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BACKGROUND: Epilepsy surgery has been shown to significantly improve the quality of life of patients with drug resistant epilepsy. Despite this, epilepsy surgery remains remarkably underutilized in Nigeria. There are high misconceptions about epilepsy and its management among physicians and trainees. METHODS: This study aims to identify knowledge gaps in epilepsy surgery among medical doctors in Nigeria and factors associated with their level of knowledge of the procedure. A cross-sectional study was carried out among 566 medical doctors in Nigeria, at different levels of post-graduate training (House officers, Medical officers, Resident doctors and Consultants). An online survey with a 24-item questionnaire adapted from a standardized pro forma was utilized. Binary and multiple logistic regression were used to identify associations between the independent variable and outcome variable (good or poor knowledge) RESULTS: Majority of the respondents were medical officers (post-intern physicians) comprising 65.7 % of the participants. Significant predictors of poor knowledge included being a medical officer [P=0.006], working in north-central [P=0.017] and north-western Nigeria [P=0.045], seeing less than 20 epilepsy patients per month [1-10 patients, P=0.015; 11-20 patients, P=0.011], and enrolment in online epilepsy course [P=0.004]. CONCLUSION: Comprehensive education and awareness about epilepsy surgery are important in overcoming the knowledge gap and improving access to care.

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BACKGROUND: Stroke is a leading cause of death and disability in Nigeria. Effective stroke management is essential to reduce morbidity and mortality. Few trained neurologists in Nigeria are mostly concentrated in the cities, making non-specialists the backbone of acute stroke management in Nigeria. Physicians-related factors have been identified as one of the factors leading to sub-optimal stroke care. This study aimed to describe the knowledge of medical doctors in acute stroke care and the factors responsible for the disparity in their skills. METHODS: A descriptive cross-sectional survey was conducted among 404 medical doctors across all the six geo-political zones in Nigeria using the Acute Stroke Management Questionnaire (ASMaQ). Data were analysed using descriptive statistics and simple logistics regression to predict the relationship between independent variables and the outcome variable (good knowledge vs poor knowledge). RESULTS: 67 % (95 % CI =63-72 %) of respondents had good overall knowledge of stroke management. Most respondents [88.6 %, 95 % CI =85-92 %] had good knowledge of General Stroke Knowledge (GSK) followed by Hyperacute Stroke Management (HSM) [52.5 %, 95 % CI=47.3-57.7 %] and Advanced Stroke Management (ASM) [49.5 %, 95 %CI= 49.5-54.4 %]. Working in a primary healthcare center (PHCs) and government hospital were significant predictor of overall poor knowledge of stroke. Physicians at PHCs had 2.29 times the odds of poor knowledge compared to those in tertiary hospital CONCLUSIONS: It is essential to retrain doctors on stroke management regularly, as part of their professional development.

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Background Teleneurology has been in existence for decades, and the COVID-19 pandemic has escalated its widespread usage. Neurological conditions are a leading cause of death globally, with sub-Saharan Africa bearing the bulk of the burden. Nigeria has few trained neurologists with the few available concentrated in an urban region. The adoption of teleneurology will help close this treatment gap. Despite evidence of its advantage, the adoption and state of teleneurology in Nigeria are very low. This study aims to determine the state and perception of teleneurology in the care of neurological patients in Nigeria and identify challenges to its wide usage. Methods The primary research method was a descriptive cross-sectional survey among 48 neurologists in Nigeria across the six geo-political zones of the country. Descriptive statistics such as frequency and percentage were used to summarize and present the results. Results A total of 48 neurologists participated, of which 46 (95.8%) specialized in general neurology. Videoconferencing is the most preferred means of telemedicine (24, 50%), followed by phone calls (16, 33.3%) and short messages (6, 12.5%). Three-quarters of the respondents are concerned about legal actions from telemedicine use. The majority (34, 70.9%) are not familiar with telemedicine tools, and 40 (83.3%) indicate low telemedicine seminar attendance. More than 90% (46) of neurologists believe that it is a viable approach and can save time and money. Barriers to telemedicine included the lack of incentive to use the technology (38, 79.2%), poor Internet connectivity (36, 75%), and the lack of exposure to telemedicine (36, 75%). Conclusions It is important to overcome the existing barrier to teleneurology in order to fully harness its potential in addressing the shortage of health professionals in Nigeria as most neurologists are open to using it.

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Introduction: the high expectations that heralded the development of COVID-19 vaccines has been plagued with vaccine hesitancy (VH). The prevalence and associated factors of COVID-19 VH in the six geopolitical zones in Nigeria are explored. Methods: using a cross sectional survey, a pre-tested and validated questionnaire on a "Google form" was distributed via social media platforms and hard copies in the six geopolitical zones of Nigeria. Included, using a chain-reference sampling technique, were healthcare workers (HCW), university students and adults in the general population. Participants who expressed unwillingness to receive COVID-19 vaccine in the event of an available vaccine were considered to have vaccine hesitancy. Frequency and percentage were used to describe categorical variables. Multivariable logistic regression analysis was used to assess for factors associated with VH. Level of significance was set at 5% on two-sided tails test. Results: among 1615 respondents, mean (standard deviation) age was 36.7 (11.3) years, and 847 (52.4%) were males. More than half were healthcare workers (943; 58.4%), 97.4% had at least secondary level of education, and majority 60.5% belonged to the upper social class. The prevalence of VH was 68.5% (1107/1615), and 67.2% preferred foreign manufactured COVID-19 vaccines. On multivariable regression analysis, residence in Northeast (AOR 6.01, 95% CI 2.24, 16.10) and Northwest (AOR 3.33, 95% CI 1, 48, 7.48) geopolitical zones, the Igbo ethnic group (AOR 1.88, 95% 1.10, 3.22), Christians (AOR 1.86, 95% 1.10, 3.14), nurses (AOR 3.50, 95% CI 1.25, 9.80), pharmacist (AOR 5.82, 95% CI 2.12, 16.32) and participants without confidence in foreign vaccines (AOR 4.13, 95% CI 2.99, 5.72) were at higher likelihood of VH. Conclusion: vaccine hesitancy is high among adults in Nigeria, with higher likelihood among the Igbo ethnic group, Christian faith, residence in Northeast and Northwest geopolitical zones and those with an aversion to foreign-made vaccines. Targeted interventions are required for the desired COVID-19 vaccine uptake rate and herd immunity.

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BACKGROUND: The burden of mental health problems among medical students is on the increase especially when compared with their counterparts in other disciplines. This has counterproductive impact on the society. Understanding the prevalence and predictors of common mental health problems can inform early intervention to curb this menace. AIMS: This study was conducted to determine the prevalence, pattern and correlates of common mental health problems (anxiety and depression) amongst medical students of the University of Ibadan, Nigeria. METHODOLOGY: A descriptive cross-sectional survey was conducted among 690 pre-clinical and clinical medical students of the University of Ibadan. Data were analyzed using descriptive statistics, Chi-square test and binary logistic regression at p < 0.05. RESULTS: The prevalence of anxiety and depression were 26.5% and 10.1%, respectively, with 6.8% having both. Perceived risk factors included overwhelming academic workload (65.2%) and failure to meet up with academic expectations (64.1%). The predictors of comorbid anxiety and depression were: polygamous family setting (OR 2.7: 95% CI: 1.156-6.536) and preclinical studentship (OR: 6.2; 95% CI: 2.282-16.868). CONCLUSION: This study shows that the prevalence of mental health problems is high among medical students.

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