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Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further. Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic. Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients. Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic. [ABSTRACT FROM AUTHOR]

While shocks driven by exchange rate volatility and its impact on growth have been investigated in the extant literature, the recent exchange depreciation of major currencies has reignited interest among scholars. This study scrutinizes a novel Bootstrap Autoregressive Distributed Lag (BARDL) model for the effect of exchange rate shocks on the growth of the Nigerian economy. The results reveal several key findings. First, the finding from the bootstrap bound test revealed the presence of a cointegration relation between exchange rate and economic growth, indicating that exchange rate is a key indicator of inducing growth performance in Nigeria in the long-run horizon. Second, the results also show an inverted U-shaped effect of exchange rate on growth performance in the short-run horizon. This finding indicates that the coexistent positive effect of exchange rate shock on growth metamorphosed into a negative effect within a second lag. Third, while exchange rate depreciation retards economic growth in the short-run, the pattern demonstrates a strong potential for currency devaluation on external trade competitiveness of Nigeria. Fourth, the finding from the nonlinear model reveals the existence of strong asymmetries in exchange rate and economic growth nexus which validate the J-curve effect in Nigeria. The shocks driven from trade, particularly the import shocks are exacerbating the instability in the exchange market. Thus, controlling the asymmetric effects of exchange rate and import shocks is key to the sustainable growth of the Nigerian economy.

Vaccine stockouts are prevalent in Africa. Despite the importance of this as a barrier to universal vaccination coverage, rigorous studies looking at ways to reduce vaccine stockouts have been limited. We causally evaluated the effect of Vaccine Direct Delivery (VDD), an intervention to ensure the vaccine stock availability at health facilities, on the reduction of stockouts in Bauchi state, Nigeria. Employing the interrupted time-series method, we evaluated the change in the occurrence of vaccine stockouts before and after the introduction of VDD in July 2015. We used health facility level data from January 2013 to December 2018 among 175 facilities in Bauchi state, collected through the District Health Information Software 2 (DHIS2) for monthly information on stockouts and stock balances in all the health facilities in Nigeria. Data were analyzed using Stata 15 SE. To validate the causal relationship between VDD and vaccine stockouts, we conducted two sets of robustness checks. First, we evaluated the effect of VDD on the stockouts of other commodities. Second, we compared the trend of the prevalence of vaccine stockouts among health facilities between Bauchi state where VDD was introduced and another state (Adamawa state) where VDD was never introduced. After the introduction of VDD, vaccine stockouts in Bauchi state decreased by 9 percentage points on average, and they have been decreasing monthly by 0.4 percentage points more than pre-VDD. In Adamawa state, where VDD was never introduced, the prevalence of vaccine stockouts did not change over time. In Bauchi state after VDD introduction, the stock balances of target vaccines all increased, and the number of vaccinations carried out increased in neighboring health facilities. VDD intervention resulted in a significant reduction of vaccine stockouts as well as in an increase in the number of vaccinations performed. However, we should consider how to improve the system to provide vaccination service to the population in a sustainable way. [ABSTRACT FROM AUTHOR]

This paper estimated a monetary policy rule for Nigeria by augmenting the traditional Taylor rule model, using data spanning 2010Q1 to 2023Q2 in a Dynamic Ordinary Least Square regression. The results from competing models – the Taylor rule and extended Taylor rule (exchange rate augmented) – were subjected to forecast evaluation to ascertain their relative predictive power. Same models were estimated for South Africa for the purposes of comparison, and the results were consistent with Nigeria's. The findings indicate the predictors of the policy rate – monetary policy inertia, inflation, output gap and exchange rate – to be significant and with the expected signs. Forecast evaluation of the estimated extended Taylor rule model produced lower Root Mean Square Error (RMSE) and Theil statistics, compared with the traditional Taylor rule model, reflecting the higher predictive power of the former. The baseline and unequally-weighted two-quarter-ahead forecast of the extended model predicts a maximum inflation rate of 20.77 % and 21.04 % in 2023Q3 and 2023Q4, respectively, suggesting lower inflationary episode for Nigeria. The implication of the finding is that the extant monetary policy rule based on the traditional Taylor rule is inadequate in setting the nominal interest rate by the Central Bank of Nigeria, and recommends the adoption of the extended Taylor rule to enhance the effectiveness of monetary policy in Nigeria.

