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Background: Computers and other visual display devices have become essential in the present era and have led to a rise in computer-related health problems. Using computers in homes, universities and other institutions has increased output greatly but has also led to an increased risk of developing Computer vision syndrome (CVS). Objectives: To determine the prevalence and risk factors associated with computer vision syndrome among undergraduates. Methodology: A cross-sectional study was conducted among153 respondents who were selected using a multi-stage sampling technique. A pretested, structured, interviewer-administered questionnaire was used to collect data. SPSS version 23 was used to analyze the data. A Chi-square test was used to determine the relationship between CVS and associated risk factors at a P-value of

Introduction: Complementary feeding plays an important role in children's growth and development. Exclusive breastfeeding provides the best source of nutrients at early stage of life but beyond six months, more nutrients are required than are generally available from breast milk alone. This makes the child vulnerable to developing malnutrition. This study aims to assess the knowledge, practices and factors affecting complementary feeding practices among Fulani mothers in Makarfi Local Government Area, Kaduna state. Methods: The study was cross-sectional in design. A sample of 209 respondents (mother/caregiver – child pair) was selected using a multistage sampling technique. Quantitative data were analyzed using SPSS version 20.0. Mothers' knowledge of complementary feeding and the quality of complementary feeding practices were assessed and scored. Bivariate analysis (Chi square and Fishers' exact test) was used to test for association between socio-demographic factors, and mothers' knowledge, and complementary feeding practices. Statistical significance was determined at an alpha level of 0.05. Results: Results revealed that 93.3% of the Fulani mothers had poor knowledge while only 27.5% had good practices of complementary feeding. The pattern of complementary feeding was characterized by poor dietary diversity. There was a significant association between child's age (p < 0.01); fathers' occupation (p = 0.05) and complementary feeding practices. Conclusion and Recommendations: The study showed that the overall knowledge and practice of complementary feeding among the Fulani mothers/caregivers were poor. Therefore, the need for more education by the state ministry of health, targeted at Fulani mothers towards improving knowledge and practices on complementary feeding. Keywords: Infant feeding, Knowledge, Practices, Complementary feeding, Makarfi, Fulan

Background: In spite of concerted global efforts to reduce childhood mortality, countries in Sub-Saharan Africa are still being plagued with incomparably high mortality rates; thereby contributing majorly to the global burden. These deaths occur from causes which are preventable. Men play a pivotal role in sustained efforts to reduce childhood mortality, however, they are usually overlooked in favour of the mothers. The study aimed to assess the knowledge and attitude of men towards factors influencing childhood mortality in a semi-urban community, North-Western Nigeria.Methods: A descriptive cross-sectional study was conducted using structured interviewer-administered questionnaire. A total of 174 married men were sampled using a multistage sampling technique. Data collected were analysed using the IBM SPSS version 21. Results were presented in tables and bar charts. The level of statistical significance was set at p

Background: Nutritional status of young children is an important measure of their health status, growth, and development. There is a knowledge gap in the nutritional status of Fulani children aged 6 – 24 months in Nigeria. Our study, therefore, aims to assess the nutritional status of Fulani children (6 – 24 months old) and its determinants. Methods: A cross-sectional study of 209 children were selected using a multistage sampling technique. Anthropometric measurements were obtained from the children and converted to Z-scores to determine nutritional status. Quantitative data were analyzed using SPSS version 20.0. Bivariate analysis was conducted to examine the relationships between respondents’ socio-demographic factors and nutritional status. Statistical significance was determined at a p-value of ≤0.05. Results: A majority (62.2%) of the children were aged 6 – 12 months. The prevalence’s of stunting, wasting and underweight were 44.9%, 9.6% and 16.3% respectively. A higher proportion (55.3%) of male children were stunted compared to females. Most (51.1%) of the children aged 6 – 12 months were stunted compared to those aged 13 -24 months. There was a statistically significant association between stunting and age (p = 0.004). Children aged 6 -12 months (OR = 2.5, CI: 1.3 – 4.8) were at higher risk of developing stunting compared to those aged 13 – 24 months. Conclusion and Recommendation: The proportion of children that were stunted and those that were underweight was high. Therefore, there is a need for health authorities to ensure continuous growth monitoring practices of young children among the Fulani people to detect growth failure early in life and institute interventions.

