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The study was carried out to evaluate the radioactivity concentrations of 40K, 232Th and 238U in five maize samples collected from maize farms within Ekiti State, Nigeria. The activity concentration measurements were determined using n -- type co-axial HPGe detectors for the state. The activity concentrations were found to vary from 994.67 - 2457.01 Bq Kg-1 for 40K, 32.84 - 91.88 Bq kg-1 for 232Th and 43.21 - 97.77 Bq kg-1 for 238U respectively. The annual effective dose to individuals from the consumption of the Maize was estimated on the basis of the measured radionuclides content in the food crop which ranged between 0.41 and 1.51 m Svy-1 respectively. The value 1.04 m Svy-1 were obtained for the state as the mean total annual effective dose. The mean excess life time cancer risk was also calculated to be 2.06x10-9. The value was compared with the internationally acceptable limits and found to be far less to the maximum permissible dose of 1.0 x10-3 recommended for the public by the United Nations Scientific Committee on the Effects of Atomic Radiation. Hence, the maize was found to be safe for human consumption. [ABSTRACT FROM AUTHOR]

Purpose: To determine the predictive value of the Pirani scoring system in the need for tenotomy using the Ponseti method for management of idiopathic clubfoot. Method: This is a prospective observational study involving patients less than 2 years of age with idiopathic clubfoot. The consenting parents and institution ethical board approved the study. The relationship between Pirani scores and the need for tenotomy was evaluated using the independent t -test and the binary logistic regression to predict the need for tenotomy. Pearson’s r and Cohen’s κ were used to measure correlation and agreement, respectively, between the predicted and observed values. A receiver operating characteristic curve was used to interpret sensitivity and specificity levels as well as to obtain a cutoff score for predicting the requirement for tenotomy. Results: Eighty-four clubfeet from 50 patients were studied. Thirty-eight feet (45%) had percutaneous tenotomy. The initial total Pirani and hindfoot scores were found to predict the need for tenotomy with the model for prediction being able to predict correctly in 72.6% and 75% of the time, respectively. A higher Pirani score was associated with higher odds of requiring tenotomy (OR = 4.402, p < 0.001) and total Pirani score above the cutoff point of 4.75 predicted the need for tenotomy. Conclusion: The indication for tenotomy appears to be well predicted using the Pirani scoring system with the odds of requiring a tenotomy increasing by more than fourfold for every unit increase in Pirani score.

Background: Sexual violence among higher education students is a global public health problem. Identifying the characteristics of students who report victimization can serve as basis for programmes that target vulnerable students., Methods: The study was conducted among 30,114 Nigerian higher education students. They were selected from 18 institutions comprising universities, polytechnics, and colleges of education. The purpose of the study was to assess the characteristics of students who reported sexual violence (rape, attempted rape and sexual harassment) and to determine the association between reporting and their characteristics., Results: Our findings showed that 37% of the students reported experiencing sexual violence. Regression analysis showed that the odds of reporting among female students were two times greater than that of the male students (CI = 1.58-1.78; P < 0.001). The students who were traditionalists (aOR = 2.65, p < 0.001) or from other religious groups (aOR = 3.28, p < 0.001) had higher odds of reporting than those who were Christians. All the age groups represented in the study had significantly higher odds of reporting except those between 25 and 29 years (aOR = 1.03; p = 0.616). Non-final year students had significantly 7% lower odds of reporting (p = 0.037) than the first-year students. The students in the arts and humanities-related programmes significantly had higher odds of reporting than those in the science-related programs (aOR = 1.08; p = 0043). In addition, polytechnic and colleges of education students were two times more likely to report sexual violence than university students (p < 0.001). Also, the students from other regions were two times more likely to report sexual violence than those from Southwest region., Conclusion: The study concluded that sexual violence reporting by higher education students differ by their types of schools, sex, religion, level of education and geographical location., (© 2024. The Author(s).)

Background: Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction., Objective: The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities., Methods: A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios., Results: A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics., Conclusion: The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities., (© 2024. The Author(s).)

