Contemporary Anti-Retroviral Drugs (ARVDs) Disrupt Follicular Development in Female Wistar Rats.

Introduction: There are genuine concerns that long-term use of anti-retroviral drugs may be associated with reproductive complications in females. This study aimed to ascertain the effect of highly active anti-retroviral drugs on the ovarian reserve and reproductive potential of female Wistar rats and by extension to HIV-positive human females. Methods: A total of 25 female Wistar rats, weighing between 140g and 162g, were randomly allotted into non-intervention and intervention groups, receiving the anti-retroviral drugs, Efavirenz (EFV), Tenofovir Disoproxil Fumarate (TDF), Lamivudine (3TC), and a fixed-dose combination (FDC). The dosage was administered orally at 8 am daily for 4 weeks. Serum concentrations of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH), and estradiol were measured using standard biochemical techniques (ELISA). Follicular counts were made on fixed ovarian tissue from the sacrificed rats. Results: The mean AMH level for the control group and the EFV, TDF, 3TC, and FDC groups were 11.20, 6.75, 7.30, 8.27, and 6.60 pmol/L, respectively. The EFV and FDC groups had the lowest AMH, compared to the other groups, but there was no statistically significant difference in AMH across the groups. The mean count of antral follicles was significantly lower in the group that received EFV when compared to the other groups. The corpus luteal count was significantly higher in the control group than in the intervention groups. Conclusion: The study demonstrated a disruption in the reproductive hormones of female Wistar rats receiving anti-retroviral regimens containing EFV. Clinical studies are required to determine if these changes are seen in women receiving EFV-based treatment, as this may compromise reproductive function and predispose them to early menopause.

Self-reported use of and access to personal protective equipment among healthcare workers during the COVID-19 outbreak in Nigeria.

The SARS-CoV-2 virus is highly infectious resulting in increased infection and death among the front-line Healthcare Workers (HCW) because of limited access to personal protective equipment (PPE). This study assesses the availability and self-reported use of PPE amongst HCW during the COVID-19 pandemic in Nigeria. A mixed-method study was conducted through a cross-sectional survey and in-depth interviews amongst HCW. Quantitative data analysis was done using SPSS version 26 and thematic analysis was done for the in-depth interview. A total of 258 HCW completed the survey while 15 HCW took part in the in-depth interview. The mean age was 40 (±8.6) years, 67.4% were female and 83.3% were married. 49% were Doctors, 21.1% were Nurses, 28.7% were other allied HCW and 62.2% had at least 10 years of practice experience. Only 22.1% of HCWs had regular access to PPE and only 20.6% had access to N-95 facemask compare to other PPEs. Male HCWs and those working at secondary or tertiary facilities had access to N-95 facemask (p-value 0.025 and 0.010 respectively). The facilitator of PPE use is leadership quality of hospital head and donation of PPE to the facilities while the barriers to PPE use include a limited supply of PPE, as well as facility's infrastructural and operational challenges. The study reported limited access to essential PPE with varying perspectives on its use. Therefore, access, knowledge, and appropriate use of PPE need urgent attention with improved implementation of infection control policy at the facility level.

Implementation of a modified drive-through sampling strategy for SARS-CoV-2-the Nigerian experience.

INTRODUCTION: effective and safe means of sample collection is a crucial component of testing for Covid-19. Uptake of testing is key to containing and controlling the spread of the virus. Scientists have been working on various strategies that will increase the uptake of testing for COVID-19. One such method involves the use of the drive-through sampling strategy. METHODS: data was collected by both qualitative and quantitative methods. An eligibility form was filled online. While in-depth interviews were conducted for the qualitative aspect of the study. RESULTS: 2,600 visits were recorded at the website, 2300 (88.46%) participants successfully registered for the test. 57.4% were found eligible of which 78.0% presented for the test. This Consisted of 78.0% drive-through and 22.0% walk-in. The average time for transiting through the drive-through site was 19.2 ± 4.6minutes while that of the walk-in was 28 ± 9.2min. This difference was statistically significant (p<0.001). In the qualitative component, respondents opined that maximum safety measures were deployed to protect both participants and health workers. Most said that the turnaround time for the sampling process was short. CONCLUSION: the sampling strategy although largely successful, is largely dependent on Internet penetrability, thus this sampling modality will be best utilized as an adjunct to established models of sample collection.

HIV Status Discordance: Associated Factors Among HIV Positive Pregnant Women in Lagos, Southwest Nigeria.

The HIV negative partner in a HIV serodiscordant relationship is at high risk of becoming HIV infected. The annual risk of HIV infection for a partner of a person with HIV is about 10%, with higher annual transmission rates of 20-25% per year reported in Rwanda and Zambia. Although there is considerable variation across countries, recent studies in southern and east Africa countries with mature epidemics reported that up to two-thirds of infected persons in stable relationship are discordant. HIV serodiscordance is thus a recognized priority for HIV prevention intervention. In Nigeria only few studies have studied the burden of serodiscordance, making planning difficult. In this study HIV serodiscordance rate and associated factors among pregnant women were assessed in a large PMTCT clinic in Lagos Nigeria over a 9 years period. Information on HIV status disclosure, partners HIV status (confirmed by HIV test results), sociodemographic characteristics and reproductive information were obtained from the women after enrollment and entered into the case file. In the study, relevant information was managed with SPSS for windows version 19.0. The variables independently associated with HIV status discordance were determined in both univariate and multivariate analysis. P values and Odd ratio with their confidence intervals were calculated. Out of the 4435 women enrolled during the study period, 3712 (83.7%) had disclosed their status to their partner. Partner's HIV status among the women with confirmed HIV status was negative in 2065 (66.8%) women, thus a discordant rate of 66.8%. HIV status disclosure rate was 83.7%; with significantly higher disclosure rate in concordant couple (83.3%) compared to 76.8% among women in serodiscordant relationship (p = 0.00; OR: 1.5; 95% CI: 1.25-1.82). Discordant HIV status in a female positive relationship was found to be associated with history of at least two termination of pregnancy (OR: 3.05; 95% CI: 2.91-3.89) and five or more total life time sexual partnership (OR: 2.3; 95% CI: 1.27-3.21). The perception that men are the index cases is not supported by evidence from this study. We recommend the tracking of both men and women as index cases in other to reduce HIV transmission within stable relationship. Social marketing aimed at reducing concurrency should focus on both male and females, if we must reduce new HIV infection within stable relationships.