Background: Complying with guidelines established to control COVID-19 pandemic is critical to the successful outcome of the response. We assessed the willingness of non-symptomatic incoming international air travelers into Nigeria to comply with COVID-19 public health measures upon arrival and identified the factors influencing them- March 2020. Method: We conducted a cross-sectional study among 500 incoming international air travelers involving 17 nationals across four major international airports in Nigeria using a pre-tested self-administered electronic questionnaire. We estimated the proportions and determined predictors of participants’ willingness to comply with the COVID-19 preventive measures. Predictors were examined using multiple logistic regression at 5% level of significance.Results: Majority (83%) were extremely/very willing to comply with public health guidelines. Perception of severity was a significant predictor of their willingness to stay at home for 14 days upon arrival (AOR: 6.82, 95 CI%: 1.19-24.45). Self -efficacy towards observing self for COVID-19 symptoms was a significant predictor of willingness to observe self for symptoms (AOR: 6.82, 95%CI: 1.19-24.45), and willingness to call of national COVID-19 numbers if symptoms develop (AOR: 6.82, 95% CI: 1.19-24.45). Conclusion: There is a need to improve risk communication interventions against COVID-19 for international air travelers particularly enhancing self-efficacy to improve their compliance to public health measures

Introduction: COVID-19 was first detected in Daura, Katsina State, Nigeria on 4 April 2020. We characterized the cases and outlined factors associated with mortality. Methods: We analysed the COVID-19 data downloaded from Surveillance Outbreak Response, Management and Analysis System between 4 April and 31 July 2020. We defined a case as any person with a positive SARS-CoV-2 test within that period. We described the cases in time, person, and place; calculated the crude and adjusted odds ratios and 95% confidence intervals for factors associated with mortality. Results: We analysed 744 confirmed cases (median age 35, range 1-90), 73% males and 24 deaths (Case fatality rate 3.2%, Attack rate 8.5/100,000). The outbreak affected 31 districts, started in week 14, peaked in week 26, and is ongoing. Highest proportion of cases in the age groups were 26.7% (184) in 30-39, 21.7% (153) in 20-29 years, and 18.3% (129) in 40-49 years. While the highest case fatality rates in the age groups were 35.7% in 70-79, 33.3% in 80-89 years, and 19.4% in 60-69 years. Factors associated with death were cough (AOR: 9.88, 95% CI: 1.29-75.79), age ≥60 years (AOR: 18.42, 95% CI: 7.48-45.38), and male sex (AOR: 4.4, 95% CI: 0.98-20.12). Conclusion: Male contacts below 40 years carried the burden of COVID-19. Also, persons 60 years and above, with cough have an increased risk of dying from COVID-19. Risk communication should advocate for use of preventive measures, protection of persons 60 years and above, and consideration of cough as a red-flag sign.

Children living with HIV (CLWH) are at risk of colonisation and infection with meticillin-resistantTo estimate the prevalence of nasal colonisation withA cross-sectional study was performed in the infectious diseases clinics of two public hospitals in Kano involving 214 CLWH/caregiver pairs. Children were selected from clinic registers by simple random sampling and an interviewer-administered questionnaire used to elicit factors associated with MRSA carriage from the caregivers. Clinical records were reviewed for patients' medical histories. Standard laboratory techniques were used to isolateNasalThe rate of MRSA nasal colonisation among CLWH in Kano was similar to that reported in other studies in Africa. Infection prevention and control measures including MRSA screening and decolonisation, as well as education for CLWH and their carers should be introduced to reduce MRSA spread.