Background: The Lafiyan Yara Project aimed to increase demand for HIV counselling, testing, treatment, and prevention services among pregnant women and children in Taraba State, Nigeria. Implemented from 2019 to 2021, the project utilized existing community structures, including traditional birth attendants, village health workers, and patent and proprietary medicine vendors, for mobilization. This study assessed the project's activities, contributors, relevance, effectiveness, and efficiency., Methods: The process evaluation was conducted using focus group discussions and key informant interviews with beneficiaries, community leaders, project staff, health facility personnel, and government officials. Data analysis employed framework analysis., Results: The Lafiyan Yara project was reported to have achieved notable successes, including increased HIV testing rates among children and pregnant women, improved linkage to care services, reduced mother-to-child transmission of HIV, increased HIV/AIDS awareness and knowledge, and enhanced community engagement and support. Challenges identified included insufficient funding for community mobilizers, training needs for health workers, and inadequate availability of test kits at health facilities. Confidentiality and stigma issues arose during community mobilizations. A key lesson learned was the importance of a comprehensive HIV care approach, emphasizing testing and ensuring support for individuals testing positive., Conclusions: The project's approach of leveraging community structures to create demand for HIV services among women and children proved effective, provided proper linkage to care for those testing positive. Addressing stigma and involving husbands/fathers in the community approach are crucial for improving outcomes., Trial Registration: IPHOAU/12/1384., (© 2024. The Author(s).)

Infant and young child feeding (IYCF) interventions in low-resource countries mainly target pregnant women and mothers of young children; however, fathers and grandmothers also influence IYCF practices. We conducted focus group discussions with mothers, fathers and grandmothers of young children across three time points in areas where an IYCF social and behaviour change intervention was implemented in Nigeria to explore differences by participant type and shifts over time in attitudes, beliefs and social norms related to breastfeeding and dietary diversity (DD). Overall, across time points, we found more discrepancies in attitudes, beliefs and social norms for early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) among different participant types than for DD. Although most participants agreed EIBF and EBF are good practices, mothers believed this more strongly than fathers and grandmothers; however, at endline, a shift towards acceptance of EIBF and EBF appeared among fathers and grandmothers. Across time points, all participant types acknowledged the nutritional and health benefits of green leafy vegetables and animal-source foods but described various barriers to feeding them to children. Across time points, all participant types also highlighted the importance of health workers and antenatal visits as important sources of IYCF knowledge and facilitators to following recommended practices. Insights from this study highlight the importance of including key influencers of IYCF practices in qualitative research., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

The Adolescent Health Quality of Care (AHQOC) index is a tool designed to evaluate the quality of facility-based adolescent sexual and reproductive health (ASRH) services. This descriptive cross-sectional study aimed to validate the AHQOC index in 27 primary and secondary public health facilities located in a rural and an urban local government area (LGA) of Ogun State, Nigeria. To conduct the study, 12 mystery clients (MCs) were recruited and performed 144 visits to the health facilities. The MCs were young males and females who were seeking information on premarital sex, pregnancy prevention, sexually transmitted infections (STIs), and contraception. The validity, and reliability of the AHQOC index were evaluated using exploratory factor analysis, Cronbach's Alpha, and intra-class correlation coefficient tests. The Kaiser-Meyer-Olkin test result for the initial 37-item pool was 0.7169, and the final tool retained 27 items with a Cronbach's Alpha of 0.80. Two subscales of the index had Cronbach's Alpha of 0.76 and 0.85. The intra-rater consistency assessed by the intra-class correlation coefficient was 0.66 (0.10-0.92) p = 0.001 for the urban LGA and 0.72 (0.37-0.91) p = 0.001 for the rural LGA. Positive and statistically significant relationships were observed between the full scales and subscales and the validity item (MC ranking of health worker on proficiency from 1 to 10). The results of this study demonstrate that the validated AHQOC index is a valuable tool for assessing the quality of ASRH services in public health facilities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Arije 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: Global response to the growing burden of non-communicable diseases (NCDs) in developing countries includes the development of WHO Package of Essential Non-communicable Disease Interventions (WHO PEN) for Primary Health Care (PHC). The study assessed the level of preparedness of PHC facilities on implementation of essential NCD interventions in rural and urban Local Government Areas (LGAs) of Osun State, Nigeria., Methods: The study was a comparative cross-sectional survey. Information was collected from heads of 33 rural and 33 urban PHC facilities and through direct observation on the domains of staff training, basic equipment, diagnostics and essential medicines for cardiovascular diseases, diabetes and chronic respiratory diseases (CRDs) using a semi-structured interviewer administered questionnaire., Results: Manual sphygmomanometer was found in similar proportions (84.8%) of PHC facilities in rural and urban LGAs. Glucometer was available in 45.5% of the PHC facilities in urban and 33.3% of the PHC facilities in the rural LGAs, the difference was not statistically significant (χ2 = 1.015; p = 0.314). Basic equipment for CRDs were not available in majority of PHC facilities in both locations. Moduretic tablets were the most reported essential NCD medicines, available in 15% of PHC facilities in rural LGAs and none in urban LGAs. The anti-diabetic medicines were not available in any of the PHC facilities in both locations. More than 90% (≥ 30) of the PHC facilities in both locations were not prepared to implement essential interventions for each NCD across domains of staff training and essential medicines. Overall, 97.0% of the PHC facilities in the rural LGAs and all the PHC facilities in urban LGAs were not prepared on implementation of essential interventions for the three NCDs., Conclusion: The level of preparedness of the PHC facilities on implementation of essential NCD interventions in the rural and urban LGAs of Osun State is very low. Government needs to strengthen the PHC system by providing needed essential medicines, basic diagnostics, equipment, and training of clinical health care workers for implementation of essential NCD interventions in the state., (© 2023. The Author(s).)

