This column describes the current state of resources and practice in mental health care in the Anglophone countries of West Africa: the Gambia, Sierra Leone, Ghana, Nigeria, and Liberia. Information was systematically gathered from the five countries by using a standard framework for country situation analysis. Mental health services, which are in various stages of development, are characterized by inadequate human resources and long policy neglect. Despite the low numbers of specialists, the region has made important contributions to community service development and global mental health research. Challenges include manpower development, policy and legislation updates, and increased attention to policy and budget. Although mental health service is still grossly inadequate in the context of human and material constraints, there are slowly evolving signs of positive modernization and service development.
Background: Depression is a common and severe disorder among low-income adolescent mothers in low-and middle-income countries where resources for treatment are limited. We wished to identify factors influencing health service utilization for adolescent perinatal depression, in Nigeria to inform new strategies of care delivery. Methods: Focus Group Discussions (FGDs) were conducted among purposively selected low-income young mothers (with medical histories of adolescent perinatal depression), and separately with primary care clinicians treating this condition in Ibadan, Nigeria. Participants from this community-based study were from the database of respondents who participated in a previous randomized control trial (RCT) conducted between 2014 and 2016 in 28 primary health care facilities in the 11 Local government areas in Ibadan. Semi-structured interview guides, framed by themes of the Behavioral Model for Vulnerable Populations, was developed to obtain views of participants on the factors that promote or hinder help-seeking and engagement (see additional files 1 & 2). FGDs were conducted, and saturation of themes was achieved after discussions with six groups. Transcripts were analyzed using content analysis. Results: A total of 42 participants, 17 mothers (who were adolescents at the time of the RCT), and 25 care providers participated in 6 FGDs. The availability of care for perinatal depression at the primary care level was an important enabling factor in healthcare utilization for the adolescents. Perceived health benefits of treatment received for perinatal depression were strong motivation for service use. Significant stigma and negative stereotypes expressed by care providers towards adolescent pregnancy and perinatal depression were obstacles to care. However, individual patient resilience was a major enabling factor, facilitating service engagement. Providers trained in the management of perinatal depression were perceived to deliver more tolerant and supportive care that adolescent mothers valued.
Religious advisors play an important role in mental health care and require appropriate training and collaboration with formal mental healthcare systems. Religious attitudes are strong predictors of religious advisors usage.
BackgroundAlzheimer’s disease (AD), an age-related neurodegenerative disease characterized by loss of memory has been attributed to oxidative stress induced by accumulation of Amyloid (Aβ) protein in the brain; environmental and genetic alterations have been implicated as the pathogenesis of the disease. This work investigated levels of selected trace (Iron, Zinc and Copper) and toxic (Cadmium and Lead) metals in AD patients.MethodIn this case-control study, a total of 38 participants (aged ≥ 60 years) consisting of 18 clinically diagnosed AD subjects and 20 apparently healthy age-matched adults were recruited from the University College Hospital Ibadan Geriatric Centre. Semi-structured questionnaire was used to obtain demographic information, clinical history, lifestyle and dietary patterns from participants. Blood levels of iron, copper, zinc, lead and cadmium were analyzed using Atomic Absorption Spectrophotometry (AAS); levels of malondialdehyde (MDA), total antioxidant capacity (TAC), hydrogen peroxide (H2O2), and total plasma peroxide (TPP) were determined spectrophotometrically, while oxidative stress index (OSI) and copper to zinc ratio (Cu:Zn) were calculated.ResultsMean plasma level of zinc was significantly lower in cases (86.04 ± 11.07 µg/dl) compared to controls (108.80 ± 12.47 µg/dl), while blood lead (13.85 ± 2.96 µg/dl, 8.32 ± 2.10 µg/dl) and cadmium (1.34 ± 0.71 µg/L, 0.71 ± 0.14 µg/L) levels were significantly higher in cases than in controls respectively. Although Fe and Cu levels were similar in cases and controls, Cu:Zn ratio was significantly elevated in cases compared to controls (p = 0.000). Though other OS markers were not significantly different in both groups, TPP was significantly higher in cases (64.96 ± 7.20 µmol/H2O2 vs. 55.41 ± 2.38 µmol/H2O2) while MDA correlated inversely with TAC in cases (r= − 0.477, p = 0.045).DiscussionThe low plasma Zn coupled with high blood Pb and Cd levels may precipitate the elevated TPP and Cu:Zn ratio in cases. The reduced metallothionine defense of the system as indicated by the elevated Cu:Zn ratio in cases may also exacerbate this problem.ConclusionThe damaging effect of increasing toxic metal levels may be accentuating development of oxidative stress facilitating the progression of AD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.