BackgroundBlood culture diagnostics are a critical tool for sepsis management and antimicrobial resistance (AMR) surveillance. A baseline study was conducted to assess existing sepsis case finding, blood culture diagnostics and antimicrobial susceptibility testing (AST) at secondary health care facilities to inform the development of diagnostic stewardship improvement strategies in Nigeria.MethodsA cross-sectional online survey was conducted among 25 public secondary health care facilities in Abuja, FCT and Lagos State in Nigeria to evaluate the capacity for pathogen identification and AST. Following this, data were prospectively extracted on all patients with suspected sepsis from electronic medical records at two facilities in Abuja from October 2020 to May 2021 to further assess practices concerning sepsis case-finding, clinical examination findings, samples requested, and laboratory test results. Data were descriptively analysed, and a multivariate logistic regression analysis was conducted to determine factors associated with blood culture requests among suspected sepsis patients.ResultsIn the online survey, 32% (8/25) of facilities reported performing routine blood cultures. Only one had access to a clinical microbiologist, and 28% (7/25) and 4% (1/25) used standard bacterial organisms for quality control of media and quality control strains for AST, respectively. At the two facilities where data abstraction was performed, 7.1% (2924/41066) of patients were found to have suspected sepsis. A majority of the suspected sepsis patients came from the paediatrics department and were outpatients, and the median age was two years. Most did not have vital signs and major foci of infection documented. Blood cultures were only requested for 2.7% (80/2924) of patients, of which twelve were positive for bacteria, mainly Staphylococcus aureus. No clinical breakpoints were used for AST. Inpatients (adjusted odds ratio [aOR]:7.5, 95% CI:4.6 – 12.3) and patients from the urban health care facility (aOR:16.9, 95% CI:8.1 – 41.4) were significantly more likely to have a blood culture requested.ConclusionLow blood culture utilisation remains a key challenge in Nigeria. This has implications for patient care. AMR surveillance and antibiotics use. Diagnostic stewardship strategies should focus on improving access to clinical microbiology expertise, practical guidance on sepsis case finding and improving blood culture utilisation and diagnostics.

Background Nigeria, the last endemic country in the WHO African Region, was certified free of Wild Polio Virus (WPV) in 2020. However, due to low immunity in some communities in Sokoto, outbreaks of the circulating Vaccine Derived Polio Virus (cVDPV) occur. The aim of this study is to evaluate the Acute Flaccid Paralysis (AFP) surveillance indicators in Sokoto state, Nigeria. Methods This retrospective study was an analysis of routinely collected AFP surveillance data between 2012 and 2019 by the Sokoto state surveillance network. We assessed the Sokoto state AFP surveillance system using the AFP surveillance performance indicators. We performed all analyses using Microsoft Excel 2019. Results Cumulatively, 3001 Acute Flaccid Paralysis (AFP) cases were reported over the evaluation period, out of which 1692 (56.4%) were males, and 2478 (82.4%) were below five years. More than half, 1773 (59.1%), had a fever at the beginning of the disease, and 1911 (63.7%) had asymmetric paralysis. The non-polio AFP rate (9.1 to 23.5% per 100,000 children Conclusions Sokoto State has exceeded the WHO minimum standards in most of the AFP surveillance indicators. The performance of the system is sufficient enough to detect any reintroduction of WPV into the state. However, there is a need for improvement in data quality.

Background Tobacco use is associated with medical, social and economic problems. There is paucity of data on tobacco use among undergraduates in northern Nigeria. This study assessed pattern and predictors of tobacco use among undergraduates in Zaria, North-western Nigeria. Method It was a cross-sectional study of undergraduates in three tertiary institutions. Multi-stage sampling technique was used to select 1,080 undergraduates. Data was collected using a questionnaire adapted from Global Adult Tobacco Survey and Global Youth Tobacco Survey. Bi-variate analysis was used to identify independent variables showing statistically significant association with current tobacco use. These were entered into step-wise logistic regression. Results Their median age was 24 years (range:15–47). Prevalence of current tobacco use was 27.0%. About 58.7% smoked tobacco daily and 40.0% used smokeless tobacco daily. Commonest places where tobacco was used were off campus accommodation (30.2%), social center (30.2%) and bar or club (28.1%). Predictors of tobacco use were being a male [2.64(1.82–3.84)], married [2.33(1.49–3.70)], experiencing tobacco promotional activity [1.56(1.12–2.17)], willing to use promotional objects [2.06(1.35–3.14)], using of promotional objects [2.74(1.90–3.96)], and exposure to secondhand smoke [14.10(4.16–47.81)]. Predictors of non-use of tobacco were spending two years or less awaiting university admission [0.65 (0.46–0.91)], parents currently together [0.48(0.33–0.69)], and supporting ban on tobacco [0.34 (0.23–0.48)]. Conclusion Prevalence of tobacco use and expenditure on tobacco were high. University authorities should commence programs to identify tobacco users and encourage cessation. The findings also highlight the need to establish effective tobacco surveillance system that includes students of tertiary institutions.

