Impact of mobile health technologies on human papillomavirus vaccination uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria (mHealth-HPVac): study protocol of a randomised controlled trial.

BACKGROUND: Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) has the potential to empower patients to manage their health, reduce health disparities, and enhance the uptake of HPV vaccination. AIM: The "mHealth-HPVac" study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9-14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers. METHODS: This protocol highlights a randomised controlled trial involving women aged 25-65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n = 123 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant's school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be assessed using the independent sample t-test for normally distributed data, or the Mann-Whitney U test for skewed data. For two groups of categorical variables, the Chi-square (X2) test or Fisher's exact test will be used, as appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be reported as P < 0.05. DISCUSSION: The mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake. REGISTRATION: PACTR202406727470443 (6th June 2024).

Prenatal anaemia and risk of postpartum haemorrhage: a cohort analysis of data from the Predict-PPH study.

BACKGROUND: Most previous clinical studies investigating the connection between prenatal anaemia and postpartum haemorrhage (PPH) have reported conflicting results. OBJECTIVES: We examined the association between maternal prenatal anaemia and the risk of PPH in a large cohort of healthy pregnant women in five health institutions in Lagos, Southwest Nigeria. METHODS: This was a prospective cohort analysis of data from the Predict-PPH study that was conducted between January and June 2023. The study enrolled n = 1222 healthy pregnant women giving birth in five hospitals in Lagos, Nigeria. The study outcome, WHO-defined PPH, is postpartum blood loss of at least 500 milliliters. We used a multivariable logistic regression model with a backward stepwise conditional approach to examine the association between prenatal anaemia of increasing severity and PPH while adjusting for confounding factors. RESULTS: Of the 1222 women recruited to the Predict-PPH study between January and June 2023, 1189 (97·3%) had complete outcome data. Up to 570 (46.6%) of the enrolled women had prenatal anaemia while 442 (37.2%) of those with complete follow-up data had WHO-defined PPH. After controlling for potential confounding factors, maternal prenatal anaemia was independently associated with PPH (adjusted odds ratio = 1.37, 95% confidence interval: 1.05-1.79). However, on the elimination of interaction effects of coexisting uterine fibroids and mode of delivery on this association, a sensitivity analysis yielded a lack of significant association between prenatal anaemia and PPH (adjusted odds ratio = 1.27, 95% confidence interval: 0.99-1.64). We also recorded no statistically significant difference in the median postpartum blood loss in women across the different categories of anaemia (P = 0.131). CONCLUSION: Our study revealed that prenatal anaemia was not significantly associated with PPH. These findings challenge the previously held belief of a suspected link between maternal anaemia and PPH. This unique evidence contrary to most previous studies suggests that other factors beyond prenatal anaemia may contribute more significantly to the occurrence of PPH. This highlights the importance of comprehensive assessment and consideration of various maternal health factors in predicting and preventing this life-threatening obstetric complication.

An assessment of WRF-urban schemes in simulating local meteorology for heat stress analysis in a tropical sub-Saharan African city, Lagos, Nigeria.

Megacities, such as Lagos, Nigeria, face significant challenges due to rapid urbanization and climate change, resulting in a higher intensity of the urban heat island effect, coupled with high population density, making the city fall under the category of moderate to high heat stress/risk. Despite this, very few studies have analyzed the urban impact on heat stress over the coastal city, albeit with poor resolution data. In this study, we assessed the performance of an integrated high-resolution WRF-urban scheme driven by the readily available urban canopy information of the local climate zone (LCZ) to simulate local meteorological data for analyzing the spatiotemporal pattern of heat stress over the megacity. Our results show that the WRF-BEP scheme outperformed the other evaluated urban schemes, reducing the normalized root mean squared error by 25%. Furthermore, using humidex, we found a generally high incidence of intense discomfort in highly urbanized areas and noted the significant influence of urban morphology on the pattern of heat stress, particularly at night due to the combined effect of urban warming and higher relative humidity. The most socioeconomically disadvantaged urban areas, LCZ7, were most affected, with "hot" heat stress conditions observed over 90% of the time. However, during the afternoon, we found reduced heat stress in the core urban areas which might be due to the shading effect and/or cold air advection. Our findings would be relevant in the development of the urgently needed climate/heat adaptation plans for the city and other sub-Saharan African cities.

