Investigation of community knowledge, attitudes and stigma towards leprosy in Nigeria: a mixed-methods study.

BACKGROUND: Little is known about community knowledge and stigma towards leprosy in endemic settings. The aim of this study was to evaluate community knowledge, attitudes and stigma towards leprosy in Nigeria. METHODS: This was a mixed-methods study consisting of a quantitative cross-sectional survey of community members and qualitative focus group discussions with community members and people affected by leprosy as well as key informant interviews with healthcare workers and community leaders. RESULTS: Of the 811 survey participants, 401 (49.4%) had a poor knowledge of leprosy that was driven by cultural beliefs, fear of its contagiousness and poor knowledge of its means of transmission. The participants reported high stigma levels with a mean score of 18.96±7.73 on the Explanatory Model Interview Catalogue Community Stigma Scale and 9.39±7.03 on the Social Distance Scale. Stigma levels were influenced by age, residence, education and knowledge of leprosy. Qualitative data suggested that community members were scared of leprosy infectiousness, and local illness concepts and misconceptions informed attitudes and behaviour towards leprosy in the community. CONCLUSION: Community members have a poor knowledge of, and high stigma levels towards leprosy. Culture-specific health education and behavioural change interventions are needed to address the identified gaps.

The transmission line foreign body detection algorithm based on weighted spatial attention.

Introduction: The secure operation of electric power transmission lines is essential for the economy and society. However, external factors such as plastic film and kites can cause damage to the lines, potentially leading to power outages. Traditional detection methods are inefficient, and the accuracy of automated systems is limited in complex background environments. Methods: This paper introduces a Weighted Spatial Attention (WSA) network model to address the low accuracy in identifying extraneous materials within electrical transmission infrastructure due to background texture occlusion. Initially, in the model preprocessing stage, color space conversion, image enhancement, and improved Large Selective Kernel Network (LSKNet) technology are utilized to enhance the model's proficiency in detecting foreign objects in intricate surroundings. Subsequently, in the feature extraction stage, the model adopts the dynamic sparse BiLevel Spatial Attention Module (BSAM) structure proposed in this paper to accurately capture and identify the characteristic information of foreign objects in power lines. In the feature pyramid stage, by replacing the feature pyramid network structure and allocating reasonable weights to the Bidirectional Feature Pyramid Network (BiFPN), the feature fusion results are optimized, ensuring that the semantic information of foreign objects in the power line output by the network is effectively identified and processed. Results: The experimental outcomes reveal that the test recognition accuracy of the proposed WSA model on the PL (power line) dataset has improved by three percentage points compared to that of the YOLOv8 model, reaching 97.6%. This enhancement demonstrates the WSA model's superior capability in detecting foreign objects on power lines, even in complex environmental backgrounds. Discussion: The integration of advanced image preprocessing techniques, the dynamic sparse BSAM structure, and the BiFPN has proven effective in improving detection accuracy and has the potential to transform the approach to monitoring and maintaining power transmission infrastructure.

Participatory Development and Assessment of Audio-Delivered Interventions and Written Material and Their Impact on the Perception, Knowledge, and Attitudes Toward Leprosy in Nigeria: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: In Nigeria, similar to many leprosy-endemic countries, leprosy is highly stigmatized. High levels of stigma among community members as well as internalized stigma among persons affected by leprosy often result in negative psychosocial consequences for those affected. To break this vicious cycle, it is important to conduct context-specific behavioral change activities. Although written material has been successful in improving knowledge and perception, it is not suitable for populations with low educational levels. Audio-delivered interventions are likely to be more suitable for people who are illiterate. This study proposes to assess the impact of an audio-delivered intervention on the perception (knowledge, attitudes, and beliefs) of community members with regard to leprosy in Nigeria. OBJECTIVE: This study aims to assess the impact of audio-delivered and written health education on the perception of leprosy. Specific objectives are to (1) investigate the perception (local beliefs, knowledge, and attitudes) of community members toward leprosy and persons affected by leprosy; (2) investigate whether there is a difference in impact on perception between participants who have received audio-delivered health education and those who have received written health education, with specific reference to gender differences and differences between rural and urban areas; and (3) assess the impact of the participatory development of the audio-delivered and written interventions on empowerment and internalized stigma of persons affected by leprosy who developed the interventions. Additionally, we will translate and cross-culturally validate 4 study instruments measuring outcomes in 2 major Nigerian languages. METHODS: We will use a mixed methods, cross-sectional study design for the intervention development and a 3-arm cluster randomized controlled trial for its implementation and evaluation, comprising (1) baseline assessments of knowledge, attitudes, perceptions, and fears of community members, to develop the audio-delivered content and written material, and the self-esteem and internalized stigma of persons affected by leprosy; and (2) participatory development of the audio-delivered content and written material by persons affected by leprosy and the pilot and implementation of the interventions. This will be done among different groups (selected using cluster randomization) that will be compared (control group, audio-intervention group, and written material group) to evaluate the intervention and the impact of developing the intervention on the persons affected. RESULTS: This study was funded in June 2022, and community member participant recruitment started in January 2023. Baseline data collection was completed by May 2023 (n=811). Participatory cocreation of the audio and written health education content began in July 2023, and the materials are currently under development. Study results are expected in September 2024. CONCLUSIONS: Study findings will contribute to developing evidence-based, context-specific behavioral change interventions, which are critical to addressing stigma in many leprosy-endemic communities where leprosy is highly stigmatized, and contribute toward global triple zero leprosy efforts. TRIAL REGISTRATION: Pan African Clinical Trial Registry PACTR202205543939385; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23667. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53130.

