Nigerian Medical Students Research Articles

Nigeria still searching for right formula

In 1990, Michael Asuzu held high hopes for the development in of a primary health care (PHC) system based on community participation, using well-trained, well-equipped and motivated community health professionals. Writing in the March 1990 issue of World health magazine, Asuzu, at the time a lecturer and consultant in the Department of Preventive and Social Medicine at the University College Hospital in Ibadan, enthused about a bottom-up grassroots PHC project in the hamlet of Elesu, 32 kilometres north of lbadan. Members of Asuzu's university department had helped villagers develop a programme to control outbreaks of waterborne guinea-worm disease and adopt other PHC measures. We expect to be able to replicate this programme in any local community ready to take charge of its needs for PHC as the Elesu community has, he said. case history shows that, when community health development workers are available and willing to go out and assist communities, it is possible for them to come forward to request and be helped to provide community-owned and self-reliant PHC programmes for themselves. Fast forward 18 years and Asuzu, now professor of Public Health and Community Medicine at the University of Ibadan, is less ebullient when discussing PHC in his country. Addressing the Nigerian Academy of Science Seminar in Abuja in May this year, Asuzu said: Nigeria has never succeeded in establishing community medical and health services for very many reasons ... some limited levels [have] been practised in Nigeria, even during the colonial days, but never fully. In June, Asuzu told the Nigerian Medical Students Association that had in the mid-1980s joined the international push for PHC after the 1978 Alma-Ata Declaration of 'health for all'. Some progress seemed to have been made with the health services between then and the mid-1990s, he said. However, the health indices have been deteriorating since then [judging] by every health system evaluation [carried out] in the country. Unfortunately, has never learnt or developed any system of authentic and full-scale community health care before Alma-Ata or after it. This explains why we have not made any success of the The world health report 2000 ranked 187 out of 191 countries for health service performance, a situation that has not changed much since then, according to Asuzu, who cites several statistics to highlight the inadequacies in Nigeria's PHC system. Annual budget allocations to health have been persistently below 5% except for the years 1998-1999 and 2002-2003 when they were at or just above this level. Infant mortality rates have been deteriorating from 85 per 1000 live births in 1982, 87 in 1990, 93 in 1991 to 100 in 2003, according to the Demographic and Health Survey, 2003. And in 2007, the Federal Ministry of Health reported 110 deaths per 1000 live births. Maternal mortality ratios are estimated at 1100 per 100 000 live births in WHO's Worm health statistics 2008. Asuzu identifies five attempts at reform over the past 70 years: * 1940s. The Nigerian Colonial Development Plan had a limited framework for a unitary health service. * 1950s. Regional governments ran independent and sometimes parallel health systems to the federal government. * 1960s. The Second National Development Plan in the post-independence era did not articulate a system with clear responsibilities for each level of government. * 1970s. The ambitious Third National Development Plan had the Basic Health Services Scheme as its focus, but again failed to share responsibilities between the governments for resource generation, manpower development, health professional deployment and service delivery. * 1980s. Following the Declaration of Alma-Ata, there were serious attempts at health system reform, based on the principles of PHC resulting in the National Health Policy in 1988. …

Prevalence of depressive symptoms among Nigerian medical undergraduates

This study assessed the epidemiology of depressive symptoms in Nigerian medical students. A cross-sectional study of 262 medical students from University of Nigeria, Enugu campus, one of the foremost medical schools in Nigeria was studied. Data were collected using structured self-administered questionnaires and the Zung self-rating depression scale developed by Zung as an instrument, which measures the subjective experience of depression. The age range of students was 16-30 years. The prevalence of depression among the students was 23.3%. Students aged 16-20, females, and those who had a professional examination during the period of the study had higher levels of depression, although these findings were not significant. However, students who smoked regularly had significantly higher levels of depression than those who did not smoke. Medical educators in Nigeria need to be aware of the vulnerability of medical students to depression.

