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Background: Despite the global decline in pediatric HIV infections, infants in sub-Saharan Africa still acquire HIV infection through inappropriate feeding. Objective: The objective of the study was to compare knowledge and predictors of infant feeding behavior between mothers living with HIV and controls of unknown HIV status in Gombe, northeast Nigeria. Methods: A cross-section of clinic-based samples of 84 HIV-positive mothers and 170 controls of unknown status were interviewed using validated questionnaires. Knowledge scores and self-reported infant feeding practices were analyzed. Multivariate logistic regression models were employed to determine predictors for infant feeding practices. Results: Transmission risk perception (95.2% vs. 65.3%) (p0.05). Antenatal attendance, hospital delivery, knowledge, and positive attitude predicted infant feeding practices in both groups. The predictive roles of education and parity were limited to HIVpositive mothers, while the effects of maternal age and infant death were restricted to controls. Conclusion: Risk perception, knowledge, and exclusive breastfeeding rates were higher among mothers living with HIV. Antenatal care, hospital delivery, knowledge, and attitude predicted infant feeding practices in both groups. Girl child education, antenatal care, hospital delivery, and sustained promotion of exclusive breastfeeding with antiretroviral therapy are key to HIV-free infant survival.

Background: Overconsumption of energy drinks (EDs) is a global public health concern because of its potential health consequence. Objectives: This study aimed to determine the prevalence and factors associated with ED consumption amongst undergraduate students in Kano, Northwest Nigeria. Methodology: A descriptive cross-sectional study design was used to study 381 undergraduate students, selected using a two-stage sampling technique. Data were collected using interviewer-administered questionnaires and analysed using SPSS version 22.0 with P ≤ 0.05 considered to be statistically significant. Results: A total of 381 students were studied. The mean ± standard deviation age of the students was 23.1 ± 3.6 years with male-to-female distribution of about 1:1. Period prevalence of 67.0% within the last 30 days and point prevalence of 23.9% were found. The commonly used ED was Power Horse 44.6%. Up to 59.6% consumed EDs to boost their physical and mental capacity. Odds of ever-consuming EDs were lower in female undergraduates (adjusted odds ratio [aOR]: 0.5, 95% confidence interval [CI]: 0.3–0.7) and higher in Hausa/Fulani ethnic group (aOR: 1.7, 95% CI: 1.04–2.7). Amongst those who were currently consuming EDs, being 24 years or less (aOR: 1.9, 95% CI: 1.04–3.4) and coming from the Hausa/Fulani tribe (aOR: 2.5, 95% CI: 1.4–4.4) were associated with increased consumption. Male undergraduates (aOR: 0.2, 95% CI: 0.1–0.4) and students who were residing on campus were less likely to be current consumers of EDs (aOR: 0.5, 95% CI: 0.3–0.9). Conclusion: Consumption of EDs is increasing amongst students and therefore relevant government agencies should ensure regulated advertisement and consumption to avert the health consequences.

Changes in nasopharyngeal (NP) carriage of vaccine-type (VT) Streptococcus pneumoniae can be used to assess the effectiveness of a pneumococcal conjugate vaccine (PCV10). We conducted a baseline carriage survey in rural (Kumbotso, Kano) and urban (Pakoto, Ogun) Nigeria. In this cross-sectional study, we obtained data on demography, clinical history, risk factors, and took NP swabs for pneumococcal culture. We calculated crude and age-standardised carriage prevalence and used log-binomial regression to assess risk factors for carriage. Among children aged 40% across all ages. The age-standardized prevalence of pneumococcal carriage was 66% in Kumbotso and 40% in Pakoto. The most commonly identified serotypes were 19 F, 6 A and 23 F. Risk factors for carriage were young age, recent rhinorrhoea, cohabitation with ≥2 children aged

Background Successful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria. Methods We retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes. Results Among 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27–3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16–1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15–5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49–2.64). Conclusion Rural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings.

Background The global burden of anemia is large especially in sub-Saharan Africa, where HIV is common and lifestyles are changing rapidly with urbanization. The effects of these changes are unknown. Studies of anemia usually focus on pregnant women or children, among whom the burden is greatest. We describe prevalence and risk factors for anemia among rural and urban men and women of all ages in Malawi. Methods We analyzed data from a population-wide cross-sectional survey of adults conducted in two sites, Karonga (rural) and Lilongwe (urban), commencing in May 2013. We used multinomial logistic regression models, stratified by sex to identify risk factors for mild and moderate-to-severe anemia. Results Anemia prevalence was assessed among 8,926 men (age range 18–100 years) and 14,978 women (age range: 18–103 years). Weighted prevalence levels for all, mild, and moderate-to-severe anemia were 8.2, 6.7 and 1.2% in rural men; 19.4, 12.0 and 7.4% in rural women; 5.9, 5.1 and 0.8% in urban men; and 23.4, 13.6 and 10.1% in urban women. Among women, the odds of anemia were higher among urban residents and those with higher socioeconomic status. Increasing age was associated with higher anemia prevalence in men. Among both men and women, HIV infection was a consistent risk factor for severity of anemia, though its relative effect was stronger on moderate-to-severe anemia. Conclusions The drivers of anemia in this population are complex, include both socioeconomic and biological factors and are affecting men and women differently. The associations with urban lifestyle and HIV indicate opportunities for targeted intervention.