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Background: Sub-Saharan Africa (SSA) is undergoing a rapid demographic change, with more people reaching old age. There is, however, little information available about healthcare policies with regards to this age group in this region of the world. Objectives: This scoping review aims to map the healthcare policies in sub-Saharan Africa (SSA) after the 2002 United Nations Madrid International Plan of Action on Ageing (MIPAA) with an eye towards to identifying strategies for promoting older people’s access to health care, integration of older people’s diseases into primary health care and the level of training and research in geriatrics and gerontology in SSA. Methods: This review adopted Arskey and O’Malley’s five-step methodology for scoping review and used the guide by Levac et al to operationalize the steps. Potentially relevant literature in English published between January 2003 and December 2017 was identified through PubMed, Google Scholar, EBSCOhost, and manual search. Articles that related to ageing in SSA in line with the aims of the review were included. The identified articles were independently assessed by the authors and the decision on the articles to be included was reached by a consensus. Findings: A total of 363 articles were identified through the databases and manual search of which only 4.7% (17/363) of the articles were included in the review. The findings showed that many SSA countries have formulated policies on healthy ageing and a few have policies to promote access to health care for the older people. The integration of non-communicable diseases (NCDs) management into primary health care (PHC) is encouraging but mental health appears to have been completely neglected. Training and research in gerontology and geriatrics are hardly supported by governments in SSA. Conclusions: Significant progress has been made by the SSA countries in policy formulation with regards to older persons but not much has been achieved with the implementation of the policies.

BackgroundThe Beers Criteria were developed with the aim of improving the safety of medicines among older persons. While the association between the Beers’ list of potentially inappropriate medicines (PIMs) and adverse drug reactions (ADRs) among older Caucasians is contentious, the ability of the Criteria to predict ADRs among older persons in Africa remains unexplored.ObjectivesThis study aimed to compare the prevalence of PIMs and ADRs among hospitalized older persons in Nigeria and South Africa, and to determine the association between the 2015 American Geriatrics Society-Beers (AGS-Beers) PIMs and ADRs.MethodsThe medical records of older persons aged ≥60 years who were hospitalized in teaching hospitals in Nigeria and South Africa were randomly selected, and retrospectively evaluated for ADRs by two clinical pharmacists using the Naranjo algorithm. The PIMs were assessed using the 2015 AGS-Beers Criteria. A multivariate logistic regression was used to determine the associated factors for ADRs among the hospitalized older persons, with P<0.05 being considered significant.ResultsThe samples which comprised 268 and 339 hospitalized older persons (mean age 70.53±8.22; 95% CI −0.21 to 2.32 vs mean age 69.49±7.64; 95% CI −0.25 to 2.34, P=0.11) were evaluated in Nigeria and South Africa, respectively. The PIMs among the older persons in Nigeria were 32.1% (86/268) and 30.1% (102/339, OR=0.91, 95% CI 0.64–1.29, P=0.6) for South Africa; 13.8% (37/268) of the hospitalized older persons in Nigeria experienced 43 cases of ADRs compared to 9.1% (31/339) in South Africa (95% CI 0.38–1.04, P=0.07). The multivariate analysis showed no association between PIMs and ADRs among the hospitalized older persons in Nigeria (OR=1.48 95% CI 0.70–3.17, P=0.31) and South Africa (OR=1.09, 95% CI 0.48–2.49, P=0.83).ConclusionThe 2015 AGS-Beers PIMs were not associated with ADRs among the hospitalized older persons in Nigeria and South Africa. However, physicians should be cautious when prescribing certain medications in the AGS-Beers list.

There have been conflicting reports about prevalence of Urinary Tract Infections (UTIs) causing bacteria in elderly in recent times. This study aims to evaluate the prevalence and resistance pattern of UTIs causing bacteria in elderly Nigerian patients. A prospective cross-sectional study was carried out among elderly patients attending the general and medical outpatients’ clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Patients aged 60 years and above with at least two signs of UTIs were purposefully selected for the study. Clean catch mid-stream urine specimens from 100 eligible patients were examined for significant bacteriuria. Identification and antibiotics susceptibility patterns of the isolates were determined using standard techniques. Data were analysed using descriptive statistics such as frequency and percentage. Association between variables was determined using Chi-squared test. P values<0.05 were considered significant. One hundred elderly outpatients were evaluated. Majority of the study participants were males (68, 68.0%) and (64, 64.0%) were married. More than half of the participants (59, 59.0%) had no significant bacteriuria. Among the participants with significant bacteriuria (41, 41.0%), males (29/41, 70.7%, p=0.001) were more than the females (12, 29.3%). Klebsiella pneumoniae (19/41, 46.3%) was the most isolated organism in the participants’ urine specimens, (35/41, 85.4%) of the isolates were resistant to nitrofurantoin. Klebsiella pneumoniae was the most isolated UTIs-causing bacteria among the elderly evaluated. Physicians need to be aware of trends in profiles of UTIs-causing bacteria for effective diagnosis of the disease in elderly.Journal of Medical and Biomedical Sciences (2017) 6(3), 15 - 22

Background There is growing concern about the adequacy of undergraduate curricula in schools of pharmacy worldwide regarding mental health. In Nigeria, both Bachelor and Doctor of Pharmacy degrees (BPharm and PharmD, respectively) are offered, but little is known about the scope of mental health care in either curriculum. Aim This study evaluated the perceptions of final year undergraduate students regarding the adequacy of the pharmacy curriculum in mental health care and their preparedness for a career in the field. Methods A pretested 33‐item questionnaire was administered to 950 (BPharm, n = 858; PharmD, n = 92) consecutively selected final year undergraduate students in the 19 accredited schools of pharmacy in Nigeria who had undergone experiential learning in teaching hospitals and community pharmacies and registered for the 2017–18 academic year. Results Most respondents (618/950; 65.1%) had no explicit learning on common mental disorders at the time of the study, and this did not differ significantly between the BPharm and PharmD respondents (p = 0.66). Most respondents (763/950; 80.3%) strongly disagreed or disagreed with the assertion that ‘the curriculum exposes students to real‐life mental health practice’. Furthermore, of the 932 that responded to the assertion that ‘pharmacy undergraduate curriculum prepares one adequately to practice mental health pharmacy’ 613 (65.8%) strongly disagreed or disagreed, with no significant difference between the PharmD and BPharm groups (p = 0.085). The respondents (460/950; 48.4%) would not specialise in mental health pharmacy, 38.0% (175/460) because they felt unprepared in terms of skills. Conclusion The respondents perceived the pharmacy curriculum as inadequate for mental health care and considered this inadequacy a hindrance towards its practice in Nigeria.