Attitude to sperm donation among medical students in Enugu, South-Eastern Nigeria

SummaryThis study investigated the knowledge, attitude and practices of a sample of Nigerian medical students towards sperm donation. It was a self-administered semi-structured questionnaire survey of fifth and final year medical students of the College of Medicine, University of Nigeria, Enugu campus, South-eastern Nigeria. Out of 205 eligible medical students in both classes, 180 (87.8%) responded. There were 99 male and 81 female respondents. Their ages ranged from 20 to 30 years with a mean of 24.0 ± 2.0 years. All the participants were Christians. A total of 177 (98.3%) of the respondents were aware of the practice of sperm donation for the treatment of infertility, while three students had never heard of it. A total of 15 (15.2%) of the male respondents reported their willingness to donate their sperm for infertile couples. The main motivation for wanting to donate sperm was a desire to help infertile couples. A total of 24 (30%) of the female respondents were willing to accept donor semen should the need arise. The leading factors which discouraged the male respondents from donating semen were that the practice was either against their religious belief (41.7%) or in their opinion, was morally wrong (22.6%). Some 10.7% were afraid of a possible adverse effect on future fertility, while 9.5% were afraid of being screened for sexually transmitted infections; 20 (35%) of the female respondents would not accept donor semen because of the psychological and emotional effects of having to bring up a child that is not their husband's; 13 (23%) said it was against their religious faith, while 10 (18%) believed that adopting a child was better than accepting donor semen. Eight (14%) were afraid of contracting HIV infection through donor semen, while six (11%) declined because they would not want the paternity of their child to be questioned later. With respect to the participants' views on identity disclosure, 35 (90%) of the 39 respondents willing to donate or accept sperm objected to their identities being disclosed to the recipient couples or the donor, while four (10%) did not mind. It was concluded that, despite the high level of awareness of sperm donation among medical students in Enugu, the majority of them were unfavourably disposed to it and none had ever practiced it. Public enlightenment through the mass media and correction of false notions about infertility treatment will go a long way in addressing this problem.

Nigerian medical students are at risk for hepatitis B infection

Medical students are exposed to blood and body fluids. This study was conducted to estimate the prevalence of hepatitis B virus (HBV) infection amongst medical students of the Lagos State University College of Medicine, Ikeja, Nigeria. Data were collected through a self-administered questionnaire and through blood analysis for hepatitis B surface antigen (HBsAg), hepatitis B 'e' antigen (HBeAg) as well as antibodies to the core (anti-HBc), surface (anti-HBs) and 'e' (anti-HBe) antigens. Three hundred and thirteen of 325 students (96%) participated. The mean age was 24.3+/-3.98 years; 231 (74%) were pre-clinical students and 82 (26%) were in the clinical years of study. Only 8 (2.6%) had received three doses of vaccination against HBV. Eighty-one (26%) tested positive for anti-HBc, 10 (3.2%) were positive for HBsAg and 56 (17.9%) had anti-HBs antibodies. A significant relationship was found between students who had a positive history of hepatitis B in the family and anti-HBc (P=0.03). Age was also significantly associated with HBsAg (P=0.012). Two hundred and twenty-five (72%) students were susceptible to the infection and required vaccination. Most students at this medical school are susceptible to HBV infection and should be vaccinated.

Book Review<br><br>Practice and practitioners of medicine in Nigeria \'must read\' for Nigerian medical students<br> By Adelola Adeloye (2005)

Book Review<br><br>Practice and practitioners of medicine in Nigeria \'must read\' for Nigerian medical students<br> By Adelola Adeloye (2005)

Evidence for a dissociation in the control of sparteine, debrisoquine and metoprolol metabolism in Nigerians.

The 0-8 hour urinary distributions of the metabolic ratios of sparteine (100 mg), debrisoquine (10 mg) and metoprolol (100 mg) were measured in 165 healthy, unrelated, black Nigerian medical students. There was a weak correlation (rs = 0.51, p < 0.001; n = 82) between the metoprolol/alpha-hydroxymetoprolol (M/HM) and the sparteine/total (2- + 5-) dehydrosparteine (S/DHS) ratios. No significant correlations were found between the debrisoquine/4-hydroxydebrisoquine (D/HD) and M/HM ratios (rs = 0.16, n = 33) and between the D/HD and S/DHS ratios (rs = 0.31, n = 38). Both visual inspection and kernel density analysis of the data suggested the presence of two phenotypic groups for sparteine oxidation, with 4% of the population studied being putative poor metabolizers. In contrast biomodality was not apparent in the distribution of the log10M/HM and log10D/HD ratios. These findings provide evidence for a dissociation in the control of metoprolol, sparteine and debrisoquine oxidation in Nigerians and highlight the difficulties in the interpretation of data from pharmacogenetic studies in different ethnic groups.

