IntroductionSub-optimal adherence constitutes a significant impediment to the management of severe mental illnesses (SMIs) as it negatively impacts on the course of the illness and the treatment outcome. In this study, the levels of adherence, prevalence and the predictors of sub-optimal adherence were assessed in a sub-Saharan African setting.MethodsThree hundred and seventy (370) respondents with diagnoses of schizophrenia, bipolar disorder or severe depression were randomly enrolled and interviewed at the out-patient department of the Federal Neuropsychiatric Hospital, Maiduguri in northeastern Nigeria. An anonymous sociodemographic questionnaire and a clinical proforma designed by the authors, Oslo social support scale and the 8-item Morisky Medication Adherence Scale (MMAS-8) were used for data collection.ResultsThe prevalence of sub-optimal adherence was 55.7%. The independent predictors of sub-optimal adherence were; seeking for traditional/ spiritual treatment (Odds Ratio (O.R.) = 6.523, 95% C.I. = 3.773 - 11.279, P = < 0.001), male gender (O.R. = 3.307, 95% C.I. = 1.907 - 5.737, P = < 0.001), low levels of insight (O.R. = 1.753, 95 C.I. = 1.220 - 2.519, P = 0.002), and low social support levels (O.R. = 1.528, 95% C.I. = 1.097 - 2.129, P = 0.012).ConclusionBased on the outcome of the study, we recommend the development of psycho-educational programmes on adherence and the active involvement of the relations and significant others in the management of patients with SMIs in sub-Saharan Africa.

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.

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INTRODUCTION Cardiovascular disease has been leading cause of early disability and worldwide, and hypertension is the most important preventable risk factor for the development of cardiovascular disease Oliveira-Filho et al., 2014; Irazola Adherence to blood pressure lowering agents has been shown to be the cornerstone for achieving hypertension control, h developing countries, the effective treatment of blood pressure among people taking antihypertensive medication, wa average, particularly due to ABSTRACT Adherence to antihypertensive medication is the cornerstone for achieving hypertension control. Morisky Medication Adherence Scale (MMAS reported medication adherence measures. The aim of this study was to examine the evidence of the validity of adapted Hausa MMAS hypertensive patients in North individuals with hypertension, self treatment was measured using the Morisky Medication Adherence Scale consistency of the Morisky Medication Adherence Scale factorial validity was assessed by identifying the underlying components using principal component analyses (PCA). A total of 130 individuals completed the study. Cronbach's alpha was 0.79. Two components were identified. One component comprised medication when hypertension is under control, stopping when feeling hassled abou to the prescription. The second component comprised two other items that were all related to forgetfulness. A significant relationship between MMAS and control (t = 2.2; p = .030), (χ specificity, with positive and negative predictive values were respectively. The results suggest that the adapted Hausa Morisky Medication Adherence Scale-8 is a two-dimensional scale assessing intentional (first co (second component) non-adherence to the antihypertensive drug treatment. The findings of this validation study indicate that the Hausa version of the MMAS is a reliable and valid measure of medication adherence among hypertensive

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