To determine the relationship between bullying victimization and PTSD among students attending public Junior Secondary Schools in Abeokuta. The Prevalence of Bullying victimization and PTSD as well as some socio-demographic correlates were also assessed.

About 411 junior students from five randomly selected public secondary schools were approached for the study and given consent forms to take home to their parents/guardians. Those who subsequently returned signed consent forms and who gave assent to participate in the study were administered the Socio-demographic questionnaire and the Multidimensional Peer Victimisation Scale (MDPVS). They were thereafter interviewed with the PTSD module of the MINI KID.

A total of 351 students completed the study to yield a response rate of 85.4%. The age range of the respondents was 9–17 years with mean (SD) of 12.48 (1.50) years. The gender distribution was 49.3% males and 50.7% females. 68.7% of the respondents were from a monogamous home, 22.2% had divorced parents, 74.3% lived with both parents, and 6% reported being an only child. 14.8% of the respondents reported having experienced higher levels (moderate & high) of victimization by peers. The mean score of the overall bullying victimization level was 9.6 (±6.5). Verbal victimization subscale had the highest mean score of 3.2 (±2.0), while physical victimization had the lowest mean of 1.9 (±2.1). Seventy (19.9%) students admitted to the experience of a significant traumatic event, with only 7.1% of these meeting the current diagnosis of PTSD in the past month. There was no statistically significant association between bullying victimization and PTSD (χ2 = 2.666; df = 2; p = 0.261). Traumatic event experience was however significantly associated with high levels of bullying victimization experience (χ2 = 4.266; p = 0.039). None of the assessed socio-demographic, familial or self-perceptual factors was found to be significantly associated with either bullying victimization or PTSD.

The experience of bullying victimization among secondary school students remains a prevailing problem in our local setting, as it is across the globe. Verbal bullying is the most common while physical bullying is the least common peer victimization experience in this study. The study points out that PTSD among high school students in our environment may be more prevalent than had previously been reported. Given the high rates of peer victimization experiences reported by students, there is a need for policy changes to make the school environment safer for students, thereby promoting their mental health.

Stigma is a formidable barrier to the treatment and rehabilitation of patients with mental illness or HIV-AIDS, even among young persons. In contrast with HIV-AIDS, efforts by Nigerian policy makers to reduce the stigma associated with mental illness are virtually non-existent. Information on the attitude of school children towards affected individuals is essential in placing the need to combat the stigma associated with these disorders in the right perspective.

This study determined the social distance of a sample of secondary school students in Nigeria towards individuals with mental illness, as compared with those with HIV-AIDS.

A cross-sectional comparative survey. Secondary school students (n=170) in Lagos, Nigeria completed the modified Borgadus Social distance Scale.

The respondents were more likely to be socially distant from patients with mental illness than those with HIV/AIDS (p< 0.001, 95% CI, 2.56-8.24). About seven out of ten (71.8%) and 20.6% of the participants would be afraid to have a conversation with someone who has mental illness and HIV-AIDS respectively (p< 0.001). Those unwilling to be in the same classroom with a student that has mental illness and HIV/AIDS were 74.7% and 17.6% respectively (p< 0.001). Less than a tenth (9.4%) could maintain friendship with someone who has mental illness.

The findings suggest that secondary school students in Nigeria desire a higher level of social distance from individuals with mental illness than those with HIV-AIDS. Interventions targeted at reducing the stigma associated with mental illness among school children deserve priority attention.

Sexual abuse of children and adolescents is a public health problem with potentially dire mental health consequences. Studies suggest that the first sexual experience of one out of three girls in sub-Saharan Africa is forced. However the relationship between sexual abuse and mental health problems among children and adolescents is grossly under-researched in Nigeria.

This study determined the association between sexual abuse and mental health problems in a sample of adolescents attending secondary school in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, Global School-based Health Survey Questionnaire, Strength and Difficulties Questionnaire, Suicidality module of the Mini International Neuro-Psychiatric Interview and the Hospital Anxiety and Depression Scale.

The mean age of the participants was 15.9 (± 1.3) years, and 58.7% were males. A fifth (21.9%) of the respondents had experienced sexual abuse in the past year. Less than a tenth of the victims reported the abuse, and none had accessed mental health service. On regression analysis, being a victim of sexual abuse was independently predictive of depression (p=0.041), anxiety (p=0.007), peer problems (p=0.014), emotional problems (p=0.005) and suicidal ideation (p=0.014).

Exposure to sexual abuse is under-reported and un-detected among Nigerian school children, despite its association with several mental health problems. There is need for interventions targeted at facilitating the access of victimised children to timely supportive care and appropriate mental health intervention. Furthermore, efforts to protect children from sexual abuse must be intensified.

Teachers are potential partners in the referral and management of children with Attention Deficit Hyperactivity Disorder (ADHD) especially in resource constrained settings. However, their ability to play this role is a function of their knowledge of ADHD and their attitude towards children with the disorder. There is paucity of information on the attitude of Nigerian school teachers towards children with ADHD.