Antenatal care utilization and its associated factors in Somalia: a cross-sectional study.

BACKGROUND: WHO recommends attending minimum four ANC consultations during pregnancy to ensure early detection of complications. The objective of this study was to quantify ANC attendance and factors associated with it. METHODS: Participants were randomly selected using the WHO Cluster survey methodology in Southern and Central Somalia. A paper-print questionnaire was used to collect all data. Outcomes of interest were: access to at least one ANC consultation, completion of at least four ANC consultations, initiation of breastfeeding and place of delivery, while exposures included factors related to the latest pregnancy and demographic characteristics. Associations were assessed through logistic regression. RESULTS: Seven hundred ninety-two women answered the questionnaire; 85% attended at least one and 23% at least four ANC consultations, 95% started breastfeeding and 51% had an institutional delivery. Encouragement to attend ANC increased the odds of attending at least one consultation (aOR = 8.22, 95%CI 4.36-15.49), while negative attitude of husband or family decreased the odds (aOR = 0.33, 95%CI 0.16-0.69). Knowing there is a midwife increased the odds of at least four visits (aOR = 1.87, 95%CI 1.03-3.41). Attending at least four consultations increased the odds of delivering in a health structure (aOR = 1.50, 95%CI 1.01-2.24), and attending at least one consultation was associated with higher odds of initiating breastfeeding (aOR = 2.69, 95%CI 1.07-6.74). CONCLUSIONS: Family has a strong influence in women's ANC attendance, which increases the likelihood of institutional delivery and initiating breastfeeding. Women and families need to have access to information about benefits and availability of services; potential solutions can include health education and outreach interventions.

Groundwater pollutants characterization by geochemometric technique and geochemical modeling in tropical savanna watershed.

Multiple interactions of geogenic and anthropogenic activities can trigger groundwater pollution in the tropical savanna watershed. These interactions and resultant contamination have been studied using applied geochemical modeling, conventional hydrochemical plots, and multivariate geochemometric methods, and the results are presented in this paper. The high alkalinity values recorded for the studied groundwater samples might emanate from the leaching of carbonate soil derived from limestone coupled with low rainfall and high temperature in the area. The principal component analysis (PCA) unveils three components with an eigenvalue > 1 and a total dataset variance of 67.37%; this implies that the temporary hardness of the groundwater and water-rock interaction with evaporite minerals (gypsum, halite, calcite, and trona) is the dominant factor affecting groundwater geochemistry. Likewise, the PCA revealed anthropogenic contamination by discharging [Formula: see text] [Formula: see text][Formula: see text] and [Formula: see text] from agricultural activities and probable sewage leakages. Hierarchical cluster analysis (HCA) also revealed three clusters; cluster I reflects the dissolution of gypsum and halite with a high elevated load of [Formula: see text] released by anthropogenic activities. However, cluster II exhibited high [Formula: see text] and [Formula: see text] loading in the groundwater from weathering of bicarbonate and sylvite minerals. Sulfate ([Formula: see text]) dominated cluster III mineralogy resulting from weathering of anhydrite. The three clusters in the Maiganga watershed indicated anhydrite, gypsum, and halite undersaturation. These results suggest that combined anthropogenic and natural processes in the study area are linked with saturation indexes that regulate the modification of groundwater quality.