This study explores the mediating role of stock market volatility in the economic growth and environmental degradation nexus in Nigeria using data covering period from 1984 until 2020. The study uses Nonlinear Autoregressive Distributed Lag (NARDL) and a nonparametric asymmetric causality model. While the Wald test in model 1 reveals evidence of weak long-run asymmetric nexus between CO2 and economic growth however, findings in model 2 indicates that stock market volatility (SMV) exerts a strong asymmetric effect in growth-CO2 relation in the long-run. The result of nonlinear model validates the inverted U-shaped growth-degradation nexus consistent with EKC hypothesis. The finding in model 1 reveals that investment exerts a strong impact on CO2 in both the short-run and long-run. On the other hand, the results in model 2 show that the positive component of economic growth has a positive and significant impact on CO2 in Nigeria. However, the negative component of economic growth has a negative impact on CO2. Moreover, the dynamic causality model reveals: (i) a feedback causality between CO2 and the negative component of GDP; and (ii) a unidirectional causality flowing from CO2 to the positive component of GDP. Similarly, result of nonlinear causality test reveals a feedback causality between CO2 and GDP. The implication of the finding suggests that while asymmetric properties of economic growth must be controlled in efforts of promoting environmental sustainability, the stock market has a dedicated role to play in widening access to funds for green investment in Nigeria and other developing economies.

Desertification is the reflection of the environmental problem facing Nigeria today, it is estimated that the country is losing about 350,000 hectares to desertification annually, affecting almost the northern part of the country.Series of government efforts were made to address the issue but due to the gap between policy and implementation, the situation keep advancing to southwards at the rate of 1.5 km per year.Thus, desertification is a growing ecological problem, causing economic losses, threatening national unity, as well undermining the country’s national security. The purpose of this research are to: (1) examine the role of climatic variability and human factors to desertification and its (desertification) impact to national security; (2) suggest appropriate measures to address desertification for sustainable peace between farmers and herdsmen. The research is situated within the theoretical framework of Political Economy Approach, to explain economic issues as the primary cause of tension and conflict between Farmers and Herdsmen in their struggle for economic survival. The method in obtaining data for this research was mainly through secondary.Two major findings emerged from the research; (1) Desertification a source of conflict and threat to national security and (2) Strategic intervention to curb desertification for sustainable peace. The research recommends the adoption all the strategic intervention measures to counter climate change and excessive human activities toward the successful recovery of the land productivity for sustainable peace.

Objective. We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in pregnancy. Methods. To gather information on the frequency of triplex infections, we searched the databases of PubMed, CINAHL, and Google Scholar. Without regard to language, we utilized search terms that covered HIV, HBV, HCV, and pregnancy. Pregnant women with triplex infections of HIV, HBV, and HCV were included in studies that also examined the prevalence of triplex infections. Review Manager 5.4.1 was employed to conduct the meta-analysis. Critical appraisal and bias tool risk data were provided as percentages with 95% confidence intervals (95% CIs), and I2 was used as the statistical measure of heterogeneity. The checklist was created by Hoy and colleagues. The study protocol was registered on PROSPERO, under the registration number CRD42020202583. Results. Eight studies involving 5314 women were included. We identified one ongoing study. Pooled prevalence of triplex infections was 0.03% (95% CI: 0.02–0.04%) according to meta-analysis. Subgroup analysis demonstrated a significantly high prevalence of 0.08% (95% CI: 0.06–0.10%; 3863 women) in HIV-positive population than 0.00% (95% CI:−0.00-0.00; 1451 women; P

The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health. [ABSTRACT FROM AUTHOR]

As is glaringly apparent, the world is now bedeviled with environmental challenges and ecological complications. This may not be unconnected with the persistent ecological challenges emanating from fossil fuel consumption and changing lifestyles. This is why various attempts are ongoing to advance the course of renewable energy and economic growth as a response to environmental change. Therefore, this study seeks to investigate the dynamic effect of external debt, energy usage, and real income on the ecological footprint in Turkey, covering the period 1985–2017. To achieve the stated objective, the study used the newly developed Bootstrap Autoregressive Distributed Lag (BARDL) test and the Granger causality test to unravel the co-movement as well as the direction of causality among the variables. The results revealed that external debt influences environmental quality in both the short and the long run. However, energy consumption and real income have been found to have retarded environmental quality in both the short and the long run. The Granger causality test results revealed that the causal flow direction runs from external debt, economic growth, and energy usage to environmental quality. Therefore, the study argues that for the Turkish government to achieve a long-term plan of environmental sustainability, there is a need for the government to venture into debt consolidation programs such as implementing tax increases and cutting public spending in order to increase fiscal space that would finance long-term environmental protection policies.