Background: Adolescent girls and young women (AGYW) in Nigeria are especially at risk of HIV in Nigeria. Their vulnerability to HIV is linked to multiple concurrent sexual relationships, transgenerational sex, and transactional sex, amongst other factors. These factors have sociocultural contexts that vary across a multi-cultural country like Nigeria. The aim of this study was to use an innovative collaborative approach to develop a minimum HIV prevention package for AGYW which is responsive to sociocultural settings and based on combination HIV prevention., Methods: We conducted action research to develop and implement actionable HIV prevention intervention models that address AGYW's vulnerabilities to HIV in three Nigerian States and the Federal Capital Territory (FCT) Abuja. The action research adopted the breakthrough series (BTS) collaborative, which accelerates improvement through mutual learning. The BTS implementation involved rapid Plan-Do-Study-Act (PDSA) cycles: an iterative process to plan and implement a basket of interventions. Problems or problematic situations, termed change topics, for which interventions could be carried out were identified in each study location. Using participatory approaches during a series of meetings called learning sessions, specific and innovative interventions, termed change ideas, were developed. These learning sessions were conducted with young women groups and other stakeholders. The change ideas were tested, studied, adapted, adopted, or discarded at each participating site. Exposure to and uptake of the implemented interventions was assessed in the study areas using a household survey with 4308 respondents, 53 focus group discussions, and 40 one-on-one interviews in intervention and control study sites., Results: Five categories of interventions were collaboratively developed, namely: Parental communication; Peer to peer interventions; Facilitator-led interventions; Non-traditional outlets for condoms, and Social media-based interventions. A good reach of the interventions was demonstrated as 77.5% of respondents reported exposure to at least one type of intervention. Nearly half of the respondents reported being exposed to the parental communication interventions, while 45.1% reported being exposed to the youth facilitator-driven interventions. Social media interventions had the lowest penetration. Also, there was between 15 to 20 positive percentage point difference between intervention and control for the uptake of HIV testing, and between 5 to 9 positive percentage point difference for uptake of male condoms. These differences were statistically significant at p<0.001., Conclusions: Interventions developed through participatory approaches with young people and well-tailored to local realities can improve the acceptability and accessibility of programs that are able to reduce the risk of HIV infection among AGYW., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Arije 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.)