Introduction The global tobacco epidemic contributes to more than 8 million deaths annually. However, most tobacco control interventions have been driven by an emphasis on smoked tobacco. Globally and more so in Nigeria, less attention has been paid to the similarly harmful smokeless tobacco (SLT) whose use appeals to a different demography. We examined the prevalence, patterns of use and correlates of SLT in Nigerian adults to guide targeted control efforts. Methods We conducted a secondary analysis of the 2012 Global Adult Tobacco Survey (GATS) data. We obtained data on 9,765 non-institutionalised adults aged 15 years and older. Variables included current SLT use, sociodemographic characteristics and perceived harm of SLT use. We used Chi-square test to examine associations and binary logistic regression to assess predictors of current SLT use. All analyses were conducted with sample-weighted data. Results The prevalence of current SLT use was 1.9% of all adults. About 1.4% were daily users. The main types were snuff by nose (1.6%) and snuff by mouth (0.8%). There were higher odds of current SLT use for those in the South-East region (aOR = 13.99; 95% CI: 4.45–43.95), rural area residents (aOR = 1.56; 95% CI: 1.04–2.35), males (aOR = 4.43; 95% CI: 2.75–7.11), the 45–64 years age-group (aOR = 10.00; 95% CI: 4.12–24.29), those with no formal education (aOR = 2.67; 95% CI: 1.01–7.05), and those with no perception of harm from SLT use (aOR = 3.81, 95% CI: 2.61–5.56). Conclusion The prevalence of SLT use among Nigerian adults was low with clearly identified predictors. While a majority were aware of harm from SLT use, an unacceptably high proportion remain unaware. We recommended targeted interventions to increase awareness of the harmful effects of SLT use especially among residents of the South-East, those in rural areas, males, and individuals with no formal education. We also recommended a follow-up survey.

Background: Chlamydia trachomatis (Ct) is now being considered as an “obstetric pathogen” due to its potential in causing adverse pregnancy and perinatal outcomes. Consequent to being the commonest bacterial sexually transmitted infection, screening is recommended at the initial visit of antenatal care, but few countries have routine pregnancy screening and treatment programs. Prevalence assessment is a core component of the World Health Organisation sexually transmitted infection -surveillance programming which enables a country to monitor trends of this infection, for appropriate implementation of preventive measures. Aim: To determine the prevalence of Ct infection among pregnant women, and to describe sociodemographic characteristics and reproductive profile of seropositive pregnant women attending the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria. Methods: Socio-demographic characteristics and risk factors were sought from 90 pregnant women using a proforma. Their sera were assayed for the presence of Ct immunoglobulin G (IgG) using ELISA. Data were analysed using SPSS version 21. Categorical variables were represented using frequency and percentages while associations between categorical variables were determined using Fisher’s exact test with p < 0.05 considered significant. Results: Prevalence of Ct infection was found to be 3.3% (3/90). The mean age of infected women was 34.3 ± 4.6 years. All seropositive women were gainfully employed and had tertiary education. Mean parity was 3, the majority (2/3,66.7%) had no previous miscarriage and none had a history of prior stillbirth.Conclusion: The prevalence of Ct in this study is low compared to the pooled prevalence for the West African sub-region. A broader community-based study using a nucleic acid amplification technique is suggested.

Introduction:in Nigeria, perinatal mortality rate remains high among births at the health facility. Births occur majorly at the secondary healthcare level in Abuja Municipal Area Council (AMAC) of the Federal Capital Territory (FCT). Identifying factors influencing perinatal deaths in this setting would inform interventions on perinatal deaths reduction. We assessed perinatal mortality and its determinants in public secondary health facilities in AMAC. Methods:delivery and neonatal data from two selected public secondary health facilities between 2013 and 2016 were reviewed and we extracted maternal socio-demographics, obstetrics and neonatal data from hospital delivery, newborns´ admissions and discharge registers. Data were analyzed using descriptive statistics and Cox proportional hazard models (α = 5%). Results:perinatal mortality rate was 129.5 per 1000 births. Asphyxia 475 (34.0%), neonatal infection 279 (20.0%) and prematurity 242 (17.3%) accounted for majority of the 1,398 perinatal deaths. Unbooked status [aHR = 1.8 (95% CI 1.4 - 2.2)], antepartum haemorrhage [aHR = 2.8 (95% CI 1.2 - 6.7)], previous perinatal death [aHR = 2.3 (95% CI 1.7 - 3.1)] and maternal age ≥ 35 years [aHR= 1.4 (95% CI 1.0 - 1.8)] were associated with increased risk of perinatal death. Conclusion:perinatal mortality in the studied hospitals was high. Determinants of perinatal death were unbooked antenatal care (ANC) status, antepartum haemorrhage, previous perinatal death and high maternal age. Reducing perinatal deaths would require improving antenatal care attendance with healthcare staff identifying and targeting women at risk of pregnancy complications.