Background: Food additives are being utilized for both small- and large-scale food production but often find more applicability in mass food production. Food additive consumption over a long period could pose adverse health outcomes. The study determined knowledge, perception, and consumption of food additives among female lecturers in Zaria. Methodology: It was a cross-sectional study conducted among 180 full-time female lecturers of the three tertiary institutions, selected through a multistage sampling technique. Data were collected using a pretested self-administered questionnaire. The data were entered into IBM SPSS Statistics 20 and analyzed. Univariate analysis for categorical variables was done using simple proportions. Results: A total of 167 female lecturers responded giving a response rate of 92.8%. Their mean age was 42.7 ± 8.2 years. Majority (109, 65.3%) had good knowledge of food additives, less than half (77, 46.3%) had a good perception of them, and the overall consumption rate for food additives was 97.1%. Majority (77.8%) felt that the risks associated with food additives must never be ignored, about half (47.3%) felt that foods consumed by Nigerians were now generally more harmful. However, only about one-fifth felt that most fast foods do contain food additives (28.1%). Consumption rates were high for both natural and synthetic food additives (61.7%–92.2%), except for Ajinomoto and Vedan which were consumed by only 38 (22.8%). Conclusion: Knowledge of food additives was good, but their perception was poor and consumption was high. Stakeholders must begin to organize and sustain periodic sensitization campaigns on risks associated with the consumption of food additives. Futures studies should identify the reasons for poor perception and high level of consumption despite good knowledge among the study population.

Abstract Background Nigeria contributes significantly to the global burden of HIV, Hepatitis B and C infections, either singly or in combinations, despite progress in HIV care regionally and globally. Although some limited data on mono infection of HIV, Hepatitis B and C virus infections do exists, that of dual and triplex infections, including seroconversion and mother-to-child transmission (MTCT) rates necessary for planning to address the scourge of infections in pregnancy are not available. Objectives To determine the seroprevalence, rate of new infections, MTCT of dual and triple infections of HIV, Hepatitis B and C viruses and associated factors, among pregnant women in Nigeria. Method A multicenter prospective cohort study will be conducted in six tertiary health facilities randomly selected from the six geopolitical zones of Nigeria. All eligible pregnant women are to be tested at enrollment after informed consent for HIV, Hepatitis B and C virus infections. While those positive for at least two of the infections in any combination will be enrolled into the study and followed up to 6 weeks post-delivery, those negative for the three infections or positive for only one of the infections at enrolment will be retested at delivery using a rapid diagnostic test. On enrolment into the study relevant information, will be obtained, and laboratory test of CD4 count, liver function test and full blood counts, and prenatal ultrasonography will also be obtained/performed. Management of mother-newborns pairs will be according to appropriate national guidelines. All exposed newborns will be tested for HIV, HBV or HCV infection at birth and 6 weeks using PCR technique. The study data will be documented on the study case record forms. Data will be managed with SPSS for windows version 23. Ethical approval was obtained from National Health Research Ethics Committee (NHREC) (NHREC/01/01/2007–23/01/2020). Conclusion Pregnant women with multiple of HIV, HBV and HCV infections are at increased risk of hepatotoxicity, maternal and perinatal morbidity and mortality. Additionally, infected pregnant women transmit the virus to their unborn baby even when asymptomatic. Children born with any of the infection have significantly poorer quality of life and lower five-year survival rate. Unfortunately, the seroconversion and MTCT rates of dual or triplex infections among pregnant women in Nigeria have not been studied making planning for prevention and subsequent elimination of the viruses difficult. The study is expected to fill this knowledge gaps. Nigeria joining the rest of the world to eliminate the triple infection among children rest on the availability of adequate and reliable data generated from appropriately designed, and powered study using representative population sample. The establishment of the three-in-one study of prevalence, rate of new infection, rate and risk factor for MTCT of dual and triple infection of HIV, Hepatitis B and C viruses among pregnant women in Nigeria is urgently needed for policy development and planning for the improvement of the quality of life of mothers and the elimination of childhood triplex infection.