This study assessed the attitude of a sample of primary school teachers in Lagos, Nigeria towards children with ADHD.

Primary school teachers (n = 144) recruited from four mainstream schools in Lagos State were presented with vignettes describing school children with ADHD. Thereafter, they completed questionnaires which elicited their knowledge of ADHD and attitudes towards children with the disorder.

The responses of the participants indicated a high level of misperception about ADHD and negative attitudes towards children with the disorder. Only 9.0% and 16.7% of the respondents agreed that ADHD could be successfully managed with medications and psychological interventions respectively. One out of four (25.7%) teachers affirmed that they would avoid relating with a child with ADHD, while 35.4% would be unwilling to accept a student with ADHD in their class.

There is a high level of misperception about ADHD among Primary school teachers in Nigeria. This highlights the need for educational Interventions targeted towards improving the knowledge of teachers about ADHD. Furthermore, mental health literacy could be incorporated into the curriculum of institutions training primary school teachers.

Globally, children and adolescents are victims of various forms of violence, including physical, psychological and sexual violence perpetrated by peers or adults within the community, school or domestic setting. Suicidal behavior is public health problem with escalating trends among young people. There is dearth of research on the relationship between violence and suicidal behavior in sub-Saharan Africa.

This study determined the association between violence victimization and suicidal behavior (suicidal idea and attempts) in a sample of secondary school students in Lagos, Nigeria.

A cross-sectional study of 230 secondary school students in Lagos, Nigeria. Participants completed a socio-demographic questionnaire, the Global School-based Health Survey Questionnaire (violence module) and the ‘Suicidality’ module of the Mini International Neuro-Psychiatric Interview (MINI).

In the past year, a fifth of the respondents were victims of weapon-related violence (23.8%) and sexual violence (21.9%). More than half (56.4%) reported peer-related violence/bullying, while 60.7% were exposed to domestic violence. Less than a third (31.3%) reported lifetime history of suicidal idea, while 13% had attempted suicide. Suicidal behavior was significantly associated with history of bullying (p=0.020), sexual violence (p=0.014), weapon-related violence (p=0.005), and exposure to domestic violence (p=0.020).

Exposure to violence is associated with suicidal behavior among secondary school children in Nigeria. This highlights the need for urgent interventions to protect Nigerian children and adolescents from violence. There is also need for improved access of victimized children to mental health care and other support services.

Suicide is a major public health problem with escalating global trends, and high rates of recidivism. Patients with suicidal behavior have frequent contacts with Emergency Departments (ED). Therefore, the ED has been recognized as a strategic site for initiating interventions targeted at engaging suicidal patients in treatment. However, there is dearth of baseline data to guide such interventions in Nigeria.

This study determined the rates of treatment-engagement (compliance with follow-up appointment) among patients with suicidal behaviour after discharge from a psychiatric ED in Lagos, Nigeria.

The clinical database of 225 consecutive patients discharged from the ED of the Federal Neuro-Psychiatric Hospital Yaba between January and June 2012 were retrieved from the out-patient clinics/mental health service they were referred to. Data were abstracted regarding their adherence with recommended follow-up appointments over a period of six months.

The mean age of the service users was 35.9 ± (14.2) years and 62% were females. At one week post-discharge from the ED, 71.5% attended their appointments. By the end of the fourth week, third month and sixth month, engagement in treatment declined to 54%, 35.5% and 23% respectively.

There is a low rate of engagement in treatment among suicidal patients in Nigeria. This finding highlights an urgent need to develop local ED-based interventions targeted at engaging suicidal patients in treatment, with the view of reducing the risk of recidivism.

In psychiatric emergencies, there is a high premium on rapid assessment, acuity categorization and objectivity in decisions regarding the disposition of patients. The Crisis Triage Rating Scale (CTRS), a 3-item clinician-rated instrument, has demonstrated validity in determining the disposal of patients in psychiatric emergency settings. However, its utility has not been evaluated in Nigeria.

This study aimed to assess the validity of the CTRS in predicting the disposal (need for hospitalisation or out-patient treatment) of patients presenting to a psychiatric emergency unit in Nigeria.

The CTRS was administered to consecutively presenting patients (N=247) at the Emergency Unit of the Federal Neuro-Psychiatric Hospital, Yaba, Lagos. Following a comprehensive psychiatric evaluation, clinicians blinded to the CTRS scores made appropriate decisions regarding the disposal of the patients. The ability of the CTRS to predict the need for hospitalisation at different threshold scores, compared with clinical judgement as criterion, was determined statistically.

The optimal threshold on the CTRS for detecting the need for hospitalisation is a cut-off score of 9 as it has the best trade-off with a sensitivity of 0.94 and specificity of 0.89. At this threshold, the overall misclassification rate is 0.09, while the area under the Receiver operating characteristics curve is 0.95. The positive predictive validity for the assessment of disposal at the optimum threshold is 0.91.