Nigeria carries a high burden of HIV infections, with Taraba State having a prevalence of 2.49%. This quasi-experimental study evaluated the impact of the Lafiyan Yara project, which utilised various community-based mobilisation models, on the enhancement of HTS uptake among women during pregnancy, and children. The intervention involved the implementation of mobilisation by Traditional Birth Attendants (TBA), Village Health Workers (VHW), Patent and Proprietary Medicine Vendors (PPMVs), and a combination of the three in four study local government areas (LGA) in Taraba State. Baseline and end-line surveys were conducted focused on women aged 15-49 years who delivered a child in the past 1 year, and children in their households, in the study and a control LGA. A difference-in-difference (DID) approach was applied by using a probit regression model with interaction terms for treatment status (intervention vs. control) and survey timing to compute the DID estimates of uptake of HTS. The TBA model showed the highest impact in the referral of women to HTS, while the combined model demonstrated the greatest impact in referrals for children. Scaling up and strengthening these community mobilisation efforts can improve access to HIV testing and contribute to HIV/AIDS prevention and control in the region.

Background: To support the policy drive for the promotion of sexual and reproductive health (SRH) of adolescents and young people (AYP), it is necessary to understand the characteristics of the existing SRH services available to them., Objective: To assess the provision and experiences of care in SRH services for AYP in a Nigerian setting., Methods: Twelve male and female mystery clients (MCs) conducted 144 visits at 27 selected primary and secondary health facilities in two Local Government Areas (LGA) in Ogun State, Nigeria. A 27-item adolescent quality of care (AHQOC) index with a Cronbach's Alpha of 0.7 was used to obtain a quality-of-care score for each clinic visit. Linear panel-data random-effects regression models using the generalised least square estimator were used to assess quality associated factors. Sentiment analysis was done on the qualitative narrative summaries provided by MCs after each visit., Results: There was an absence of the use of educational materials during the 60.4% of the visits. The MCs' medical history (90.3%), social record (63.9%), sexual/reproductive history (53.5%), and contraceptive experience (66.0%) were not obtained in most of the visits. Female MC visits had a lower AHQOC index rating on average compared to males (β=-0.3, CI -1.6 - 1.0 p = 0.687), rural health facilities had a lower AHQOC index rating on average compared to urban (β=-2.7, CI -5.1 - -0.2, p = 0.031), and a higher ranking of the health worker on the scale of 1-10 corresponded to a higher AHQOC index of the MC visit (β = 1.9, CI 1.6-2.1, p < 0.001). There were more positive than negative sentiments about the clinic encounters., Conclusion: This study found gaps in the competencies of the health workers, non-usage of educational materials in clinic encounters with young people, as well as the differential perception of quality of care by male and female AYP.

Background: A major component of the validity of the discrete choice experiment (DCE) research design lies in the correct specification of attributes and levels relevant to the research focus. In this paper, we set out the validation steps we took in designing the tool for a DCE on preferences in sexual and reproductive health (SRH) services for adolescents and young people., Methodology: This study was carried out among adolescents and young people (AYP) in Ogun State, Southwest Nigeria. We used a three-step mixed-methods process in developing the attributes and attribute-levels for our DCE tool. The first was to conduct a series of 16 focus group discussions (FGD) with AYP ensuring maximal variation (by age group, sex, marital status, and location). The FGD included a priority listing process in which participants were asked to list and rank the most important characteristics of optimal SRH services for AYP. The lists were harmonized and items were scored. The main (highest scoring) themes emerging from the harmonized priority list were converted into an initial set of attributes and the subthemes as level. These initial attributes and levels were presented to a panel of methods and content experts in a virtual modified Delphi process. This was for deciding on the importance of the attributes in providing optimum sexual and reproductive health services for young people, and the appropriateness of the levels. The same set of attributes was presented to another set of AYP in a series of four FGD to clarify meanings, and test whether the wordings were well understood. We applied some decision rules for including and excluding attributes and levels in the different phases of the development process., Results: We extracted an initial set of nine attributes with 2-4 levels each from the first FGD sessions. These were revised to a final set of seven attributes with 2-4 levels each based on findings from the expert review and final validation FGDs with AYP. The final attributes were: the type of staff, physical environment, health worker attitude, cost, waiting time, contraceptive availability, and opening hours., Conclusion: The final set of attributes covered those relating to the services provided, the health workers providing the services, and the AYP. Our three-step process which included both quantitative and qualitative approaches ensured a rigorous process that produced a reliable combination of attributes and levels. Although we had to trade off some competing attributes to come to a final list, our decision rules helped us to conduct a transparent and reproducible process., (© 2022. The Author(s).)

