Project Status Report:

 

• Introduction

We are pleased to share the progress of our ongoing research project titled “Everyday Worries, Fears, and Anxiety in a Low Resource Setting: Patterns and Determinants of Generalized Anxiety Disorder and Depression among Adults in Northwest Nigeria”.

 

Generalised anxiety disorders and depression are currently a crisis in low resource settings of rural sub Saharan West Africa (SSWA) with far reaching effects on public health and national budgets prioritizing infectious, metabolic, and cardiovascular diseases.There is a limited literature on the awareness, determinants, prevalence, and patterns in SSWA. This study looks at the prevalence, patterns, and determinants of generalised anxiety disorders and depression in Jigawa, a largely rural low resource setting in North-West Nigeria.

 

• Timelines

1. Preliminary works which included research concept, resources mobilization, and concept notes
February 2024 to March 2024

2. .Ethical Clarance from Jigawa State Ministry of Health
April 2024 to July 2024

3. Data Collection
Training of data collectors
August 2024

 

Following the approval, we organized an onboarding training session for our selected data collectors on the 7th of August, 2024. The data collectors are experienced data collectors with extensive field exposure in health data collection. The training took place virtually via Google Meet at 8:00 PM and was focused exclusively on farmiliarising the team with the peculiarities of data collection and ethical issues in mental health research, and specifically on how to apply questionnaires and interview techniques during the exercise.

 

• Overview of Anxiety and Depression: Introduce the concepts of anxiety, depression, and the associated risk factors.
• Research Methodology: Provide a detailed overview of the research methods and data collection process.
• Ethical Issues: Discuss the ethical principles and guidelines for conducting research with human subjects.
• Community Entry and Interview Techniques: Highlight best practices for community entry and conducting interviews.

 

Training Schedule

Time	Topic	Facilitator
08:00-08:05 PM	Opening Prayer	Amir Muhammad
08:06-08:10 PM	Opening Remarks	Dr. Nuruddeen Muhammad
08:10-08:30 PM	Overview of Anxiety and Depression	Dr. Usman M. Ibrahim
08:40-09:20 PM	Research Methods	Dr. Usman M. Ibrahim
09:40-10:20 PM	Ethical Issues in Human Research	Dr. Usman M. Ibrahim
10:40-11:20 PM	Community Entry and Interview Tips	Dr. Usman M. Ibrahim
11:30 PM	Closing Remarks	Dr. Nuruddeen/Dr. Usman

 

Expected Outcomes

• Data collectors gained a solid understanding of anxiety and depression in the local context.
• They were trained to follow research protocols to ensure data quality and consistency.
• Practical tips on community engagement and interviewing were shared.

 

Questionnaires were immediately pretested on 12th of August, 2024.

This was followed by a debriefing session on 13th of August, 2024 were all concerns were raised and adequately addressed. Then the data collection phase commenced, which lasted between 14th to 16th of August, 2024.

Data collectors were fully mobilised for transport and paid their duty tour allowance (DTA) for both the pretesting exercise and the main data collection. The payment receipt is attached.

 

4. Data Analysis
24th August, 2024
Team held a post-data collection meeting. This was followed immediately by analysis.

 

5. Abstract

Mental health services including for anxiety disorders and depression are neglected public health areas in sub Saharan Africa despite an emerging trend and potential negative consequences. Materials and Methods: A cross-sectional survey assessed the prevalence and factors associated with anxiety disorders and depression amongst 405 adults in Jigawa state, North West, Nigeria. The Generalized Anxiety Disorders (GAD-7), Patient Health Questionnaire-9 (PHQ-9 questionnaires and a multi-stage sampling technique were employed and data were analysed using IBM SPSS version 22.0 with statistical significance set at a P≤5% Results: The minimum age of the respondents was 18 and the maximum was 82 with a Mean± SD of 39.2±14.9 years. About a quarter of respondents (24.7%) had a chronic medical condition and were on regular follow-ups to health facilities. In comparison, more than a quarter of them (26.7%) reported having a prior adverse life event. More than half (52.1%) of respondents reported knowing someone with a mental health disorder. The commonest medical condition reported by the respondents with chronic medical conditions was hypertension (11.6%), while flooding (12.3%) was the commonest adverse life event. 

The prevalence of anxiety disorders and depression were (29.1%), and (5.7%) respectively A significantly higher proportion of respondents (47.0%, p<0.001) who were on regular follow-ups to the health facility for chronic health conditions, those who smoked cigarettes (68.2%, p<0.001†), and those who used substances other than cigarettes and alcohol (69.2%, p<0.001) had an anxiety disorder. The odds of developing anxiety disorders were significantly lower amongst those with no family history of mental disorders. Those without a family history of mental disorders were 30% less likely to develop anxiety disorders compared with those who reported a family history of mental disorders (adjusted odds ratio [aOR] = 0.3, 95% CI = [0.2–0.4]). In addition, a significantly higher proportion (10.0%, <0.04†) of those who were on follow-up to the health facility for chronic medical condition were depressed. The odds of being depressed were significantly lower among respondents who were not on follow-up to the health facility for a medical condition, those who were not on follow-up for medical condition were 20% less likely to have depression compared to those who were not on follow-up for chronic medical condition (Adjusted odds ratio [aOR] = 0.2, 95% CI = [0.1–0.8]).

 

Conclusions: The anxiety disorders and depression were associated with substance use, chronic medical conditions, and adverse life events including conditions linked to climate change and global warming and a family history of mental health conditions. This is generally an extremely low resource setting, with lack of access to mental health services most acute in the study area. Relevant stakeholders should escalate the provision of mental health services including awareness campaigns, preventive interventions of the identified risk factors and prompt identification and appropriate treatment of cases.

Keywords: Factors, patterns, determinants, anxiety, depression, mental health, Jigawa, Nigeria

 

• Research Contributors:

Dr Usman Muhammad Ibrahim
MBBS, MRH, Msc.PH, FMCPH, FWACP, PhD
Department of Community Medicine, Federal University Dutse,
Jigawa State
Nigeria
usmanmi2000@gmail.com

 

Dr Nuruddeen Muhammad
MBBS, MWACP, FMCPsych
Unik Impact Foundation
Hadeja
Jigawa State
Nigeria
nmanku77@gmail.com

 

Dr Fawaz Babandi
MBBS, FWACP, FMCPsych
Department of Psychiatry,
Abubakar Tafawa University, Bauchi, Bauchi State
Nigeria.
babandif@yahoo.com