Objectives: To systematically review literature and identify mother-to-child transmission rates of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among pregnant women with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria. PRISMA guidelines were employed. Searches were on 19 February 2021 in PubMed, Google Scholar and CINAHL on studies published from 1 February 2001 to 31 January 2021 using keywords: “MTCT,” “dual infection,” “triplex infection,” “HIV,” “HBV,” and “HCV.” Studies that reported mother-to-child transmission rate of at least any of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among pregnant women and their infant pairs with single, dual, or triplex infections of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Nigeria irrespective of publication status or language were eligible. Data were extracted independently by two authors with disagreements resolved by a third author. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary mother-to-child transmission rates in terms of percentage with 95% confidence interval. Protocol was prospectively registered in PROSPERO: CRD42020202070. The search identified 849 reports. After screening titles and abstracts, 25 full-text articles were assessed for eligibility and 18 were included for meta-analysis. We identified one ongoing study. Pooled mother-to-child transmission rates were 2.74% (95% confidence interval: 2.48%–2.99%; 5863 participants; 15 studies) and 55.49% (95% confidence interval: 35.93%–75.04%; 433 participants; three studies), among mother–infant pairs with mono-infection of human immunodeficiency virus and hepatitis B virus, respectively, according to meta-analysis. Overall, the studies showed a moderate risk of bias. The pooled rate of mother-to-child transmission of human immunodeficiency virus was 2.74% and hepatitis B virus was 55.49% among mother–infant pairs with mono-infection of HIV and hepatitis B virus, respectively. No data exists on rates of mother-to-child transmission of hepatitis C virus on mono-infection or mother-to-child transmission of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among mother–infant pairs with dual or triplex infection of HIV, hepatitis B virus and HCV in Nigeria.

Chitinases which degrade chitin have attracted attention as biological antifungal agents. The purpose of this study is to isolate Streptomyces from Fadama soil and assess its chitinolytic and antagonist potential against phytopathogenic fungi for application as biocontrol agent. Streptomyces were isolated from Fadama soil. The selected isolate CT02 exhibited chitinolytic characteristics. Chitinase production was performed under different temperatures, pH and varying incubation period. The highest chitinase production by CT02 isolate was observed after five days of cultivation. The highest chitinase activity was observed at 35°C and pH 7. The crude extracellular enzyme exhibited a specific activity of 4.20 U/µg whereas partially purified extracellular enzyme exhibited a specific activity of 6.19 U/μg with purification fold of 1.47. The selected isolate CT02 and its extracellular crude chitinase showed in vitro antifungal antagonist potential by inhibiting the growth of Aspergillus niger and Aspergillus oryzae. This indicates that Streptomyces derived chitinases are potential biocontrol agents against phytopathogenic fungi. [ABSTRACT FROM AUTHOR]

Background: There are no national data on hepatitis C virus awareness and burden among pregnant women to justify its routine screening. Objectives: To investigate awareness, seroprevalence and risk factors for hepatitis C virus infection among pregnant women in Nigeria. Methods: A total of 159 pregnant women from antenatal clinics across six geopolitical zones in Nigeria consented to anti-hepatitis C virus testing which was confirmed using polymerase chain reaction technique. Confirmed hepatitis C virus positive women were further tested for hepatitis B and HIV. Participants were evaluated for risk factors for hepatitis C virus. Odds ratios, adjusted odds ratios, and their 95% confidence intervals (CIs) were determined, and p-values of