LULC Assessment and Green Infrastructure Conservation in residential neighborhoods: a case of FESTAC Town, Lagos, Nigeria.

In addressing environmental challenges and ecosystem resilience, green networks are preserved, repaired, and rebuilt by green infrastructure. However, urbanization effects have seen urban land form undergo significant modifications over time due to different anthropogenic activities. The objective of this study is to evaluate the land use and land cover (LULC) change in FESTAC Town, a government-owned residential neighborhood in Lagos, with the goal of recommending interventions for conserving green infrastructure. The study mainly focuses on employing remote sensing and geographic information system (GIS) techniques to detect alterations in land use in FESTAC Town from 1984 to 2022. The ERDAS Imagine software was utilized, employing a supervised classification-maximum likelihood algorithm, to identify changes in LULC. Additionally, an accuracy assessment was conducted using ground truth data. Findings from this study show significant increase in built-up areas at the cost of loss in dense vegetation over a 38-year period thereby, putting pressure on available green spaces. In terms of the area under each LULC category, most significant changes have been observed in built-up area (410.86%), bare surface (- 79.79%), sparse vegetation (- 53.42%), and dense vegetation (- 31.83%). Effective conservation strategies should focus on promoting connectivity between green spaces, engaging stakeholders in the planning and implementation of green infrastructure projects.

The Perspectives of Lagos Healthcare Leaders on Faith-Institution Involvement in Hypertension Health.

BACKGROUND: Hypertension is an important challenge for the Nigerian healthcare system and multiple stakeholder mitigation is imperative. Faith institution mitigation is evolving but the opinion of healthcare leaders on their involvement in hypertension remains an important gap. OBJECTIVE: To explore the perspectives of a cross-section of leaders of healthcare institutions in Lagos (Nigeria) on faith institution-facilitated hyper tension inter vention against the background of current practice. METHODS: Attempts were made to recruit 152 healthcare institution leaders who were contacted using electronic mails, telephone conversations, institutional social media communication, institutions' web-mails and other contacts. The views of consenting leaders were gathered using an exploratory questionnaire survey, and analysed. RESULTS: The views of 23 leaders from the variety of institutions were that most (60%) hypertension cases were diagnosed during emergency presentations; and the public's hypertension health knowledge remains generally inadequate. Hypertension information dissemination was mostly verbal rather than in written/print form. Basic resources are deployed in hypertension management. There was majority support for collaboration in hypertension health promotion (90.0%), blood pressure screening (95.7%) and hypertension referral (95.5%). Fewer institutions had the resources to support hypertension health promotion (55.0%) and blood pressure screening (42.1%) compared to hypertension referral (90.9%). CONCLUSION: There is good support for faith institution involvement in hypertension health, with a particular interest in and capacity for health system referral. Deploying scarce resources to collaborate may be challenging. However, collaboration and better resources could improve hypertension prevention and management. Further work is needed for context specific innovation so faith institutions can contribute to hypertension health.