Focused Research on the Challenges and Productivity of Researchers in Nigerian Academic Institutions Without Funding.

Background: The challenge of research funding constraints has brought to bear enormous pressure on researchers. Research productivity is relevant to prestige and career progression of academic staff. However, this study aimed to explore significant challenges associated with researchers' productivity and the impact of non-funding of research in Nigerian research and tertiary institutions. Methods: This study adopted a qualitative exploratory design involving academics at various research and tertiary institutions across the six geographical regions in Nigeria. A semi-structured questionnaire was distributed electronically to all participants who consented to take part in this study. Exactly 4,159 questionnaires were administered and 2,350 were completely filled and returned. Pearson correlation matrices with logistic regression were used for data analysis and are presented in frequencies and percentages. Results: On challenges faced by respondents, 42.98% reported a lack of research funding, 17.11% mentioned brain drain challenge while 8.85% indicated a lack of motivation. Of the 23,927 publications reported, the number of those in sciences, engineering, and medical sciences averaged 9.6, 11.5, and 9.5 respectively. The average number of publications by women (10.8) was more than by men (9.7). Lecturers had the highest average research publication number (11.8) followed by researchers (10.2) and others (3.9). Men had the highest (11.9) average number of conferences compared to women (9.2). Participants in engineering had an average number of 13.8 conferences per respondents followed by those in education (11.2), sciences (11.1), and 10.9 for those in agricultural sciences. The result revealed a negative significant correlation between research publication and academic qualification at p < 0.01. Positive significant correlation was observed between research productivity and discipline at p < 0.05. Findings show that the combined influence of the independent variables on research productivity was significant using linear regression analysis. Conclusions: The failure to prioritize research has resulted in underdevelopment in Nigeria. It is therefore imperative that the federal government prioritize research and establish a functional Special Research Trust Fund to oversee research funding in Nigeria.

Viral suppression among HIV-positive patients on antiretroviral therapy in northwestern Nigeria: an eleven-year review of tertiary care centre records, January 2009-December 2019.

BACKGROUND: Human Immuno-Deficiency Virus (HIV) remains one of the world's significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral suppression, and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. METHODS: This retrospective descriptive cross-sectional study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral load (VL), and other relevant parameters were extracted from the patients' care records. The primary outcome was the proportion of patients that achieved viral suppression. We also analyzed variables that were associated with VL suppression. RESULTS: Of 913, records of 831 (91.0%) registered patients were analyzed. During the period, 751 (90.4%) achieved viral suppression, 427 (51.4%) had CD4 counts ≥ 500 and 477 (57.4%) were on HAART for ≥ 5 years. Majority, 793 (95.4%) were on first-line HAART regimen (Tenofovir-Lamivudine-Dolutegravir or Abacavir-Lamivudine-Dolutegravir), and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The median (interquartile range) of viral load was 20 (20-40) vs 19,989 (3311-110,340) cp/ml in virally suppressed, and unsuppressed  respectively. Factors associated with viral suppression included being unemployed (Adjusted OR [AOR] 4.9, 95% CI 2.771, 8.539), educated (AOR 4.2, 95% CI 1.098, 16.223), having a baseline CD4 count ≥ 500 cells/µl (AOR 2.7, 95% CI 1.588, 4.625), and being on first line HAART regimen [AOR 7.0, 95% CI 3.220, 15.648]. CONCLUSIONS: Our study demonstrated a good viral suppression among PLHIV on HAART. Variables associated with viral suppression included unemployment, formal education, high baseline CD4 count, and first line HAART regimen.

Global burden of active smoking among people living with HIV on antiretroviral therapy: a systematic review and meta-analysis.

