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Many studies have associated the dynamics of diseases' prevalence with differences in social, economic and demographic status, but it is not yet clear if the same variables explain the spatial distribution of COVID-19 infections in parts of sub-Saharan Africa. This study assessed the spatial spread of COVID-19 infections in relation to socio-demographic risk factors in a typical administrative state – a relatively typical ethnocentric community – in Southwestern Nigeria. Data used were socio-demographics, income variables, COVID-19 status and travel history of 40,300 households. Data were analysed for frequency, prevalence and spatial distributions. The results revealed that COVID-19 cases were heterogeneously distributed within the state. The number of cases was relatively higher in the north and south-eastern parts of the State than in other areas. Male respondents had a higher prevalence (3.7%) of COVID-19 cases compared to their female (2.4%) counterparts. Transmission was most dominant among respondents aged above 70 years old (3.5%), widowed (3.3%) and those who lived in households with between 6 and 10 (4.9%) members. Transmission was also relatively high among those with travel history within the State (9.1%), those that aquired tertiary education (3.8%) and self-employed (3.0%). The study associated imbalanced socio-economic distributions to a diverse range of COVID-19 transmission in the area and therefore advocated for improved policy on residents' education and sustainable living. [ABSTRACT FROM AUTHOR]

Introduction: sub-Saharan African countries contribute substantially to the global HIV disease burden. Despite this burden, and the promises that prevention could deliver, the implementation and uptake of HIV prevention programmes are still low. The study used the decision support system model to explore the potential impacts of prevention implementation on HIV burden (incidence) and service delivery. Methods: an operational research technique known as discrete event simulation model was used to capture an individual patient's pathways through the HIV care process from diagnosis to treatment and monitoring. The regular monitoring, over a 5-year period, including all the activities and resources utilized at each stage of the pathway were analysed, and the impact of increasing prevention measures for an HIV treatment service in a treatment centre in Nigeria was tested using the simulation model. Results: forty-three patients currently access the Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) annually, with a 20% and 80% split in the number of patients offered PrEP and PEP, respectively. Scenarios-based on increasing the number of people offered PrEP and PEP from 43 to 250 with a 50/50 split were tested. The outputs revealed improved preventive care by averting new HIV cases, reduction in service demand and utilization, but an increase in the required human resource as well as financial burden. In the next 5 years, the cumulative averted HIV cases are expected to increase from 2 and 5 people (baseline) to 24 and 20 people for PrEP and PEP, respectively. The potentially averted 2 cases per infected persons based on the basic reproductive number of HIV. Conclusion: the effective implementation of PrEP/PEP programme offers an additional safety measure to prevent HIV transmission in at-risk individuals and possibility of ending HIV epidemic. [ABSTRACT FROM AUTHOR]