CONTEXTE: L'hypertension représente un défi majeur pour le système de santé nigérian, et une atténuation impliquant plusieurs parties prenantes est impérative. L'atténuation par les institutions religieuses est en évolution, mais l'opinion des leaders de la santé sur leur implication dans l'hypertension reste une lacune importante. OBJECTIF: Explorer les perspectives d'un échantillon de leaders d'institutions de santé à Lagos, Nigeria, sur l'intervention contre l'hypertension facilitée par les institutions religieuses, dans le contexte de la pratique actuelle. MÉTHODES: Des tentatives ont été faites pour recruter 152 dirigeants d'établissements de santé qui ont été contactés par courriels électroniques, conversations téléphoniques, communication sur les médias sociaux institutionnels, courriers électroniques des établissements et autres contacts. Les points de vue des dirigeants consentants ont été recueillis à l'aide d'une enquête par questionnaire exploratoire, puis analysés. RÉSULTATS: Les opinions de 23 dirigeants provenant de divers établissements indiquaient que la plupart des cas d'hypertension (60%) étaient diagnostiqués lors de présentations aux urgences; et les connaissances du public sur la santé liée à l'hypertension demeurent généralement insuffisantes. La diffusion d'informations sur l'hypertension se faisait principalement de manière verbale plutôt que sous forme écrite/imprimée. Des ressources de base sont utilisées dans la gestion de l'hypertension. Une majorité soutenait la collaboration dans la promotion de la santé liée à l'hypertension (90,0%), le dépistage de la tension artérielle (95,7%) et l'orientation des patients atteints d'hypertension (95,5%). Moins d'institutions avaient les ressources pour soutenir la promotion de la santé liée à l'hypertension (55,0 %) et le dépistage de la pression artérielle (42,1 %) par rapport à l'orientation vers l'hypertension (90,9 %). CONCLUSION: Il existe un soutien significatif pour l'implication des institutions religieuses dans la santé liée à l'hypertension, avec un intérêt particulier et une capacité à orienter vers le système de santé. Le déploiement de ressources limitées pour la collaboration peut présenter des défis. Cependant, la collaboration et de meilleures ressources pourraient améliorer la prévention et la gestion de l'hypertension. Des travaux supplémentaires sont nécessaires pour des innovations spécifiques au contexte afin que les institutions religieuses puissent contribuer à la santé liée à l'hypertension. MOTS- CLÉS: Hypertension, Lagos, Institutions religieuses, Responsables de la santé, Intervention.

Acceptability of an Orange-Flavoured Zinc Sulphate Dispersible Tablet in the Management of Acute Diarrhoea in Under-five Children in Lagos, Nigeria.

BACKGROUND: Acute diarrhoea is a significant cause of morbidity and mortality in children under five, especially in subSaharan Africa. The WHO recommends using oral rehydration solution (ORS) and zinc therapy for its management, but the metallic taste of zinc often hinders adherence. METHOD: This prospective open-label intervention study took place at three health facilities in Lagos, Southwest Nigeria, involving children aged 3 to 59 months with acute diarrhoea. Sociodemographic and diarrhoea-related data were obtained. Palatability was assessed using a 5-point hedonic scale, and adherence was determined by the proportion of prescribed zinc sulfate tablets consumed. Caregivers received a 10-day supply of the study drug and ORS sachets for each child, along with participant diaries for tracking drug intake, palatability scores, and adverse events. Follow-up was conducted on Days 3 and 7, and diaries were collected between Days 10 and 14. RESULTS: Out of the 294 participants, most caregivers were mothers (86.0%), had at least a secondary education (88.1%), and were employed (70.7%). The majority of children were male (54.2%), and under 18 months old (52.2%). The average palatability score was 2.65 (±0.78), with no significant differences based on age or gender. Mean adherence was 93.03%, with 89.3% achieving ≥80% adherence, and adherence did not significantly differ by age or gender. The only reported adverse event, vomiting, decreased from 18.8% on Day 1 to 0.5% on Day 10. CONCLUSION: The study indicates that the orange-flavored dispersible zinc sulfate tablet is well-accepted by children aged 3 to 59 months with acute diarrhoea in Lagos, Nigeria.

CONTEXTE: La diarrhée aiguë est une cause significative de morbidité et de mortalité chez les enfants de moins de cinq ans, en particulier en Afrique subsaharienne. L'OMS recommande l'utilisation de la solution de réhydratation orale (SRO) et de la thérapie au zinc pour sa prise en charge, mais le goût métallique du zinc entrave souvent l'observance. MÉTHODE: L'étude d'intervention prospective à ciel ouvert a eu lieu dans trois établissements de santé à Lagos, dans le sud-ouest du Nigeria, impliquant des enfants de 3 à 59 mois souffrant de diarrhée aiguë. Des données sociodémographiques et liées à la diarrhée ont été obtenues. La palatabilité a été évaluée à l'aide d'une échelle hédonique à 5 points, et l'observance a été déterminée par la proportion de comprimés de sulfate de zinc prescrits consommés. Les aidants ont reçu une provision de 10 jours du médicament de l'étude et des sachets de SRO pour chaque enfant, ainsi que des journaux de suivi pour noter la prise du médicament, les scores de palatabilité et les événements indésirables. Un suivi a été effectué aux jours 3 et 7, et les journaux ont été collectés entre les jours 10 et 14. RÉSULTATS: Sur les 294 participants, la plupart des aidants étaient des mères (86,0%), avaient au moins une éducation secondaire (88,1%), et étaient employées (70,7%). La majorité des enfants étaient de sexe masculin (54,2%) et avaient moins de 18 mois (52,2%). La note moyenne de palatabilité était de 2,65 (±0,78), sans différences significatives en fonction de l'âge ou du sexe. L'observance moyenne était de 93,03%, avec 89,3% atteignant une observance ≥ 80%, et l'observance ne différait pas de manière significative en fonction de l'âge ou du sexe. Le seul événement indésirable signalé, les vomissements, est passé de 18,8% le jour 1 à 0,5% le jour 10. CONCLUSION: L'étude indique que le comprimé de sulfate de zinc dispersible à l'arôme d'orange est bien accepté par les enfants de 3 à 59 mois souffrant de diarrhée aiguë à Lagos, au Nigeria. MOTS-CLÉS: Diarrhée, moins de cinq ans, Enfants, Arôme d'orange, Comprimés de zinc, Palatabilité, Acceptabilité, Échelle hédonique, Lagos, Nigeria.

