Description of the design of a mixed-methods study to assess the burden and determinants of malaria transmission for tailoring of interventions (microstratification) in Ibadan and Kano metropolis.

BACKGROUND: Rapid urbanization in Nigerian cities may lead to localized variations in malaria transmission, particularly with a higher burden in informal settlements and slums. However, there is a lack of available data to quantify the variations in transmission risk at the city level and inform the selection of appropriate interventions. To bridge this gap, field studies will be undertaken in Ibadan and Kano, two major Nigerian cities. These studies will involve a blend of cross-sectional and longitudinal epidemiological research, coupled with longitudinal entomological studies. The primary objective is to gain insights into the variation of malaria risk at the smallest administrative units, known as wards, within these cities. METHODS/RESULTS: The findings will contribute to the tailoring of interventions as part of Nigeria's National Malaria Strategic Plan. The study design incorporates a combination of model-based clustering and on-site visits for ground-truthing, enabling the identification of environmental archetypes at the ward-level to establish the study's framework. Furthermore, community participatory approaches will be utilized to refine study instruments and sampling strategies. The data gathered through cross-sectional and longitudinal studies will contribute to an enhanced understanding of malaria risk in the metropolises of Kano and Ibadan. CONCLUSIONS: This paper outlines pioneering field study methods aimed at collecting data to inform the tailoring of malaria interventions in urban settings. The integration of multiple study types will provide valuable data for mapping malaria risk and comprehending the underlying determinants. Given the importance of location-specific data for microstratification, this study presents a systematic process and provides adaptable tools that can be employed in cities with limited data availability.

Association between Family Functionality, Sociodemographic Factors, and Severity of Depression in Women with Infertility Attending a Gynecology Clinic in Northwest Nigeria.

Background Depression is a common psychological disorder in women with infertility, which causes significant morbidity and mortality. Little attention is currently given to depression by health care providers who manage infertility, and there is a scarcity of studies on depression among women with infertility in northern Nigeria. Objective This study aimed at assessing the association between family functionality, sociodemographic factors, and depression severity in women with infertility attending a gynecology clinic in northwest Nigeria. Methods This was a cross-sectional study involving 415 females systematically selected from women with infertility attending a gynecology clinic in a Nigerian hospital. They were interviewed using Beck's Depression Inventory and Family APGAR (Adaptability, Partnership, Growth, Affection, Resolve) questionnaires over 12 weeks. Data regarding participants' sociodemographic and infertility characteristics were also collected. The association between categorical variables was assessed using the chi-square or Fisher's exact test. The determinants of depression severity were assessed using logistic regression analysis. A p -value of < 0.05 was considered significant. Results The mean age of respondents was 30.9 ± 6.6 years; the prevalence of depression was 44.6% (32.5% were of mild severity). Most families (73.5%) were highly functional. Association between family functionality and depression severity was not statistically significant (chi-square =5.143, p = 0.259). Respondents' religion (chi-square = 10.813, p = 0.029), education (chi-square = 36.835, p = 0.001), and monthly income (chi-square = 9.261, p = 0.010) were associated with depression severity. Being a Muslim (odds ratio [OR] = 2.9, 95% confidence interval [CI] = 1.8-5.6, p = 0.001) and having formal education (OR = 10.2, 95% CI = 4.7-16.5, p = 0.001) were determinants of depression severity. Conclusion The prevalence of depression was high among the respondents. Although no association was found between family functionality and depression severity, respondents who are Muslims or had formal education were at increased risk of depression. Therefore, a high index of suspicion for depression and holistic care is required to manage women with infertility.