Background: Integrating the care of adolescents and young people into existing public health facilities requires deliberate efforts to address challenges related to policy and service provision. This study assessed key informants' perspectives on policy- and service-level challenges, and opportunities, for implementing a strategic framework for adolescent and youth-friendly health services (AYFHS) in public health facilities in a Nigerian setting., Methods: Seventeen key informants were interviewed including members of the Adolescent sexual and reproductive health (ASRH) Technical Working Group (TWG), program managers of non-governmental organizations (NGO), State and local level health officials, and youth representatives, in Ogun State, Southwest Nigeria., Result: Findings from this study indicate that some health workers continue to have a negative attitude toward young people's sexual and reproductive health. There was some level of inclusion of adolescents and young people living with disabilities in ASRH programming which is welcome and extremely important. Some of the challenges in ASRH service provision included insufficient coordination of activities of donors/partners working in the adolescent health space. Also found was the missed opportunity to strengthen policy implementation with research, and the need for increased focus on mental health, substance use, and other aspects of adolescent and young people's health. There was noted the opportunity to explore the Basic Health Care Provisions Funds (BHCPF) as a new source of funding for health services for AYP in Nigeria., Conclusion: This study provided the context of the implementation of a strategic framework for adolescent reproductive health in a Nigerian setting from the perspectives of policy and service-level stakeholders. Opportunities for improving program delivery identified include ensuring research-based policy implementation and seeking program sustainability through tapping into new sources of funding., (© 2022. The Author(s).)

Aim : Women and girls living with or at high risk of acquiring HIV (WGL&RHIV) in Africa are economically vulnerable. This study aims to advance understanding of the economic impact of COVID-19 on WGL&RHIV and to identify the factors associated with this insecurity. Methods: Data were collected from a cross-sectional survey conducted among a convenience sample of WGL&RHIV in Nigeria between May and September 2021. Logistic regressions enabled the study of the role of HIV status, mental health and macrosocial characteristics (people with disability, transgender women, sex workers, persons engaged in transactional sex, substance users, and people on the move) on economic vulnerability, measured by food, financial and housing insecurity, since the COVID-19 pandemic began. The model accounted for the possible interactions between the macrosocial characteristics and controlled for confounders. Results: There were 3 313 (76.1%) of 4 355 respondents facing food insecurity, 3 664 (83.6%) of 4 385 with financial vulnerability and 1 282 (36.2%) of 3 544 with housing insecurity. Being a member of the key and vulnerable groups was strongly associated with food insecurity, financial vulnerability and housing insecurity, regardless of HIV serostatus. For example, WGL&RHIV engaging in transactional sex were more than four times more likely (aOR 4.42; 95% CI 2.57-7.59) to face housing insecurity and more than twice more likely to face food insecurity (aOR 2.47, 95% CI 1.35-4.52) and financial vulnerability (aOR 2.87, 95% CI 1.39-5.93). This economic vulnerability may reduce their negotiating power for safer sex or the use of HIV prevention methods, exposing them to increased risks of HIV infection. Poor mental health was also associated with the three forms of economic vulnerability. Conclusions: As the long-term impact of the COVID-19 crisis on African economies unfolds, HIV programmes at the country level must include economic vulnerability and mental unwellness mitigation activities for WGL&RHIV.