BACKGROUND: Although the high burden of both active smoking and human immunodeficiency virus (HIV) is clearly known, the relationship between them is still not well characterized. Therefore, we estimated the global prevalence of active smoking in people living with HIV (PLHIV) on antiretroviral therapy (ART) and investigated the association between exposure to active smoking and risk for suboptimal adherence to ART. Main text: We searched PubMed, Embase, and Web of Science to identify articles published until September 19, 2019. Eligible studies reported the prevalence of active smoking in PLHIV on ART or investigated the association between active smoking and ART adherence; or enough data to compute these estimates. We used a random-effects model to pool data and quantified heterogeneity (I2). The global prevalence of active smoking was 36.1% (95% CI: 33.7-37.2; 329 prevalence data; 462 104 participants) with substantial heterogeneity. The prevalence increased with level of country income; from 10.1% (95% CI: 6.8-14.1) in low-income to 45.2% (95% CI: 42.7-47.7) in high-income countries; P < 0.0001. With regards to the Joint United Nations Programme on HIV/AIDS (UNAIDS) regions, the prevalence was higher in West and Central Europe and North America 45.4% (42.7-48.1) and lowest in the two UNAIDS regions of sub-Saharan Africa: Eastern and Southern Africa 10.7% (95% CI: 7.8-14.0) and West and Central Africa 4.4% (2.9-6.3); P < 0.0001. Globally, we estimated that there were 4 110 669 PLHIV on ART who were active smokers, among which the highest number was from Eastern and Southern Africa (35.9%) followed by Asia and the Pacific (25.9%). Active smoking was significantly associated with suboptimal ART adherence: pooled odds ratio 1.57 (95% CI: 1.37-1.80; I2 = 56.8%; 19 studies; 48 450 participants); even after considering adjusted estimates: 1.67 (95% CI: 1.39-2.01; I2 = 53.0%; 14 studies). CONCLUSIONS: This study suggests a high prevalence of active smoking in PLHIV on ART and an association between active smoking and ART suboptimal adherence. As such, healthcare providers and policy makers should focus on adopting and implementing tobacco harm reduction strategies in HIV care, especially in sub-Saharan Africa known as epicenter of HIV pandemic with highest number of active tobacco smoking among PLHIV on ART.

Effect of Co-administration of Glibenclamide and Aqueous Calyx Extract of Hibiscus Sabdariffa on Oxidative Stress Markers in Streptozotocin-Induced Diabetic Rats.

The hyperglycaemia of diabetes mellitus (DM) induces oxidative stress which damages the tissues. Glibenclamide, an oral hypoglycaemic drug used in the treatment of DM has associated side effects. Natural products are considered safe in the treatment of chronic diseases. Hibiscus sabdariffa (HS) is a plant that has demonstrated antidiabetic activity. We aimed to determine the potential benefits of co-administration of HS and glibenclamide in ameliorating oxidative stress in streptozotocin (STZ)-induced diabetic rats.  A total of 25 male albino Wistar rats were divided randomly into five groups: control (Non-DM), diabetic (DM), diabetic treated with 600µg/kg BW of glibenclamide (DM + GLIB), diabetic treated with 500mg/kg BW of HS (DM + HS), diabetic treated with both 600µg/kg BW of glibenclamide and 500mg/kg BW of HS (DM + GLIB + HS). The interventions were administered for a period of 28 days. The Non-DM rats were significantly heavier (p<0.01) compared to rats in the other treatment groups. Glibenclamide or HS alone and in combination, significantly lowered (p < 0.001) the final fasting blood glucose concentration of the rats in the respective treatment groups. HS and a combination of HS+ GLIB resulted in increased (p<0.05) serum activity of catalase, glutathione peroxidase and superoxide dismutase compared to the DM untreated rats.  The serum level of malondialdehyde was significantly lowered (p=0.000) in rats that received a combination of HS + GLIB compared to the DM untreated rats. Coadministration of HS + GLIB showed beneficial regeneration of islet-cells in the pancreas. Co-administration of HS + GLIB appears to be more beneficial in the treatment of DM and associated oxidative stress than when given as single agents. Thus, a case for their incorporation as a combined therapy for DM should be considered.

Epidemiology of COVID-19 and Predictors of Outcome in Nigeria: A Single-Center Study.

There is a paucity of information regarding the epidemiology and outcome of COVID-19 from low/middle-income countries, including from Nigeria. This single-center study described the clinical features, laboratory findings, and predictors of in-hospital mortality of COVID-19 patients. Patients admitted between April 10, 2020 and June 10, 2020 were included. Forty-five patients with a mean age of 43 (16) years, predominantly male (87%), presented with fever (38%), cough (29%), or dyspnea (24%). In-hospital mortality was 16%. The independent predictors of mortality were hypoxemia (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.3-5.1) and creatinine > 1.5 mg/dL (aOR: 4.3; 95% CI: 1.9-9.8).

Stopping circulatory vaccine-derived poliovirus in Kaduna state by scaling up special interventions in local government areas along rivers of interest- kamacha basin experience, 2013-2015.