Assessment of cardiovascular risk factors in Nigerian students.

The present study assessed the prevalence of cardiovascular risk factors in 65 Nigerian medical students attending the University of Benin, Benin City, Nigeria. Their ages ranged from 17 to 28 years with a mean age for men of 20.9 years and for women of 18.8 years. Approximately 8% of the men and 0% of the women were current cigarette smokers, whereas alcohol use was observed in 14.6% of the men and in 0% of the women. The Nigerian men had significantly higher diastolic blood pressures than did American black and white men. Compared to American black men, the Nigerian men had considerably lower total cholesterol and triglyceride concentrations. The Nigerian women did not differ from American black women with respect to total cholesterol, but had significantly lower triglyceride concentrations.

Aphthous ulceration in Nigerian and British medical students

International Journal of Clinical PracticeVolume 41, Issue 3 p. 655-658 Clinical Study Aphthous ulceration in Nigerian and British medical students A D Harries MD, MRCP, A D Harries MD, MRCP Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorP Mohammed, P Mohammed Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorK S Chugh MD, FICA, K S Chugh MD, FICA Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorD Burnell MB, D Burnell MB Department of Gastroenterology, University Hospital of Wales, Heath Park, CardiffSearch for more papers by this authorJ Rhodes MD, FRCP, Corresponding Author J Rhodes MD, FRCP n/[email protected] Department of Gastroenterology, University Hospital of Wales, Heath Park, CardiffCorrespondence to: Dr J Rhodes, Consultant Physician, University Hospital of Wales, Heath Park, Cardiff CF4 4XW.Search for more papers by this author A D Harries MD, MRCP, A D Harries MD, MRCP Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorP Mohammed, P Mohammed Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorK S Chugh MD, FICA, K S Chugh MD, FICA Department of Medicine, University of Maiduguri, Maiduguri, NigeriaSearch for more papers by this authorD Burnell MB, D Burnell MB Department of Gastroenterology, University Hospital of Wales, Heath Park, CardiffSearch for more papers by this authorJ Rhodes MD, FRCP, Corresponding Author J Rhodes MD, FRCP n/[email protected] Department of Gastroenterology, University Hospital of Wales, Heath Park, CardiffCorrespondence to: Dr J Rhodes, Consultant Physician, University Hospital of Wales, Heath Park, Cardiff CF4 4XW.Search for more papers by this author First published: 01 March 1987 https://doi.org/10.1111/j.1742-1241.1987.tb08081.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume41, Issue3March 1987Pages 655-658 RelatedInformation

Choice of general practice for postgraduate training among medical graduates and undergraduates in Nigeria

A questionnaire survey of career choices was carried out among 112 medical graduates, after one year's internship (group I), during their National Youth Corps programme in Kaduna, Lagos, Cross River and Oyo states of Nigeria, and 365 final-year medical undergraduates (group 2) in the colleges of medicine in the corresponding states. A total of 13% in group I and 40% in group 2 were undecided as regards their first choice. Obstetrics and gynaecology was the most popular first choice in both groups. General practice ranked fifth among group I, but displaced surgery to rank second among group 2. The differences were statistically significant. A total of 41% of group I and 46% of group 2 preferred to work in a teaching hospital, reflecting the high preference for surgical specialties. Twenty-six per cent and 33.7% of respondents in groups 1 and 2 respectively wished to own their own practice or work in the private sector. General practice is a new specialty and its growth is supported by a national postgraduate training programme. A shift towards general practice is seen compared with previous studies of career preference among Nigerian medical graduates and students. This may be due to a changing balance of supply and demand in the medical work-force, or a better assessment of the nation's health problems and manpower needs.

Attitudes of Nigerian medical students towards use and abuse of tobacco, alcohol and drugs.

The questionnaire devised by WHO as a standardized instrument for use across cultures, and modified to suit an African culture, was completed by 104 clinical medical students (male and female) selected at random. After statistical analysis, the results were discussed regarding attitudes (approval/disapproval); perceived availability; social connotation; perceived harmfulness; perceived problems; perceived parental norms; religion; and exposure to use. A significant finding was that 78% of the medical students disapprove of people using all the listed drugs, 11% disapprove slightly and only 11% do not disapprove.