Aim : Women and girls living with and at high risk of HIV (WGL&RHIV) had an increased risk for gender-based violence (GBV) during COVID-19. The study aimed to assess the associations between vaccine hesitancy and GBV, HIV status and psychological distress among these vulnerable women and girls in Nigeria. Methods: This cross-sectional study collected data from WGL&RHIV in 10 states in Nigeria between June and October 2021. The dependent variable was vaccine hesitancy. The independent variables were the experience of physical, sexual, economic and emotional GBV, HIV status and psychological distress during the COVID-19 pandemic. We conducted a multivariable logistics regression analysis to test the associations between vaccine hesitancy and the independent variables and covariates. Results: Among the 3 431 participants, 1 015 (22.8%) were not willing to be vaccinated against COVID-19. Not knowing or willing to disclose HIV status (aOR 1.40) and having mild (aOR 1.36) and moderate (aOR 1.38) symptoms of anxiety and depression were significantly associated with higher odds of vaccine hesitancy. Being a survivor of intimate partner physical violence (aOR 5.76), non-intimate partner sexual violence (aOR 3.41), as well as emotional abuse (aOR 1.55) were significantly associated with respectively more than five, three and one and half times higher odds of vaccine hesitancy. One positive outcome is that HIV-positive women and girls appeared to be more likely to get the COVID-19 vaccine when available. Conclusions: Sexual and gender-based violence, low socio-economic status, psychological distress and an unknown HIV status are essential determinants of COVID-19 vaccine hesitancy among vulnerable women and girls in Nigeria. National authorities and civil society organisations need to better integrate COVID-19 mitigation activities with HIV and gender-based violence interventions through a more feminist approach that promotes gender equality and the empowerment of women and girls in all their diversity for better access to health services.

Adolescents and young people (AYP) experience many barriers in the utilization of sexual and reproductive health (SRH) services. These barriers can be cultural, structural, personal or health worker-related. In this study, we explored the perceptions and preferences of AYP in receiving SRH services at public health facilities in a Nigerian setting. We conducted 16 focus group discussion (FGD) sessions with adolescents and young people allowing for maximum variation by sex (male, female), age (15-19 years and 20-24 years), and marital status (married and unmarried). We applied a thematic framework analysis to explore the data collected. Our findings included both positive and negative attitudes of health workers at public health facilities, non-involvement of AYP in activities relating to the planning, implementation, or evaluation of SRH programs for AYP, and non-awareness among AYP of some of the rights that AYP have with respect to SRH services in public health facilities. Many participants preferred younger health workers or those living within their neighborhood. Some older health workers were said to often act as (strict) parents, not health workers. We conclude that the role ascribed to 'neighborhood' nurses in this study is instructive and deserves more attention. Also, there is a need to increase the awareness of the young people about the type of SRH services they can obtain in the public health facilities, as well as, a need for health workers to be trained and retrained in providing SRH services to AYP., Competing Interests: The authors have no conflicts of interest relevant to this article to disclose., (© 2022 The Authors.)

Aim : To determine the proportion of women and girls living with HIV (WGLHIV) who had poor access to HIV, tuberculosis and sexual and reproductive health (SRH) services in Nigeria during the COVID-19 pandemic and associated factors. Methods: This was a cross-sectional study that recruited WGLHIV with six categories of vulnerability (sex work, transactional sex, injecting or using illegal drugs, people on the move, transgender women and people with a disability) through an online survey conducted in ten Nigerian states between june and October 2021. The associations between the limited access to HIV, tuberculosis and SRH services due to COVID-19, the categories of vulnerability and the financial and non-financial barriers to these services were determined using multivariable logistics regression analysis. Results: Over 6 in 10, almost 2 in 10, and almost 4 in 10 WGLHIV had limited access to HIV, tuberculosis and SRH services respectively during the COVID-19 pandemic. Transgender women had 3.59 (95% CI 2.19-5.91) higher odds, women who engaged in sex work had 4.51 (95% CI 2.28-8.42) higher odds, and women who inject or use illegal drugs had 2.39 (95% CI 1.47-32.90) higher odds of facing limited access to sexual and reproductive health services when it was needed. In addition, the direct consequences of the COVID-19 crisis, such as the closure of HIV services and SRH service points, exacerbated pre-existing barriers significantly. Having no money, having to pay additional unofficial fees and the lack of security on the road to the health facility were the barriers with the greatest impact on access to health services. Conclusions: The COVID-19 pandemic had a negative impact on the access of WGLHIV to essential health services. This impact was disproportionately higher for marginalised groups. WGLHIV need non-discriminatory and affordable access to essential health services during the pandemic.