Background Measles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years. It has been ear marked for elimination and Nigeria adopted the measles elimination strategies of the World Health Organization (WHO) African region to reduce cases and deaths. This study was done to determine trends in measles cases in Bayelsa state, to describe cases in terms of person and place, identify gaps in the case-based surveillance data collection system and identify risk factors for measles infection. Methods We carried out a secondary data analysis of measles case-based surveillance data for the period of January 2014 to December 2018 obtained in Microsoft Excel from the State Ministry of Health. Cases were defined according to WHO standard case definitions. We calculated frequencies, proportions, estimated odds ratios (OR), 95% confidence intervals (CI) and multivariate analysis. Results A total of 449 cases of measles were reported. There were 245(54.6%) males and the most affected age group was 1–4 years with 288(64.1%) cases. Of all cases, 289(9.35%) were confirmed and 70 (48.27%) had received at least one dose of measles vaccine. There was an all-year transmission with increased cases in the 4th quarter of the year. Yenegoa local government area had the highest number of cases. Timeliness of specimen reaching the laboratory and the proportion of specimens received at the laboratory with results sent to the national level timely were below WHO recommended 80% respectively. Predictors of measles infection were, age less than 5 years (AOR: 0.57, 95% CI: 0.36–0.91) and residing in an urban area (AOR: 1.55, 95% CI:1.02–2.34). Conclusions Measles infection occurred all-year round, with children less than 5 years being more affected. Measles case-based surveillance system showed high levels of case investigation with poor data quality and poor but improving indicators. Being less than 5 years was protective of measles while living in urban areas increased risk for infection. We recommended to the state government to prioritize immunization activities in the urban centers, start campaigns by the 4th quarter and continue to support measles surveillance activities and the federal government to strengthen regional laboratory capacities.

Background: Despite earlier successes achieved in combating it, cases of tuberculosis in Nigeria are now on the increase, affecting more people and communities. Primary health care in Nigeria is through ward health system, designed to provide minimum health package to the communities including TB services. This study aimed to ascertain the capacity of PHC centres to provide TB services in Kaduna North senatorial district, Kaduna State, Nigeria.Methods: Four out of eight local Government areas in the district were randomly selected and one PHC per ward was recruited in the study. In each facility, questionnaires developed from the TB tracer items of the WHO service availability and readiness assessment tool were administered to the facility in-charges and TB/DOTS focal persons.Results: Forty four facilities were selected from Zaria, Sabon Gari, Makarfi and Kudan LGAs. Almost all facilities (98%) diagnosed TB clinically and 39 (90%) had anti-TB drugs available. National TB guidelines were lacking in 23 (52%) facilities and only 5 (11%) had additional capacity for sputum microscopy. While 35 (80%) TB/DOTS focal persons had received training on TB diagnosis and treatment, only 24 (55%)received training on TB/HIV co-infection and only 8 (18%) received training on multi-drug resistant TB.Conclusions: While TB services are widely available in the district, urgent need exists for all stakeholders to work together towards equipping those facilities with critical infrastructure that will improve their overall capacity, particularly with regards to comprehensive TB guidelines, laboratory diagnosis and personnel training for effective TB management.