Challenges in conducting population-based seroepidemiology survey of COVID-19 in Lagos State, Nigeria.

Population-based study is known to be a very essential type of study during and after a pandemic or epidemic, as it provides crucial information on the incidence, prevalence, and risk factors of the disease in question. There has been limited information about the challenges faced in conducting such surveys in Nigeria. In this paper, we will share our experience, and describe the challenges faced in conducting a population-based seroepidemiological study of COVID-19 in Lagos, Nigeria. Some challenges were peculiar to specific Local Government Areas (LGAs) while others were general. The challenges include general misconceptions of community members about health research, difficulties in mapping houses, planning for data collection, standardizing data collection, working in hard-to-reach communities when resources were limited as well as difficulty in collection of blood and naso-oropharyngeal swabs. Ways of overcoming these problems, lessons learnt, and recommendations are hereby discussed.

Prevalence and pattern of functional gastrointestinal disorders among secondary school adolescents in Lagos, Nigeria.

BACKGROUND: Limited data exist on functional gastrointestinal disorders (FGIDs) among sub-Saharan African children. This study aimed to determine FGID prevalence and pattern among secondary school adolescents in Lagos, Nigeria. METHODS: This descriptive cross-sectional study was conducted among adolescents aged 10-18 years in Isolo, Lagos, Nigeria from December 2020 to March 2021. A multi-stage sampling technique was used to select a total of 696 students from four secondary schools. Data were collected using a specifically designed questionnaire, the ROME IV questionnaire (QPGS-IV), and analyzed using the Statistical Package for the Social Sciences (SPSS) version 24. RESULTS: The mean age of the adolescents was 13.6 ± 2.1. A total of 221 (31.8%) adolescents fulfilled the criteria for at least one of the FGIDs. The most common FGIDs were functional constipation (10.1%), functional dyspepsia (9.4%) and abdominal migraine (8.6%). There was no significant difference in the overall prevalence of FGIDs between age groups (p = 0.07) and genders (p = 0.949). However, the prevalence of FGID sub-types showed that abdominal migraine, irritable bowel syndrome and functional non-retentive fecal incontinence were significantly higher in the age group 10-12 years (p = 0.045, p = 0.029 and p = 0.027, respectively) while only functional vomiting was significantly higher in male compared to female (p = 0.038). CONCLUSION: FGIDs are common among adolescents in Lagos, Nigeria. The pattern of FGIDs shows similarities and differences with reports from other parts of the world. Healthcare workers must be aware of these disorders to provide optimal care.

Incidence and Antepartum Risk Factors of Severe Postpartum Haemorrhage in Anaemic Pregnant Women in Lagos, Nigeria: A Secondary Cohort Analysis.