INTRODUCTION: Dyslipidemia confers excess atherosclerotic cardiovascular risk in type 2 diabetes mellitus (DM) patients, and this requires prompt identification and management to reduce morbidity and mortality. This study assessed the prevalence and pattern of dyslipidemia in type 2 DM patients in Zaria, Northwestern Nigeria. METHODS: this was a cross-sectional study of newly diagnosed type 2 DM patients at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Demographic, clinical and laboratory data were extracted from the case notes of eligible patients and analyzed using STATA version 14. Continuous variables were presented as mean - standard deviation (SD), or median and interquartile range (IQR) while categorical variables were as frequencies and percentages. Student t and chi-square tests were used to test for association at p = 0.05. RESULTS: a total of 322 subjects (161 male, 161 female) with a mean age of 53.5 , 10.8 years partook in the study. The prevalence of dyslipidemia was 69.3%. Mixed dyslipidemia of high triglyceride (TG) and high low-density lipoprotein cholesterol (LDL-C) was present in 41.0%; high TG and low high-density lipoprotein cholesterol (HDL-C) in 2.8%; and high LDL and low HDL in 2.5%. Atherogenic dyslipidemia, isolated hypercholesterolemia and isolated low HDL-cholesterol were present in 3.4%, 2.5% and 23.6% respectively. Dyslipidemia status was not associated with age, sex, duration of DM or hypertension, obesity, and mean fasting blood sugar (FBS) and 2-hour postprandial glucose. CONCLUSION: the prevalence of dyslipidemia is high in the newly diagnosed type 2 DM patients and therefore, initial management should incorporate measures to control dyslipidemia.

INTRODUCTION: Indoor residual spraying (IRS) is among the major vector control strategies recommended for endemic populations by the World Health Organization (WHO). The success of IRS requires high coverage which is dependent on its acceptability. In Nigeria, IRS pilots have been ongoing and rejection has been a major setback to its coverage. We assessed coverage of IRS and determined factors associated with its acceptability in Nasarawa Eggon district, Nasarawa state, Nigeria. METHODS: a cross-sectional survey involving 409 households selected using multi-stage sampling was carried out. Trained data collectors administered pre-tested structured questionnaire to collect data on socio-demographic characteristics of household heads or their representatives, their perceptions on IRS and factors associated with IRS acceptability. Descriptive, bivariate and multivariate analyses were done at 5% level of significance. RESULTS: majority of respondents were male (79.7%) and married (82.6%), and their mean age was 36.4 , 13.3 years. Coverage of IRS was 99.3%. However, only 82.6% of those who previously accepted IRS were willing to accept it in again. Factors independently associated with acceptability were perceived effectiveness of IRS (aOR = 21.8; 95%CI = 6.9-68.8) and lower household cost of malaria prevention after IRS (aOR = 5.0; 95%CI= 1.1-21.8). CONCLUSION: IRS coverage in the communities studied met WHO minimum standard of 85%. However, for similar results to be achieved in future, acceptability must be promoted by providing information on its effectiveness and its ability to reduce household cost of malaria prevention.

INTRODUCTION: Malaria is the commonest cause of morbidity and mortality among displaced populations especially children in endemic countries. Nigeria, an endemic country, has had increase in internally displaced persons (IDP) due to insurgency. Utilisation of long-lasting insecticidal nets (LLIN) is a key strategy employed to achieve global targets of malaria elimination and its effectiveness is determined by utilisation, coverage and maintenance. We determined the coverage and utilisation of LLIN among children aged 6, 59 months at IDP camps and its predictors. METHODS: A cross-sectional study was conducted among children aged 6-59 months at the three IDP camps in Abuja. We collected data on socio-demographic characteristics, LLIN ownership and utilization using computer-aided interview, complemented by direct observation of nets. We defined universal LLIN coverage as the proportion of households with one LLIN to two persons and utilisation as an eligible child sleeping under the LLIN the night preceding the survey. Bivariate analysis was done at p = 0.25 and logistic regression at 5% level of significance. RESULTS: Overall, 393 children were enrolled with mean age of 33.3 , 17.4 months, 51.6% were female. Household LLIN ownership was 76.7.5%, universal coverage 11.2% and utilisation 89.7%. Independent predictors of LLIN utilisation were LLIN hung at sleeping area (adjusted OR: 99.9, CI: 22.7 , 438.8) and type of camp site (adjusted OR: 8.2, CI: 2.5 , 27.4). CONCLUSION: LLIN utilisation was high in these IDP camps despite low coverage. LLIN distribution and hanging campaigns are recommended to reduce malaria transmission in the IDP camps.