BACKGROUND: The Kamacha river is one of the five polio environmental surveillance sites in Kaduna State where 13 circulating vaccine-derived polioviruses (cVDPDs) were isolated between 2014 and 2015. Kamacha river accounted for 5 of all reported cVDPVs in Kaduna State between 2014 and 2015. Poor quality Supplemental Immunization Activities (SIAs) and low population immunity have been reported in the 10 LGAs with tributaries that flow into the river. We described the processes of implementing the various health interventions in these targeted LGAs along the Kamacha River and assessed the effectiveness of the interventions in stopping cVDPV in Kaduna, state, Nigeria. METHODS: Special interventions that had been proven to be functional and effective in reaching unreached children with potent vaccines in the state were scaled up in these targeted 10 LGAs along the Kamacha River. These interventions included revision of house based microplans, scaling up of transit vaccination, scaling up of youth engagement, intensified supportive supervision, scaling up of Directly Observed Polio Vaccination (DOPV) and in-between rounds vaccination activities. We analyzed immunization plus days (IPDs) administrative tally sheet and monitoring data from 10 rounds before and 10 rounds after the special interventions. RESULTS: The number of children immunized increased from 1,862,958 in December 2014 before the intervention to 1,922,940 in March 2016 after the intervention. Lot Quality Assurance Sampling (LQAS) results showed an increase in the proportion of LGAs accepted at coverage > 90% after the interventions, from 67% before intervention to 84% after intervention. The proportion of non-polio AFP children with > 4 doses of oral polio vaccine increased from 2 to 8% before to 93-98% after the interventions.. No new environmental cVDPV has been isolated since the introduction of the interventions in April 2015 until July 2016. CONCLUSION: Scaling up known working interventions in the 10 LGAs with tributaries that drain to Kamacha River environmental sample site may have contributed to improved immunity and interruption of cVDPV in Kaduna state. These interventions should be replicated in LGAs and states with persistent poliovirus isolation.

Conduct of vaccination in hard-to-reach areas to address potential polio reservoir areas, 2014-2015.

BACKGROUND: The Global Vaccine Action Plan (GVAP) seeks to achieve the total realization of its vision through equitable access to immunization as well as utilizing the immunization systems for delivery of other primary healthcare programs. The inequities in accessing hard-to-reach areas have very serious implications for the prevention and control of vaccine-preventable diseases, especially the polio eradication initiative. The Government of Nigeria implemented vaccination in hard-to-reach communities with support from the World Health Organization (WHO) to address the issues of health inequities in the hard-to-reach communities. This paper documents the process of conducting integrated mobile vaccination in these hard-to-reach areas and the impact on immunization outcomes. METHODS: We conducted vaccination using mobile health teams in 2311 hard-to-reach settlements in four states at risk of sustaining polio transmission in Nigeria from July 2014 to September 2015. RESULTS: The oral polio vaccine (OPV)3 coverage among children under 1 year of age improved from 23% at baseline to 61% and OPV coverage among children aged 1-5 years increased from 60 to 90%, while pentavalent vaccine (penta3) coverage increased from 22 to 55%. Vitamin A was administered to 78% of the target population and 9% of children that attended the session were provided with treatment for malaria. CONCLUSIONS: The hard-to-reach project has improved population immunity against polio, as well as other routine vaccinations and delivery of child health survival interventions in the hard-to-reach and underserved communities.

Estimation of stature from radiographic measurement of foot dimensions: Truncated foot length may be more reliable than full foot length.

Foot length has been shown to be a reliable dimension for estimation of stature. However, phalanges of the foot are very small bones and their length may not be proportional to person's stature. Thus, we hypothesized that foot length measured excluding the phalanges, the truncated foot length, may be more reliable in stature estimation than full foot length. This study, therefore, aimed at comparing the accuracy of the regression equations derived from the truncated foot length and the full foot length. The study recruited a sample of 32 young adults (16 males and 16 females) aged from 20 to 35 years. Lateral radiographs of the right feet were obtained for each subject in a bilateral standing position while maintaining equal weight on both feet. Standing height of the participants was measured with a stadiometer. Truncated foot length and full foot length were measured on the lateral radiographs of the foot. Independent t-test was used to check for mean differences in the dimensions between genders. Linear regression analysis was used to determine the equations for stature estimation. Intra and inter-observer reliability were calculated from four precision estimates: absolute technical error of measurement (aTEM), relative technical error of measurement (rTEM), coefficient of reliability (Rr) and coefficient of variation (Cv). All the dimensions measured were significantly larger in males than females. Linear regression equations were derived for estimation of stature using both the truncated foot length and full foot length. The regression equations derived from truncated foot length have larger correlation coefficient, coefficient of determination, adjusted coefficient of determination as well as smaller standard error of estimation than those derived from full foot length. All the precision estimates showed that the measurement errors are within acceptable limits. This study suggests that even if the full foot length is available, excluding the phalanges may give more accurate stature estimation.

