ObjectivesTo assess the prevalence and factors associated with perceived stress among medical students. MethodsA cross-sectional study of students (n=623) selected across eight medical schools in Nigeria. A structured questionnaire obtained socio-demographic characteristics, alcohol use (Alcohol Use Disorders Identification Test), other psychoactive drug use (Drug Abuse Screening Test), anxiety/depression symptoms (Hospital Anxiety Depression Scale) and stress (Perceived Medical School Stress Scale). We performed bivariate analysis using the chi-squared test, t-test and one-way ANOVA, with multiple regression analysis for multivariate testing in analysing the data.  ResultsMost students reported experiencing medical school stress. Female participants were more likely to perceive medical school as competitive (t(621)=1.17, p=0.003), less likely to see medical school as a threat (t(621)=-2.70, p=0.01) or worry about finances (t(621)=-4.80, p=0.001). Nearly a quarter; 21.3% (n=133) and 28.6% (n=178) reported depression and anxiety symptoms respectively. Approximately 4.2% (n=26) were dependent on alcohol, while 14.1% (n=88) had ‘low-risk use’ for other psychoactive substances. In the multiple regression model, lack of finance (B=2.881, p=0.001), weak adherence to religious faith (B=2.376, p=0.001), anxiety symptoms (B=-2.231, p=0.002), problematic alcohol use (B=5.196, p=0.001) and choice of study influenced by parents (B=-3.105, p=0.001) were predictors of greater perceived stress. ConclusionsMedical students in Nigeria report high levels of stress. Incorporating stress reduction strategies in the medical curriculum, and the input of students in providing feedback regarding the methods and styles of undergraduate medical education is required.

Background: Undetected depression can result in a significant decline in productivity among the workforce in every system, the healthcare sector inclusive. It is vital to utilize brief screening tools to detect populations at risk of depression. The 5-item WHO Well-being Index (WHO-5) has been used as a screening measure for depression, but research on this is scarce in sub-Saharan Africa. This study aimed to determine the utility and validity of the WHO-5 in screening for depression in a population of doctors and nurses in Nigeria during the COVID-19 pandemic. Methods: A representative sample of medical doctors and nurses across Nigeria (n = 464), completed the 5-item World Health Organization Well-Being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). Results: The pattern of factors associated with cases of a positive depression screening was considerably similar for the WHO-5 and the PHQ-9. At a cut-off score of 50 for the WHO-5, the sensitivity and specificity values obtained were 0.857 and 0.851 respectively. Positive and negative predictive values were 0.404 and 0.981 respectively. ROC analysis of the WHO-5 against the PHQ-9 revealed that, at a cut-off of 50, the sensitivity of the WHO-5 was 0.857, 1-specificity was 0.152. The AUC was 0.918 (95% CI 0.884-0.953). Also, there was a strong, negative correlation between the WHO and the PHQ-9 scores (r = −0.590, p ≤ 0.0001). Conclusion: The WHO-5 well-being index has satisfactory validity as a screening tool for the detection of depression. It is also feasible for use in very busy settings, because of its brevity and ease of administration.

camels continue to be the source of human infections through separate zoonotic transmission events without sublineage separation between viruses in camels and humans. In conclusion, our study suggests multiple lineage 5 clade B viruses continue to be dominant among camels in eastern Saudi Arabia. Camels imported from Sudan and Somalia also had evidence of MERS-CoV B lineage 5 clade viruses prevalent in the Arabian Peninsula, rather than clade C viruses known to be enzootic in camels in Africa. These data suggest imported camels likely acquired MERS-CoV after arriving in Saudi Arabia and that lineage 5 viruses have the greater evolutionary fitness and appear to outcompete other viral lineages, which is concordant with other recently reported data (8). The high rates of MERS-CoV we detected and viral phylogeny suggest likely cross-transmission of MERS-CoV within the camel market and abattoir complex, even among imported animals.

ObjectiveTo estimate the prevalence of depression and anxiety and identify associated risk factors in hospitalised persons with confirmed COVID-19 in Edo, Nigeria.DesignA multicentre cross-sectional survey.SettingPatients with COVID-19 hospitalised at the three government-designated treatment and isolation centres in Edo State, Nigeria.ParticipantsThe study was conducted from 15 April to 11 November 2020 among 489 patients with confirmed COVID-19 and in treatment and isolation centres in Edo State, Nigeria. The mean age of participants was 43.39 (SD=16.94) years. Male participants were 252 (51.5%) and female were 237 (48.5%).Main outcome measuresThe nine-item Patient Health Questionnaire for depression, (total score: 0–27, depression ≥10), Generalized Anxiety Disorder-7 for anxiety (total score: 0–21, anxiety ≥10), and social demographic and clinical characteristics for associated risk factors.ResultsOf the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms, respectively. The prevalence rates of depression, anxiety and combination of both were 16.2%, 12.9% and 9.0%, respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety.ConclusionA substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address modifiable risk factors for psychiatric manifestations early in the course of the disease and integrate mental health interventions and psychosocial support into COVID-19 management guidelines.

Background Mental health disorders among adolescents is on the rise globally. For fear of stigmatization, patients seldom present to mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to evaluate the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. Methodology A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. Ethical approval was obtained prior to commencement of the study. Results Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). Conclusion Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their Family Medicine clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help reduce stigmatization and improve the management of the disease thus reducing the burden.