BACKGROUND: The magnitude and risk factors for postpartum haemorrhage (PPH) have been extensively investigated, although little is currently known about the incidence and predictors of severe PPH, specifically among women affected by prenatal anaemia in Nigeria. OBJECTIVES: The study determined the incidence and antepartum risk factors of severe PPH in anaemic pregnant women in five health institutions in Lagos, Southwest Nigeria. METHODS: A secondary analysis was performed using the data of pregnant women with anaemia from the "Predict-PPH" study that was conducted between January and June 2023. This study included n=570 pregnant women affected by anaemia who gave birth in five hospitals in the Lagos metropolis of Nigeria. The study outcome was severe PPH, defined as an estimated blood loss of at least 1000 mL within 24 hours of childbirth. A backward stepwise conditional approach in a multivariable logistic regression model was utilised to identify the independent risk factors for severe PPH in anaemic pregnant women. RESULTS: Of the 570 women with prenatal anaemia enrolled in the primary study, 42 (7.4%) had severe PPH. The identified independent risk factors for severe PPH were maternal obesity (adjusted OR = 3.85, 95% CI = 1.85-8.02), antepartum haemorrhage in index pregnancy (adjusted OR = 2.98, 95% CI = 1.29-6.90), uterine fibroids (adjusted OR = 6.10, 95% CI = 2.39-15.52), delivery gestational age ≥39 weeks (adjusted OR = 2.62, 95% CI = 1.23-5.56), and delivery by caesarean birth (adjusted OR = 16.75, 95% CI = 5.81-48.31). CONCLUSION: About one in 13 anaemic pregnant women enrolled in the study developed severe PPH during childbirth. Maternal obesity, antepartum bleeding in the current pregnancy, co-existing uterine fibroids in pregnancy, delivery gestational age beyond 38 weeks, and caesarean birth in the current pregnancy were factors that were significantly associated with severe PPH in anaemic pregnant women. These findings underscore the importance of increased vigilance during both the antenatal and peripartum periods to identify women with these risk factors for the initiation of timely interventions to prevent severe PPH.

Prevalence and determinants of moderate-to-severe anaemia in the third trimester of pregnancy: a multicenter cross-sectional study in Lagos, Nigeria.

The high burden of anaemia during pregnancy underscores the urgent need to gain a comprehensive understanding of the factors contributing to its widespread occurrence. Our study assessed the prevalence and the trends of moderate-to-severe anaemia (MSA) in late pregnancy (28 to 36 weeks) and then investigated the key determinants driving this prevalence among women in Lagos, Nigeria. We conducted a secondary data analysis involving 1216 women enrolled in the Predict-PPH study between January and March 2023. We employed a multivariate binary logistic regression model with a backward stepwise selection approach to identify significant predictors of MSA. The study revealed a 14.5% prevalence of MSA during pregnancy. Independent predictors of MSA included having given birth to two or more children (adjusted odds ratio = 1.46, 95% confidence interval: 1.03-2.07), having a maternal body mass index (BMI) of 28 kg/m2 or higher (adjusted odds ratio = 1.84, 95% confidence interval: 1.29-2.61), having less than tertiary education (adjusted odds ratio = 1.51, 95% confidence interval: 1.08-2.11), and being unemployed (adjusted odds ratio = 1.97, 95% confidence interval: 1.19-3.26). It is crucial for pregnant women, particularly those with higher parities and elevated BMI, to be monitored regularly for anaemia and its consequences during their antenatal care. Additionally, addressing the link between low education, unemployment, and anaemia necessitates comprehensive strategies that empower women in terms of education and economic status to enhance the overall well-being of individuals and communities, ultimately reducing the prevalence of anaemia and associated health issues in pregnancy.

Impact of mobile health technologies on human papillomavirus vaccination uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria (mHealth-HPVac): Study protocol of a randomised controlled trial.

Background: Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) may empower patients to control their health, reduce inequalities, and improve the uptake of HPV vaccination. Aim: The "mHealth-HPVac" study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9-14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers. Methods: This protocol highlights a randomised controlled trial involving women aged 25-65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n=224 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant's school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be tested using the independent sample t-test (normal distribution) or the Mann-Whitney U test (skewed data) and that of two groups of categorical variables with Chi-square (X2) or Fisher's exact test where appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be defined as A P<0.05. Discussion: The mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake. Registration: PACTR202406727470443 (6th June 2024).

Survival outcomes following interval versus primary debulking surgery in advanced epithelial ovarian cancer: A retrospective cohort study in Lagos, Southwest Nigeria.