Revised Household-Based Microplanning in Polio Supplemental Immunization Activities in Kano State, Nigeria. 2013-2014.

BACKGROUND: Remarkable progress had been made since the launch of the Global Polio Eradication Initiative in 1988. However endemic wild poliovirus transmission in Nigeria, Pakistan, and Afghanistan remains an issue of international concern. Poor microplanning has been identified as a major contributor to the high numbers of chronically missed children. METHODS: We assessed the contribution of the revised household-based microplanning process implemented in Kano State from September 2013 to April 2014 to the outcomes of subsequent polio supplemental immunization activities using used preselected planning and outcome indicators. RESULTS: There was a 38% increase in the number of settlements enumerated, a 30% reduction in the number of target households, and a 54% reduction in target children. The reported number of children vaccinated and the doses of oral polio vaccine used during subsequent polio supplemental immunization activities showed a decline. Postvaccination lot quality assurance sampling and chronically missed settlement reports also showed a progressive reduction in the number of children and settlements missed. CONCLUSIONS: We observed improvement in Kano State's performance based on the selected postcampaign performance evaluation indicators and reliability of baseline demographic estimates after the revised household-based microplanning exercise.

Using the effects of maternal nutritional indicators (hemoglobin and total protein) on baby's birth weight outcome to forecast a paradigm shift toward increased levels of non-communicable diseases in children.

BACKGROUND: Maternal malnutrition can lead to low birth weight in babies, which puts them at risk of developing non-communicable diseases later in life. Evidence from developed countries has shown that low birth weight is associated with a predisposition to higher rates of non-communicable diseases later in life. However, information on this is lacking in developing countries. Thus, this work studied the effects of maternal nutritional indicators (hemoglobin and total protein) on birth weight outcome of babies to forecast a paradigm shift toward increased levels of non-communicable diseases in children. MATERIALS AND METHODS: Mother-baby pairs were enrolled in this study using systematic random sampling. Maternal haemogblobin and total proteins were measured using micro-hematocrit and biuret methods, and birth weights of their babies were estimated using the bassinet weighing scale. RESULTS: Of the 168 (100%) babies that participated in this study, 122 (72.6%) were delivered at term and 142 (84.5%) had normal birth weights. Mean comparison of baby's birth weight and maternal hemoglobin was not significant (P = 0.483), that for maternal total protein was also not significant (P = 0.411). Even though positive correlation coefficients were observed between birth weight of babies, maternal hemoglobin and total proteins, these were however not significant. CONCLUSION: Maternal nutrition did not contribute significantly to low birth weight in our babies. Therefore, association between maternal nutrition and low birth weight to predict future development of non-communicable diseases in our study group is highly unlikely. However, we recommend further work.

Adherence to intermittent preventive treatment for malaria in pregnancy in urban Kano, northern Nigeria.

Malaria in pregnancy is associated with substantial risk of maternal and fetal morbidity and mortality. The uptake of preventive antimalarials is low in malaria endemic countries, including Nigeria. Using a crosssectional study design, we assessed factors associated with uptake and adherence to intermittent preventive treatment for malaria in pregnancy (IPTp) among antenatal attendees in primary health centers in Kano, northern Nigeria (n5239). A total of 137 respondents (57.3%) reported receiving preventive antimalarials, but only 88 respondents (36.8%) [95% confidence interval (CI): 30.7­43.3%] reported ingesting pills in the clinic under supervision. Factors associated with adherence to IPTp after adjustment for potential confounding included: advanced maternal age [adjusted odds ratio (AOR) (95%CI)52.1 (1.3­6.37)], higher educational attainment [AOR (95%CI)53.2 (1.32­6.72)], higher parity [AOR (95%CI)51.6 (1.07­3.94)], lower gestational age at booking [AOR (95% CI)51.72 (1.24­3.91)], and use of insecticidetreated nets [AOR (95%CI)52.03 (1.13­3.26)]. There is a need for strengthening health systems and addressing cultural factors that impede efforts at expanding coverage of malaria prevention strategies in Nigeria.