Introduction: this study evaluated the economic impact of the COVID-19 lockdown on individuals and households., Methods: a cross-sectional online survey was used to collect data. Nigerian citizens who were domiciled or restricted from travelling abroad for no less than one month since the COVID-19 restrictions and lockdown were recruited into the study through focal persons purposively selected across the different states in Nigeria. Using WhatsApp® platform, the respondents completed the survey on household income and expenditure before and during the lockdown. Economic burden of COVID-19 lockdown on individuals and families was estimated using a prevalence-based cost of illness approach., Results: four hundred and four (male = 242; female = 162) individuals have participated in the study. The mean (SD) age of the respondents was 30.98 (10.92) years. Monthly income showed no statistically significant difference (p = 0.73) before and during lockdown. The overall household expenditure before and during the lockdown periods were USD 320 and USD 290. The total mean monthly costs for COVID-19 and non-COVID-19 health related problems were ₦11746.25 (USD30.79) and ₦11784.9 (USD 30.89), respectively. Household expenditure for hand sanitizers, facemasks, hand gloves, and disinfectants increased significantly during the COVID-19 restriction lockdown (p < 0.05). However, expenditure on education, water, electricity, fuel, internet data, clothing and wears, toiletries decreased significantly during the lockdown period (p < 0.05)., Conclusion: this study suggests that the costs of continuing COVID-19 restrictions could have huge economic consequences on households and health system., Competing Interests: The authors declare no competing interests., (Copyright: Francis Fatoye et al.)

Background: To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria., Methods: This study was a subset of a larger cross-sectional study the data of which was generated through a household survey conducted in Ile-Ife, Nigeria. The study's explanatory variable was malnutrition (underweight, overweight, wasting and stunting) and the outcome variable was ECC. Poisson regression analysis was used to determine the association between ECC and malnutrition. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study were adjusted for to obtain the adjusted prevalence ratio (APR)., Results: Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03-0.69; p = 0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83-25.85; p < 0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0-0; p < 0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female., Conclusions: For this study population, the indicators of malnutrition - being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC. The frequency of sugar consumption was not a significant risk indicator when malnutrition was included as an explanatory variable for ECC in the study population.

Purpose: The majority of women managed for breast cancer in Nigeria are relatively young, many in their forties. Mastectomy, the most common surgical treatment, raises psychosocial concerns. Understanding these concerns may help address the fears of women who refuse treatment and aid in the care of those who have had mastectomy., Methods: Using qualitative methods, we purposively sampled women 45 years of age and younger who underwent mastectomy for breast cancer at a Nigerian teaching hospital. One-on-one in-depth interviews were conducted using an unstructured interview guide. Data were transcribed verbatim and analyzed to identify themes and subthemes., Results: The study identified six major themes on the impact of mastectomy on psychosocial lives of women, namely decision for mastectomy, postmastectomy transition, body image changes, relationship with husband and sexual life, coping with life postmastectomy, and social support., Conclusion: Our findings highlight the importance of addressing individual patient's psychosocial needs and preferences when discussing breast cancer treatment with young women. The experiences of women described in this study reveal several useful themes for planning treatment protocols and postmastectomy care.

Background: Violence is universal; it occurs in schools (both public and private). The study aim was to assess the rates of violence as well as existing violence prevention strategies in public and private schools in Osun state., Methodology: A cross sectional study was conducted among 800 secondary school students (599 in public and 201 in private schools) selected by multistage sampling technique using quantitative and qualitative methods of data collection., Results: The mean age for all the respondents was 14.26 years +/- 2.001 Males make up about 51% of the respondents in both public and private schools. Respondents from public schools assaulted other students and staff with a weapon more than their colleagues in private schools (24.7% and 9.7% against 12.9% and 6.5% respectively). The commonest violence 'prevention' strategy in both schools was punishment for violent acts (>90%)., Conclusion: Respondents in public schools perpetrated and experienced virtually all forms of school-related violence more than those in private, schools. There were mild differences in existing violence prevention strategies in both schools. School connectedness seems to be a major factor in the differential rates of violence between both groups of schools.