Background: The COVID-19 pandemic continues to disrupt health systems across the globe, preventing access to essential health services. Lockdown measures against the virus may impact negatively on immunization services. This study aimed to ascertain the capacity of primary health care centres in Kaduna North senatorial district to provide routine immunization services amidst a state-wide lockdown.Methods: Cluster sampling was used to select four among eight local Government areas in the district. Facility in-charges and RI focal persons were interviewed using service availability and readiness assessment tool, restricted to immunization tracer items. Paired sample t-test was used to compare the mean number of vaccine doses given in the first quarter of 2020 (pre-lockdown) and the number of doses given in the second quarter (lockdown period).Results: Forty four PHCs were selected from Zaria (29.6%), Sabon Gari (25.0%), Makarfi (22.7%) and Kudan (22.7%). In addition to well-trained RI focal persons, most facilities had vaccines and commodities available. Shortages were noted for EPI guidelines (46%), Meningitis-A vaccine (36%) and certain cold chain equipment (up to 18%). Tetanus-diphtheria (Td-1) doses given during lockdown period were significantly lower than pre-lockdown doses (Mean difference=-45.58, 95% CI: -74.78 to -16.38, d=0.48). No significant difference exists for infant doses.Conclusions: Despite widespread availability of PHC facilities, trained personnel, vaccines and commodities, gaps still exist in service delivery, cold chain practices and vaccine supply management. Lockdown measures significantly disrupted immunization services and effective risk communication was key to achieving sustained utilization.

Background: Residency training develops trainees to practice evidence-based medicine using knowledge acquired through researches. Resident doctors are not just expected to be consumers of good researches but are also expected to build their competencies in conducting researches in their fields of specialization. They are expected to engage in journal clubs as well as scientific paper presentations in local and international conferences under the mentorship and guidance of their trainers. In addition, trainers in residency training supervise the compulsory dissertation of senior residents under them. Objectives: We aimed to assess research engagement of resident doctors in training and pattern of submission and approval of their dissertation proposal. Methodology: It was a descriptive cross-sectional descriptive study involving resident doctors in accredited hospitals in Northwestern Nigeria. Electronic questionnaires were distributed to respondents via their verified electronic media contacts. Data were collected within a period of 1 month from July 10 to August 6, 2020. Data were analyzed using mean, standard deviation, simple tables as well as Z-test and Chi-square test. The level of significance was set at 0.05 for decision purposes. Results: A total of 120 questionnaires were completed. The mean age of respondents was 38.0 ± 3.8 years, with majority being males 88 (83.3%), and 107 (89.2%) being married. Only 12 (10%) and 44 (36.7%) respondents had published manuscript before and since commencement of residency training, respectively. There was a significant difference between manuscript publication before and since commencement of residency training (P = 0.012). Only 32% of the respondents who submitted their dissertation proposal to the colleges did so within 12 months of success in their Part 1 fellowship examination. There was no association between the publication of manuscript during residency training and submission of dissertation to either National Postgraduate Medical College of Nigeria (P = 0.190), West African College of Surgeons (P = 0.686), or West African College of Physicians (P = 0.317). Conclusion: Research engagement by resident doctors from this study was not satisfactory. Publication of manuscript by resident doctors was associated with prior publication before commencement of residency training and type of training hospital.

Introduction: Nigeria has one of the highest proportions of cases of HIV/AIDS globally. This burden is more pronounced in the younger population which includes secondary school students (SSS). We set out to determine the level of family communication among SSS in Zaria metropolis. Subjects and Methods: We carried out a cross-sectional study among 73 randomly selected students. Data were obtained with a semi-structured, pretested, self-administered questionnaire. Descriptive statistics were used to present data at the univariate level while Chi-square or Fisher's exact test was employed to identify the relationship between non-numeric variables with a 5% level of significance. Results: The mean age (± standard deviation) was 16.1 ± 1.1 years. Majority have heard 60 (82.2%) and have good knowledge 55 (75.3%) of family communication. There was an overall positive attitude as 44 (60.3%) believe it helps prevent HIV/AIDS and 57 (78.1%) believe it is very important and should be encouraged. Most (57 [78.1%]) have had family communication, with mother as the preferred partner 49 (86%). HIV/AIDS (44 [77.2%]) was the major issue discussed. We out that found the knowledge of family communication was significantly associated with its practice (P = 0.018). Conclusion: Awareness, knowledge, attitude, and practice of family communication were good among respondents. Father's educational level and knowledge of family communication were significantly associated with its practice among respondents. More studies are required to evaluate the determinants of the practice of family communication.