Background: There is conflicting evidence regarding the survival benefit of interval debulking surgery (IDS) compared to conventional treatment with primary debulking surgery (PDS) in women with advanced epithelial ovarian cancer (EOC). Objectives: We compared the survivals following PDS followed by adjuvant chemotherapy (ACT) versus IDS after neoadjuvant chemotherapy (NACT) in women with advanced EOC at the gynaecological oncology unit of a tertiary referral centre in Lagos, Southwest Nigeria. Methods: The data of 126 women with advanced EOC who had standard treatment with either PDS and ACT or NACT and IDS between January 2008 and December 2017 were analyzed. Kaplan-Meier estimates of progression-free (PFS) and overall survival (OS) time stratified by the types of upfront debulking surgery were calculated and compared by employing the log-rank test statistics. Cox proportional hazard models were then used to estimate hazard ratios of the association between the type of surgical debulking and survivals while adjusting for all necessary covariates. Results: We recorded no statistically significant differences in PFS (adjusted hazard ratio=1.28, 95% confidence interval 0.82-2.01, P=0.282) and OS (adjusted hazard ratio=1.23, 95% confidence interval 0.68-2.25, P=0.491) between IDS and PDS among women with advanced EOC. Conclusions: There is a need for a larger prospective multicenter study to further compare the impact of upfront surgical debulking types on the survival of women with advanced EOC in our setting. In the meantime, giving interval debulking surgery after a few courses of neoadjuvant chemotherapy should be an acceptable standard of care for women with advanced EOC.

Prevalence and Associated Factors of High-Risk Human Papillomavirus Infections among Human Immunodeficiency Virus-Infected Women in Lagos, Nigeria.

Background: Given the synergistic relationship between human immunodeficiency virus (HIV) and human papillomavirus (HPV) infections, knowledge of the genotypic prevalence and associated factors of high-risk HPV (HR-HPV) among HIV-infected women is crucial for developing targeted interventions such as appropriate screening tests and effective genotype-specific vaccination. Objectives: We determined the prevalence of any HR-HPV and multiple HR-HPV infections and identified associated factors among a cohort of women living with HIV infections (WLHIV) in Lagos, Nigeria. Methods: This descriptive cross-sectional study analysed the data of 516 WLHIV who underwent cervical cancer screening as part of the COMPASS-DUST study at the HIV treatment centre of Lagos University Teaching Hospital from July 2023 to March 2024. Multivariable binary logistic regression models were performed to explore factors associated with HR-HPV and multiple HR-HPV infections. Results: Among the 516 WLHIV enrolled (mean age, 46.5±7.3 years), the overall HR-HPV prevalence was 13.4% (95% CI, 10.6-16.6), disaggregated as 3.3% for HPV16/18 (95% CI, 1.9-5.2) and 11.6% for other HR-HPV genotypes (95% CI, 9.0-14.7). Nineteen women (3.7%; 95% CI, 2.2-5.7)had multiple HR-HPV genotype infections. Having a recent serum CD4+ cell count ≤560 cells/µL (adjusted OR 3.32; 95% CI 1.06-10.38) and HPV 16/18 genotype infections (adjusted OR 38.98; 95% CI 11.93-127.37) were independently associated with an increased risk of multiple HR-HPV infections. Conclusion: The findings of this study provide valuable insights into the epidemiology of HR-HPV infections and highlight the need for tailored interventions and continuous monitoring. By addressing these challenges through targeted screening, effective ART management, and vaccination programs, we can improve health outcomes and reduce the burden of cervical cancer in this vulnerable population.

Application of the UNAIDS Incidence Patterns Model to Determine the Distribution of New HIV Infection in Lagos State, Nigeria.

BACKGROUND: Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state. METHODS: The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months. RESULTS: The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections. CONCLUSION: The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.

A checklist of Nigerian ants (Hymenoptera, Formicidae): a review, new records and exotic species.