The CTRS is a useful tool in determining the disposition of patients presenting to psychiatric emergency service in Nigeria

The Psychiatric Emergency service occupies a strategic position where crucial interventions can be initiated and coordinated in linkage with other services in the mental health network. However, there is dearth of information on users of psychiatric emergency in Nigeria and sub-Saharan Africa.

To determine the clinical and socio-demographic characteristics, pattern of presentation and disposal of patients attending a Nigerian psychiatric emergency unit.

One thousand Patients consecutively presenting to the emergency unit of the Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria from January 2012 were prospectively assessed. Following a comprehensive psychiatric evaluation, clinical, socio-demographic and other relevant data regarding their presentation and disposition were recorded into a pro-forma and subjected to statistical analysis.

The majority were females (54.7%), single (65.6%), and unemployed (62.9%), with a mean age of 36.4 (± 14.7) years. Less than two-thirds (62.0%) were new patients. Only 10.8% of the new patients were formally referred to our facility. The most common diagnoses were schizophrenia (34.3%), depression (16.5%) and substance use disorders (11.4%). The patients were predominantly (89.4%) managed as out-patients.

The emergency room is a major port of entry into mental health care and could be prone to over-subscription by patients with non-acute problems, especially when alternatives are not readily accessible. Multipronged interventions, including community based care with relevant linkages, may facilitate appropriate utilization of mental health services and reduce the potential for overcrowding of the psychiatric emergency room.

To determine the feasibility of distributing micronutrient powders (MNP) for home fortification during biannual Maternal, Neonatal and Child Health Week (MNCHW) events, as a strategy to improve young child nutrition.

We evaluated the coverage, delivery, use and adherence of MNP, and associated behaviour change communication (BCC) materials and social mobilization, through cross-sectional surveys of caregivers attending health-service distribution events and health workers involved in MNP distribution, facility-based observations of MNP distribution activities and a repeated survey of caregivers in their homes who received MNP for their child.

Four Local Government Areas in Benue State, Nigeria.

Caregivers of children 6–59 months of age attending health-service distribution events.

The 8 million MNP delivered in this pilot during three distribution events were estimated to reach about one-third of eligible children in the area at each event. Programme fidelity was limited by shortages of MNP, BCC materials and inadequate social mobilization, with some limitations in health worker training and engagement. MNP use was consistent with the recommended two or three sachets per week among 51–69 % of caregivers surveyed at home.

MNP coverage was low, but consistent with that typically achieved with other services delivered through MNCHW in Benue. Among caregivers who received MNP, acceptance and use among targeted children was high. While some weaknesses in knowledge and delivery of MNP by health workers were observed, health system strengthening and more extensive social mobilization would be key to achieving higher coverage with MNP and other health services provided through MNCHW.

We report a rare case of cervical necrotising fasciitis arising from poorly managed acute tonsillitis.

A 23-year-old woman presented with a two-week history of fever and an eight-day history of painful neck swelling. Nine days before presentation, she had received digital manipulation of her throat by a neighbour, which had worsened her throat pain. There was associated progressive generalised neck swelling, odynophagia, dysphagia and dyspnoea. An X-ray of the neck soft tissue showed multiple gas collections.

Cervical necrotising fasciitis is rare and usually odontogenic in origin. It is associated with a high mortality rate. Our patient responded to aggressive daily bedside wound debridements and dressings, appropriate intravenous antibiotics and high-protein nutritional support. In this way, exploration under general anaesthesia was avoided, in a developing country with limited facilities.

Accurate assessment of the features of tympanic membrane perforation, especially size, site, duration and aetiology, is important, as it enables optimum management.

To describe a simple, cheap and effective method of quantitatively analysing tympanic membrane perforations.

The system described comprises a video-otoscope (capable of generating still and video images of the tympanic membrane), adapted via a universal serial bus box to a computer screen, with images analysed using the Image J geometrical analysis software package. The reproducibility of results and their correlation with conventional otoscopic methods of estimation were tested statistically with the paired t-test and correlational tests, using the Statistical Package for the Social Sciences version 11 software.

The following equation was generated: P/T × 100 per cent = percentage perforation, where P is the area (in pixels2) of the tympanic membrane perforation and T is the total area (in pixels2) for the entire tympanic membrane (including the perforation). Illustrations are shown. Comparison of blinded data on tympanic membrane perforation area obtained independently from assessments by two trained otologists, of comparative years of experience, using the video-otoscopy system described, showed similar findings, with strong correlations devoid of inter-observer error (p = 0.000, r = 1). Comparison with conventional otoscopic assessment also indicated significant correlation, comparing results for two trained otologists, but some inter-observer variation was present (p = 0.000, r = 0.896). Correlation between the two methods for each of the otologists was also highly significant (p = 0.000).

A computer-adapted video-otoscope, with images analysed by Image J software, represents a cheap, reliable, technology-driven, clinical method of quantitative analysis of tympanic membrane perforations and injuries.