HIV self-testing and repeat testing in pregnancy and postpartum in Northern Nigeria.

OBJECTIVE: Incident HIV infections in pregnant and breastfeeding mothers pose significant challenges to prevention of mother-to-child HIV transmission efforts in sub-Saharan Africa. We identified the predictors of willingness to self-test for HIV when retesting in pregnancy and postpartum among antenatal clients in a tertiary hospital in Northern Nigeria. METHODS: Structured and validated questionnaires were administered to a cross section of antenatal attendees (n = 370) in March 2021. Willingness to self-test and adjusted odds ratios of potential predictors were generated from logistic regression models. RESULTS: Of the 317 respondents who agreed to repeat HIV test during pregnancy, 29.3% (n = 93) were willing to self-test. Similarly, of those (n = 350) willing to retest after delivery, 27.4% (n = 96) were willing to self-test. Willingness to self-test during pregnancy was higher among respondents who were multiparous (2-4 births) (adjusted odds ratio, aOR = 2.40, 95% confidence interval CI, 1.14-6.43), employed (aOR = 1.49, 95% CI, 1.13-4.53) and those with at least secondary education (aOR = 2.96, 95% CI, 1.43-11.47). In contrast, willingness to self-test was lower among those who were unaware of the husband's HIV status (aOR = 0.05, 95% CI, 0.02-0.13). Willingness to self-test after delivery was higher among respondents who were married (aOR = 15.41, 95% CI, 3.04-78.2), multiparous (aOR = 2.01, 95% CI, 1.27-5.63), employed (aOR = 1.59, 95% CI, 1.08-2.35) and had at least to secondary education (aOR = 6.12, 95% CI, 1.36-27.47). In contrast, willingness to self-test postpartum was lower among those who booked late (≥29 weeks) (aOR = 0.11, 95% CI, 0.022-0.52), those who were unaware of the risk of HIV transmission during breastfeeding (aOR = 0.29, 95% CI, 0.12-0.68) and participants who were unaware of the husband's HIV status (aOR = 0.076, 95% CI, 0.03-0.19). CONCLUSION: Willingness to self-test for HIV in pregnancy and postpartum was low in this population and was influenced by risk perception, socio-demographic and obstetric attributes. Communication interventions and training of potential mentor mothers among early adopters could improve self-testing in this group and similar settings.

Hydrogeochemical and salinity appraisal of surficial lens of freshwater aquifer along Lagos coastal belt, South West, Nigeria.

In order to determine the hydrogeochemical processes and salinity status of the surficial lens of freshwater aquifer in the Lagos coastal basin, physicochemical parameters and hydrogeochemical tools were employed in this study. These tools include existing methods such as Piper diagram, Durov diagram, Gibb's diagram, statistical analysis and geochemical modelling, and the newly proposed cationic contribution evaluation and ionic ratio bivariate plots. The Piper plot revealed that chemical facies is rich in (Ca, Mg, Cl and HCO3) and (Ca and HCO3) for the groundwater in both wet and dry seasons while Mg-Cl and Na-Cl water types characterised the lagoon and the Ocean, respectively. The surficial aquifer is an essentially freshwater in the dry season and partly saline in the wet season due to flash flood, marine aerosol precipitation and infiltration from the surrounding brackish surface waters. The Ca2++Mg2+ vs total cation (TZ+); HCO3 -/Ca2+vs Ca2+/Mg2+ and HCO3 -/Ca2+ vs Ca2+/Na+ plots as well as geochemical modelling indicated that carbonate weathering is the dominant chemical process controlling the groundwater chemistry for both seasons. In a descending order, water-rock interaction, ion exchange and evaporation are the geochemical processes controlling the groundwater quality in the area. Besides the natural processes, factor analysis revealed the imminent influence of anthropogenic activities (industrial and domestic) on the groundwater chemistry indicated by the presence of Mn, Fe, Ni, Cd, Pb, Cu and NO3 above the permissible limit of drinking water standard, particularly in the wet season. In addition to the successful application of the proposed ionic plots, the study justifies the importance of multiple tools application in the hydrogeochemical deductions and recommends consistent monitoring of the shallow aquifers in the Lagos coastal basin.

Study of hepatic functions and prevalence of hepatitis B surface antigenaemia in Nigerian children with human immunodeficiency virus infection.

BACKGROUND: HIV and hepatitis B virus (HBV) co-infected patients have a significantly increased risk of dying from liver disease especially after starting treatment with highly active antiretroviral therapy. We aim to determine the prevalence of hepatitis B surface antigenaemia in HIV-infected children and their significance in relation to hepatic functions. METHOD: Two hundred and eighty four HIV-infected children aged between 4 mouths to 15 years attending the Paediatric infectious disease clinic of University of Maiduguri Teaching Hospital (UMTH) Maiduguri, Nigeria from September 2007 to December 2007 were the subject for this study. Two hundred and seventy six HIV-negative children with served as age and sex-matched controls. They underwent investigations to evaluate the liver function (serum alanine transferase (ALT), alkaline phosphotase (ALP) and bilirubin) and the prevalence of hepatitis B surface antigen (HBsAg) using ELISA technique. RESULTS: Prevalence of HBsAg of 19% and 9.4% was observed among HIV-infected children controls (p = 0.004). Serum ALT and bilirubin concentrations were significantly higher in the HIV-infected group compared to the controls, (p < 0.05). HIV-infected children with HBs antigenaemia had significantly higher ALT and ALP concentrations compared to those without HBs antigenaemia (p < 0.05). CONCLUSION: These findings point to the high risk of HBV infection and continual paranchymal damage in HIV-infected children before commencing ART. Vaccination against HBV should eliminate this risk. Ideally HBV serology should be evaluated before starting ART to help guide therapeutic decision-making.