INTRODUCTION: Worldwide, hypertension and diabetes mellitus (DM) are major causes of morbidity and mortality. This study assesses the prevalence and correlates of hypertension and DM in an urban community in northwestern Nigeria. METHODS: this was a cross-sectional descriptive study. Adults aged 18 years and above, who attended a medical outreach program were interviewed and screened for hypertension and DM. Anthropometry, blood glucose and blood pressure were measured with standard instruments and methodology. Primary outcomes were hypertension and DM. Data were analyzed using STATA version 14 and presented as mean , standard deviation and frequencies. Chi-square and Pearson's correlation co-efficient were used to identify the correlates of hypertension and DM, at 5% level of significance. RESULTS: the mean age of participants was 51.0 ,14.0 years and 87.8% were females. Prevalence of hypertension and DM were 55.9% and 23.3% respectively. Age greater than 40 years and female gender were associated with risk of hypertension and DM respectively, p = 0.05. There was a weak correlation between systolic hypertension and age (r = 0.18, p = 0.02), diastolic hypertension and body mass index (r = 0.16, p = 0.03) and blood sugar and waist circumference (r = 0.19, p = 0.02). CONCLUSION: the high prevalence of hypertension and DM among the study population highlights the need for the development and implementation of a community-based public health interventions aimed at reducing their risk factors.

Introduction: Chronic obstructive pulmonary disease (COPD) is a common, irreversible but preventable disease characterized by persistent respiratory symptoms. The mortality rate of COPD is predicted to reach 5.4 million by the year 2060. Despite its heavy burden on healthcare expenditure worldwide, only 15% of cases are medically identified. The potential benefits of facemask-wearing for COPD patients remain a topic of debate., Methods: We will conduct a systematic review of all randomized trials and non-randomized controlled trials to evaluate the impact of facemasks on COPD patients. Our review will be based on literature obtained through a comprehensive search strategy across multiple electronic databases, including the Cochrane Library, Embase, PubMed, Web of Science, the Chinese Biomedical Database (SinoMed), and China National Knowledge Infrastructure (CNKI), with no restrictions on language or date of publication. Two independent researchers will extract and assess all relevant data using pre-designed data extraction forms. The included studies will be assessed using the Cochrane RoB2 tool and the suggested risk of bias criteria proposed by the Effective Practice and Organization of Care reviews group of the Cochrane collaboration. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We will use Review Manager 5.4 software for statistical analysis., Discussion: In the context of COVID-19, it is important for COPD patients to wear facemasks. This study aims to conduct a comprehensive and systematic assessment of the impact of facemasks on the physiology and activity of COPD patients., Trial Registration: PROSPERO registration number CRD42022326265., Competing Interests: The authors have no conflicts of interest to declare., (Copyright: © 2023 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Entomopathogenic fungi (EPF) are natural enemies which affect insect population and have long been recognized as biological control agents against many insect pests. Some isolates have also been established as endophytes, benefiting their host plants without causing any symptoms or negative effects. Here we demonstrated two entomopathogenic fungal species, Isariajavanica (Frieder. & Bally) Samson & Hywel-jone 2005 and Purpureocillium lilacinum (Thom) Luangsa-ard, Hou-braken, Hywel-Jones & Samson (2011) as endophytes in tomato plants by using the seed inoculation method and examined their effect on plant growth, B. tabaci mortality, and adult emergence. Our study indicated that tomato seeds treated with a fungal suspension of I. javanica and P. lilacinum enabled their recovery from plant tissues (root, stem and leaf) up to 60 days after inoculation (DAI). Both endophytic isolates also caused significant mortality of adult B. tabaci on seedlings inoculated with, I. javanica (51.92±4.78%), and P. lilacinum (45.32±0.20%) compared to the control treatment (19.29±2.35). Adult emergence rates were significantly high in the control treatments (57.50±2.66%) compared to I. javanica (15.00±1.47%) and P. lilacinum (28.75±4.78%) treatments. This study provides evidence that endophytic isolates of I. javanica and P. lilacinum have a biocontrol potentials for used against whiteflies and could also explored as plant growth promoters., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy into the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers., Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles., Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data., Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level., Conclusions: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students' participation in health policy activities.