Background: Ants are one of the most ubiquitous, widespread and abundant groups of animals on Earth. They are eusocial and are well noted for their important ecosystem services such as nutrient recycling, seed dispersal, engaging in mutualistic associations with other organisms, as well as serving as predators and scavengers. Although Africa has been recognised as a global hotspot for ant diversity, African ant genera are not as well-known when compared with other regions. The last checklist of Nigerian ants was compiled and published in the 1970s. To contribute to new knowledge on West African ant genera and Nigeria in particular, we conducted a review of the ant species of Nigeria using 132 scientific publications mostly compiled in the database www.antmaps.org, along with a survey of ant species of Lagos and Oyo States in Nigeria which was conducted between 2018 and 2020. The study aimed to ascertain the diversity of Nigerian ant genera, as well as to confirm the presence of previously recorded species and add new species to the current checklist of Nigerian ants, based on the 1970 survey. New information: As many as 106 species were recorded from the survey in the current study, of which 28 are new to Nigeria and additional 28 are identified to the morphospecies level. In total, 317 species from 10 subfamilies and 64 genera are now recorded from Nigeria, including 11 invasive ants, of which six are new to Nigeria. The following eleven species that were included in the 1970 checklist were excluded from the current list, mostly due to previous misidentifications: Aenictusrotundatus Mayr, 1901; Anochetusjonesi Arnold, 1926; Camponotusbarbarossamicipsa Wheeler, 1992; Camponotusforaminosusdorsalis Santschi, 1926; Camponotusrufoglaucus (Jerdon, 1851); Cardiocondylazoserka Bolton, 1982; Messorbarbarus (Linnaeus, 1767); Odontomachushaematodus (Linnaeus, 1758); Technomyrmexalbipes (Smith, 1861); Tetramoriumdecem Forel, 1913 and Tetraponerapenzigi (Mayr, 1907).

Bioaccumulation dynamics, noncarcinogenic and carcinogenic risks of heavy metals in commercially valuable shellfish and finfish species from the world largest floating slum, Makoko, Nigeria.

This study examined ten heavy metals in five species: Macrobrachium vollenhovenii, Penaeus monodon, P. notialis, Chloroscombrus chrysurus, and Pseudotolithus typus, from Makoko floating slum, Lagos Lagoon to discern their bioaccumulation potentials, sources of origin, and health implications. The concentrations were in this order: Fe (4.172-10.176) > Zn (1.310-5.754) > Mn (0.475-2.330) > Cu (0.238-1.735) > Pb (0.121-0.391) > Cd (0.055-0.283) > Co (0.056-0.144) > Ni (0.039-0.121) > Cr (0.022-0.095) > As (0.003-0.031) mg/kg. The MPDI denotes "low toxicity," and the BAF/BSAF revealed that benthic species had higher bioconcentration potentials. Multivariate analyses revealed that heavy metals exhibited mutual relationships during chemical transport, and their sources were both geogenic and human-induced. The HI values were below 1, and the TCR values were below the threshold of 1 × 10-4. This suggests that the probabilities of noncancer and carcinogenic risks in human populations due to long-term consumption of the evaluated species are unlikely.

Occurrence and seasonal variation of organochlorine pesticides in selected vegetable farmlands in Lagos State, Nigeria.

Pest infestation in crop production have increased farmers' interest in pesticides use with short and long term consequences. This study investigated the occurrence and seasonal variations of organochlorine pesticide residues in vegetable farms in selected areas of Lagos State. Non carcinogenic and carcinogenic risk assessment was also evaluated. Soil samples were collected during the wet and dry seasons at soil depth of 0-30 cm. Gas chromatography coupled with an Agilent mass spectrometer was used to analyse organochlorine residues (alpha-lindane,lindane, delta.-lindane, aldrin, heptachlor epoxide, alpha.-endosulfan, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), endrin, endosulfan, m,p'-dichlorodiphenyldichloroethane (m,p'-DDD), endosulfan sulfate, o,p'-dichlorodiphenyltrichloroethane (o,p'-DDT) and endrin ketone) in soil. Heptachlor epoxide showed maximum concentration of 43.03 mg/kg in Station 19 in Western zone during the dry season while m,p'-DDD and endosulfan had minimum value of 0.004 mg/kg in Station 2 and Station 5 respectively during the wet season in the Far eastern zone. The concentrations of organochlorine residues were intermediate in the Eastern zone in both seasons. There was significant (p < 0.05) increase in dry season concentrations when compared to wet season. The risk assessment indicated Hazard Quotient (HQ) > 1 for non-cancer risk and cancer risk > 10-6. Thus a need for stringent monitoring programs for pesticides.