IES arrow-dot performance of Nigerian professionals, medical students, and psychiatric in-patients.

We chose the Arrow-Dot subtest of the IES test (Dombrose & Slobin, 1958) because we are attempting to identify a culture-free test to use with psychiauic patients. To assess the validity, we compared the Id, Ego and Superego performance of medical students and professionals who were assumed to be ego-response-oriented and psychiatric in-patients who were assumed to be more id- or superego-response-oriented. Subjects randomly selected were 38 Nigerian first-year medical students in 1982, all of whom had attended private primary and secondary schools in Nigeria. Their families would be labeled middle to upper middle class. The age range was from 16 to 20 yr. Also, 38 Nigerian professionals within the College of Medicine were selected. Their minimum degree was M.Sc. The ages ranged from 30 to 45 yr. From the psychlatry service 38 Nigerian in-patients, ages ranged from 16 to 45 yr., were selected; 80% were schizophrenic. Education ranged from high school graduate to completion of professional school. In 1983, 21 Nigerian medical students and 21 psychiatric in-patients were selected using the same criteria and given the test individually. Means and standard deviations for the 1982 and 1983 groups on IES scores appear in the table. r ratios indicate that E and S scores of professionals and patients are sig

Social and personality characteristics of Nigerian medical students.

Nigerian medical students (N = 183) were assessed with a 58-item general questionnaire, the Health Opinion Survey, and the Eysenck Personality Questionnaire (EPQ). The social, demographic, and related characteristics of the Ss were described. On the EPQ both male and female Ss obtained considerably higher mean scores than British Ss of the standardization sample. For males P, E, and N mean scores were of the same order as scores obtained by British Ss. Females had lower N scores and higher P and E scores than the British. There were significant associations between N scores and past treatment for emotional complaints and between the latter and E scores. The relationship between self-assessed mental health and N scores was almost significant at the .05 level.

Attitudes of Nigerian medical students toward rural practice

Attitudes of Nigerian medical students toward rural practice

The professional attitudes of Nigerian first year medical students

In a study of the development of professional attitudes in medical students, a modified version of the Medical Attitudes Inventory (Harris, 1974) was administered to 141 male and female first year medical students in Lagos, Nigeria. The results show that the students have well-defined attitudes on certain issues and are divided on others. The findings are discussed in terms of their implications for medical education, attitude research and durability of students' attitudes in and beyond medical school. The influence of contemporary social factors on student professional attitudes is also considered. The instrument has sufficient psychometric attributes to warrant further use.

Belief-System and the Concept of Mental Illness among Medical Students in a Developing Country: A Nigerian Example

The report focuses on the concept of mental illness among Nigerian medical students. It also deals with their attitudes toward patients who might share a magicoreligious orientation in the etiology of illness as well as their reaction to the interplay between traditional and modern medicine. To this end, students in the penultimate and final years at four medical schools were surveyed (such students would have been sufficiently exposed to various specialties in the field of medicine, including psychiatry). The major findings from our study are: (1) many medical students in the four medical schools believe that mental illness can be influenced by witchcraft despite the modernizing influence of western education; and (2) a similarly large proportion of the students feel strongly that native healing or traditional medicine is relevant to the practice of modern medicine in Nigeria.

THE TRAINING OF MEDICAL STUDENTS

Nigerian 4th year medical students from University of Ibadan spend 8 weeks training in primary health care and public health in the rural Ibarapa Community Health Programme in Oyo State, with ORT as part of the training. Their course of study there includes epidemiological projects, collecting data on diarrhea prevalence, cultural and behavioral practices, assessment and treating children with diarrhea, and teaching ORT to the community. Students worked on the ORT unit on a rotating basis, preparing ORS, monitoring children and talking to mothers. They learned that most mothers recognized diarrhea symptoms, 2/3 had heard about ORS, but less than 1/5 considered it a first step in managing diarrhea. Most would eliminate beans from the child's diet, substituting bland maize porridge. Talking with mothers made them realize that teething children put dirty objects into their mouths and that presence of visible children's feces is associated with diarrhea. Use of soap for hand washing, and availability of clean tap water, rather than well water, decreased incidence of diarrhea. After their training, medical students knew how to prepare ORS correctly, and understand its efficacy. This should increase the acceptance by the medical professionals of ORT as a desirable part of diarrhea control.