Background: Nigeria has a high burden of Tuberculosis (TB) including Drug-resistant Tuberculosis (DR-TB) and hearing loss. Despite several efforts directed toward its control, many patients fail to respond to treatment, having developed DR-TB. Lack of adherence to the DR-TB guidelines/improper implementation of the guideline has been identified as one of the factors impeding on effective treatment. This study sought to measure the implementation fidelity of health workers to management guidelines for hearing loss resulting from DR-TB treatment and to identify its determinants., Method: A questionnaire-based cross-sectional study was conducted at the Infectious Disease Hospital, Kano. Implementation fidelity of the Programmatic Management guidelines for the treatment of Drug-resistant Tuberculosis was measured under the four domains of content, coverage, duration and frequency. The determinants examined are intervention complexity, facilitation strategies, quality of delivery and participant responsiveness as proposed by the Carroll et al. framework. Other determinants used are age, sex, professional cadre and work experience of healthcare providers., Results: The Implementation fidelity score ranged from 40 to 64% with a mean of 47.6%. Quality of delivery, intervention complexity, participants' responsiveness, and being a medical doctor exerted a positive effect on implementation fidelity while facilitation strategy, age and work experience exerted a negative effect on implementation fidelity., Conclusion: The implementation fidelity of management guidelines for hearing loss resulting from DR-TB treatment was low. Implementation fidelity should be assessed early and at intervals in the course of implementing the Programmatic Management of Drug-resistant Tuberculosis guideline and indeed, in the implementation of any intervention., (© 2022. The Author(s).)

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities., Competing Interests: MW and JR work for HTA Consulting and MH works for Square Toiletries Limited. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Godman, Haque, Leong, Allocati, Kumar, Islam, Charan, Akter, Kurdi, Vassalo, Bakar, Rahim, Sultana, Deeba, Khan, Alam, Jahan, Kamal, Hasin, Munzur-E-Murshid, Nahar, Haque, Dutta, Abhayanand, Kaur, Rwegerera, Nascimento, Dias Godói, Irfan, Amu, Matowa, Acolatse, Incoom, Sefah, Acharya, Opanga, Njeri, Kimonge, Kwon, Bae, Khuan, Abubakar, Sani, Khan, Hussain, Saleem, Malande, Piloya-Were, Gambogi, Hernandez Ortiz, Alutuli, Kalungia, Hoxha, Marković-Peković, Tubic, Petrova, Tachkov, Laius, Harsanyi, Inotai, Jakupi, Henkuzens, Garuoliene, Gulbinovič, Wladysiuk, Rutkowski, Mardare, Fürst, McTaggart, MacBride-Stewart, Pontes, Zara, Tagoe, Banzi, Wale and Jakovljevic.)

Objective: Measures are ongoing to prevent the spread of COVID-19 and treat it with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding treatments such as hydroxychloroquine with misinformation fuelling prices hikes and suicides. Shortages have also appreciably increased costs of PPE, potentially catastrophic among lower- and middle-income countries such as Nigeria with high copayment levels. Consequently, a need to investigate changes in availability, utilization, and prices of relevant medicines and PPE during the pandemic in Nigeria., Methods: Exploratory study among community pharmacists with a survey tool comprising four sections including questions on changes in consumption, prices, and shortages of medicines and PPE from the beginning of March 2020 to the end of June 2020. In addition, suggestions from community pharmacists and co-authors on ways to reduce misinformation., Findings: 30 out of 34 pharmacists participated giving a response rate of 88.2%. Significant increases were seen (3-fold or more increase) in the consumption of hydroxychloroquine (100%), vitamins/immune boosters (96.7%) and antibiotics (46.7%) as well as PPE (100%). Considerable price increases (50% increase or greater) also seen for antimalarials (96.7%), antibiotics (93.3%), vitamins/immune boosters (66.7%), and PPE (100%). Shortages are also seen for hydroxychloroquine and vitamins/immune boosters but most severe for PPE (80% of pharmacies)., Conclusion: Encouraging to see increases in the utilization of vitamins/immune boosters and PPE. However, a considerable increase in the utilization and prices of antimicrobials is a concern that needs addressing including misinformation. Community pharmacists have a key role in providing evidence-based advice and helping moderate prices., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Research in Pharmacy Practice.)

A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers., Competing Interests: The authors report no conflicts of interest for this work and declare that they do not have any financial involvement or affiliations with any organization, association, or entity directly or indirectly with the subject matter or materials presented in this article. This also includes honoraria, expert testimony, employment, ownership of stocks or options, patents or grants received or pending, or royalties., (© 2020 Abubakar et al.)