Background: Antimicrobial stewardship (AMS) is a coordinated program that promotes the appropriate use of antimicrobials. According to the World Health Organization, education of medical students on AMS is an integral part of antimicrobial resistance containment activities. The perception of undergraduate clinical medical students on AMS has not been studied in Nigeria recently. This study aims to identify the perception of AMS among medical students in Ahmadu Bello University (ABU) Zaria. Methodology: We conducted a cross-sectional survey on medical students in the 4th, 5th, and 6th years of study. A stratified sampling technique was employed. Open Data Kit for android was used to administer the questionnaire. Information on sociodemographics, perception of AMS, perception of the usefulness of AMS education as well as familiarity with the term AMS were collected from study respondents. Data were presented in frequency and percentages for categorical variables, while descriptive summary statistics were used for numeric variables. Results: Most of the respondents (96.2%) belonged to the age group of 20–29 years. The mean age (±standard deviation) of our respondents was 25.75 (±2.47) years. Only 34.6% were “very familiar“/”familiar” with the term “AMS.” Majority (89.2%) of the respondents did not have any knowledge about antimicrobials before entering medical school. The perception of AMS among medical students was generally good. Conclusion: Our respondents recognized the importance of judicious antibiotic use and would like more instructions on how to make rational use of antimicrobials. There is a need by authorities of the ABU medical school to revamp our clinical medical curriculum to include more AMS teaching so as to better equip our “future prescribers” on the appropriate use of antimicrobials.

Introduction : immunization coverage for Nigeria is still below the 90% target set in the Global Vaccine Action Plan (GVAP) and Nigeria is one of the 3 countries that host about 50% of the world’s infants without the third dose of Diphtheria, Pertussis and Tetanus (DPT-3) vaccination. Ensuring that routine immunization is equitably extended to all children irrespective of their socio-economic status is a key component of GVAP. We compared the socio-economic inequality of childhood routine immunization coverage in Nigeria from 2003 - 2013. Methods : we analysed data from Nigeria Demographic and Health Survey for 2003, 2008 and 2013 for inequalities of DPT-3 coverage. We used concentration index (CI) to measure socio-economic inequalities at national and sub-national (geopolitical zones) levels. F-statistic was used to test for statistically significant difference in CI across groups at p Results : the CI for DPT-3 coverage in Nigeria was 0.398 in 2003, 0.528 in 2008 and 0.591 in 2013 (p Conclusion : there was an increase in socio-economic inequality of DPT-3 coverage in Nigeria from 2003 - 2013 in favor of those with higher socio-economic status. At the sub-national level, only the North-Eastern and North-Western zones showed an increase in socio-economic inequality of DPT-3 coverage from 2003 - 2013 in favour of those with higher socio-economic status. We recommend that targeted interventions should be introduced to reduce the inequality of immunization coverage in Nigeria particularly in the North-Eastern and North-Western zones of the country.

Introduction : despite providing free tuberculosis (TB) diagnosis and treatment services, TB patients still incur financial hardship while seeking for care. Involving private health facilities through Public-Private Mix (PPM) has been identified by World Health Organization as a strategy for eliminating catastrophic health expenditure (CHE) due to TB. There is paucity of studies comparing the incidence of CHE in public and private health facilities in Nigeria. We compared the incidence of CHE due to TB among patients in public and private health facilities rendering TB Directly Observed Treatment Short-course (DOTS) services in Kaduna State. Methods : we conducted a comparative longitudinal study in 2016, recruiting 274 pulmonary TB patients, 137 from public health facilities and 137 from private health facilities using a multi-stage sampling technique. We collected data using a questionnaire adapted from a tool developed by USAID. CHE was measured using a threshold of out of pocket (OOP) health expenditure >40% of non-food expenditure. Bi-variate analysis and binary logistic regression were used to test for association and control for confounders respectively with statistical significance determined at p Results : the average cost per TB patient successfully treated from the patient’s perspective was US$485.7 in private health facilities and US$262.9 in public health facilities (t = -2.787, p = 0.006). There was a statistically significant difference in the incidence of CHE due to TB between patients in public health facilities (21.2%) and private health facilities (13.1%) (AOR= 2.87, 95% CI = 1.224 - 6.731, p = 0.015). Conclusion : the incidence of CHE due to TB was higher in public health facilities compared to private health facilities. We recommend that efforts to reduce OOP expenditure (e.g. home management of TB) among TB patients in public health facilities in Kaduna State should be explored.