existing cultural beliefs about MHCs as spiritual curse; description of TH as the first treatment modality for MHCs; and perceived stigma associated with MHCs and help-seeking behaviours.Originality/valueA study on Nigerian cultural beliefs and TH contributes meaningfully to mental health systems. Future research and policy initiatives could explore ways of optimising TH practices and community awareness programmes to increase access to mental health care in Nigeria.

Methanol extract of Ficus platyphylla decreases cerebral ischemia induced injury in mice

Ethnopharmacological RelevanceExtracts of the stem bark of Ficus paltyphylla (FP) are used in the Nigerian traditional medicine to manage psychoses, depression, epilepsy, pain, and inflammation. Our previous studies revealed that the methanol extract of FP ameliorate body core temperature. Aim of the studyA number of pharmacological agents that utilize mechanisms that enhanced neuronal survival and/or neural regeneration have been developed for the treatment of stroke. Hypothermia protects the brain from damage caused by ischemia by attenuating destructive processes such as neuroinflammation, excitotoxicity, blood-brain barrier disruption, apoptosis, and free radical formation following cerebral ischemia. In the present study, we examined the neuroprotective potential of FP on permanent occlusion of the middle cerebral artery (MCAO)-induced ischemia in mice. Material and methodsC57Bl mice were subjected to MCAO. FP was administered 1 h prior to and immediately after surgery. The brains were collected 24 h later and infarct volumes were measured using immune-histochemical staining, DAPI, NeuN, synaptophysin, and NR2B were quantified. ResultsAdministration of FP prior to MCAO significantly reduced infarct volume, with no effect on infarct volume immediately after MCAO. Higher numbers of cells and neurons were observed in the peri-infarct area in both groups of mice. FP-induced hypothermia protected tissue in the peri-infarct region from synaptophysin reduction. NMDA receptor 2 (NR2B) immunoreactivity is enhanced by MCAO, with no difference observed in both sham-operated and FP-induced hypothermia groups of mice. ConclusionsThe data suggest that FP might be useful in the reduction of ischemia-induced infarct volume when administered prior to the initiation of ischemia with no effect observed after ischemia induction.

Attitudinal Acceptance of Intimate Partner Violence and Mental Health Outcomes for Female Survivors in Sub-Saharan Africa.

While current literature evidences a strong association between gender-based violence exposure and adverse mental health outcomes, few studies have explored how attitudinal acceptance of intimate partner violence (IPV) might impact this relationship. This analysis employed data from 13–24-year-old females as part of the Violence Against Children Surveys in Nigeria, Uganda, and Malawi. Mental health status, defined by the Kessler Screening Scale for Psychological Distress, and suicide ideation served as outcome measures. Predictors of interest included lifetime experiences of IPV and attitudinal acceptance of IPV. Country-stratified logistic and ordinary least squares regressions were used to predict outcomes and included interactions between violence exposure and attitudinal acceptance of IPV. Violence exposure was associated with increased symptoms of mental distress and increased suicide ideation in all countries. Among those who experienced IPV, exhibiting attitudinal acceptance of IPV was associated with improved mental health in Nigeria and Malawi. IPV tolerance conferred lower odds of suicide ideation following IPV exposure in Nigeria. The findings suggest that programs aiming to reduce attitudinal acceptance of IPV must consider how these changes may interact with women’s exposure to IPV.