Prevalence and Epidemiological Characteristics of Anogenital Warts Among Recently Diagnosed HIV-Positive Women on Antiretroviral Therapy in Lagos, Nigeria.

Background Anogenital warts (AGWs) are a prevalent condition resulting from human papillomavirus (HPV) infection, which is the most frequently encountered sexually transmitted infection (STI) on a global scale. Women who are HIV-positive experience a disproportionately high burden of AGWs compared to other populations. It is imperative to comprehend the epidemiological factors linked to the disease within this particular at-risk population. Objectives The objective of the study was to ascertain the prevalence of AGWs and its demographic and socio-biological epidemiological features among recently diagnosed HIV-positive women (HPW) in Lagos, Nigeria. Materials and methods The research was a descriptive cross-sectional study conducted among a sample of 420 recently diagnosed HPW. The study was conducted at the HIV clinic of a tertiary health institution located in Lagos, Nigeria. The participants clinically diagnosed with AGWs were classified as the study group, while individuals without AGWs were classified as the comparison group. Interviewer-administered pretested questionnaires were utilized to gather pertinent demographic and socio-biological epidemiological data from the participants involved in the study. The data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, USA). Results The prevalence of AGWs among recently diagnosed HPW was found to be 8.5% (34/402). These warts were frequently observed on the vulvar labia (35.3%, 12/34), vaginal walls (14.7%, 5/34), and perianal region (14.7%, 5/34). It is worth noting that over a third of cases (35.3%, 12/34) involved multiple areas within the anogenital region. The diagnosis of AGWs was found to have significant associations with occupation (p=0.005), marital status (p<0.001), and educational status (p=0.028). The majority of HPW diagnosed with AGWs were unemployed (32.4%, 11/34), single (47.1%, 16/34), and did not have tertiary education (94.1%, 32/34). The utilization of oral contraceptive pills (OCPs), smoking, low CD4 count, and high viral load were the significant socio-biological factors associated with the diagnosis of AGWs (p<0.001, respectively). Conclusion The study found that the prevalence of AGW among HPW was 8.5% (34/402). Several epidemiological factors, including occupation, marital status, education, CD4 count, viral load, history of OCP use, and smoking, were found to be significantly associated with the diagnosis of AGW. There is a need to conduct more comprehensive studies to thoroughly assess the impact of these epidemiological factors.

Rhythm abnormalities among hospitalised children in Lagos: a case series.

Arrhythmias refer to disturbances in heart rate or rhythm which leads to heart rates that are abnormally fast, slow or irregular. Rhythm abnormalities may be common among Nigerian children but there are only a few reports. The current write up is a clinical review of eight patients in various age groups including neonates, infants and older children. It is presented to highlight the different forms of arrhythmias that can occur in children, with varying underlying aetiology, thus, stressing the need for early recognition of arrhythmias in children, appropriate early intervention and challenges involved in their care.

Investigating catastrophic health expenditure among people living with HIV and AIDS in South Western Nigeria.

Background: This study aimed to determine the catastrophic healthcare expenditure (CHE) among people living with HIV (PLHIV) in Lagos and to identify factors associated with CHE among them. Methods: The study was a descriptive cross-sectional survey conducted between January and March 2021 among 578 PLHIVs drawn from various healthcare facilities in Lagos where HIV care and treatment services should be provided free of charge. Data were collected through pretested questionnaires and analyzed using Stata SE 12. Results: The mean monthly expenditure on food was N29,282 ($53.2), while expenditure on healthcare averaged N8364 ($15.2). Nearly 60% of respondents experienced CHE, while around 30% had to borrow money to pay for some aspect of their medical treatment. Almost all (96%) had no health insurance plan. Respondents' group, personal income, perception of current health status, and the number of people in their households were significantly associated with catastrophic health expenditure p < 0.05. PLHIV in the racial/ethnic minority/migrants' group and those who earned less than ₦30,000 ($55) were statistically significantly associated with CHE at p < 0.001 with OR of 28.7 and 3.15, respectively. Conclusions: The study, therefore, highlights the widespread financial hardship faced by PLHIV in accessing healthcare, and the need for policies to increase financial risk protection.