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Friday Ebhodaghe Okonofua,1– 3 Lorretta Favour Chizomam Ntoimo,1,3,4 Emmanuel Unuabonah,5,6 Titus Alfred Makudali Msagati,7 Makuachukwu Chioma Ekwo,3 Oladiran Frederick Ayodeji,8 Michael Emefiele Aziken,2 Kenneth Toby Maduako,1,2 Vivian Ifunanya Onoh,1 Akhere Omonkhua,1,9 Victor Ohenhen,10 Celestina Oluwaseun Olafusi,11 Moses O Alfred5,6 1Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin, Edo State, Nigeria; 2Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, University of Benin, Benin, Edo State, Nigeria; 3Women’s Health and Action Research Centre (WHARC), Benin City, Edo State, Nigeria; 4Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye-Ekiti, Ekiti State, Nigeria; 5Department of Chemical Sciences, Redeemer University, Ede, Osun State, Nigeria; 6African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer’s University, Ede, Osun State, Nigeria; 7Institute for Nanotechnology and Water Sustainability, College of Science, Engineering & Technology, University of South Africa, Pretoria, South Africa; 8Department of Obstetrics and Gynaecology, University of Medical Sciences, Ilaje, Ondo State, Nigeria; 9Department of Medical Biochemistry, School of Basic Medical Sciences, University of Benin, Benin, Edo State, Nigeria; 10Department of Obstetrics and Gynaecology, Central Hospital, Benin, Edo State, Nigeria; 11Department of Biochemistry, Faculty of Basic Medical Sciences, University of Medical Sciences, Ilaje, Ondo, NigeriaCorrespondence: Friday Ebhodaghe Okonofua, Women’s Health and Action Research Centre Km 11 Benin Lagos Expressway, Igue-Iheya, Benin City, Edo State, Nigeria, Email feokonofua@yahoo.co.uk; friday.okonofua@cerhi.uniben.eduBackground: Parabens, which are chemicals used as preservatives in cosmetic and pharmaceutical products, have been reported to be associated with low sperm quality in animal and human models. Despite the high exposure of men to paraben-containing products in Nigeria, there are no known studies that investigate the association of parabens with sperm quality in the country.Objective: To determine the association of urinary levels of metabolites of parabens with sperm count and quality.Design/Setting: A multicenter case–control study among fertile and infertile men in five hospitals in southern Nigeria. A total of 136 men diagnosed with male infertility (cases) were compared with 154 controls with normal fertility. Urinary levels of parabens (ethyl-paraben, methylparaben, propylparaben, and butylparaben) were measured using liquid chromatography mass spectrometry, while semen analysis and hormone assays were carried out using World Health Organization standards and radioimmunoassay, respectively. Data were analyzed with non-parametric statistics and non-parametric linear regression.Results: The results showed high levels of parabens in both cases and controls. However, there was no statistically significant difference in urinary levels of ethyl-paraben, methylparaben, propylparaben, and butylparaben between cases and controls. In contrast, propylparaben had a decreasing association with total motility in both groups, but the effect was only statistically significant in the case of male infertility. The results of the regression analysis showed that a unit increase in propylparaben significantly decreased total motility in the cases (infertile men). Similarly, a unit increase in propylparaben decreased morphology significantly in the unadjusted model for infertile men. Only serum testosterone showed an insignificant correlation with urinary parabens.Conclusion: We conclude that urinary parabens are associated with features of poor sperm quality – motility, morphology, and volume. Measures to reduce exposure of men to agents containing parabens in Nigeria may reduce the prevalence of male infertility in the country.Keywords: male infertility, Nigeria, parabens, LCMS, case–control study, spermatozoa

The authors call for urgent action to ensure that COP27, the 5th Conference of the Parties (COP) finally delivers climate justice for Africa and vulnerable countries. Topics covered include the needs for wealthy nations to step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change, the impact of the climate crisis on the environmental and social determinants of health across Africa, and how global inaction has caused the climate crisis.

Friday Ebhodaghe Okonofua,1– 3 Lorretta Favour Chizomam Ntoimo,3,4 Akhere Omonkhua,2,5 Oladiran Ayodeji,6 Celestina Olafusi,6 Emmanuel Unuabonah,7 Victor Ohenhen8 1Department of Obstetrics and Gynecology, University of Benin, Benin, Edo State, Nigeria; 2Center of Excellence in Reproductive Health Innovation, University of Benin, Benin, Edo State, Nigeria; 3Women’s Health and Action Research Centre, Benin City, Edo State, Nigeria; 4Department of Demography and Social Statistics, Federal University, Oye-Ekiti, Ekiti State, Nigeria; 5Department of Medical Biochemistry, School of Basic Medical Sciences, University of Benin, Benin, Edo State, Nigeria; 6Department of Obstetrics and Gynaecology, University of Medical Sciences, Ondo, Ondo State, Nigeria; 7Department of Chemistry, Redeemer University, Ede, Osun State, Nigeria; 8Department of Obstetrics and Gynaecology, Central Hospital, Benin, Edo State, NigeriaCorrespondence: Friday Ebhodaghe Okonofua, Department of Obstetrics and Gynecology, University of Benin, Benin, Edo State, Nigeria, Tel +234 8023347828, Email feokonofua@yahoo.co.ukBackground: Despite the evidence of declining sperm counts worldwide and the increasing prevalence of male infertility, there has been limited documentation of the potential causes and risk factors for male infertility. With limited methods of primary treatment of male infertility, understanding the causes and risk factors will pinpoint specific lines of prevention.Objective: We reviewed published studies on causes and risk factors for male infertility and identify gaps in the literature enabling more focused research and innovations.Design/Setting: The study was a scoping review. The review included studies on the causes and risk factors of male infertility published in scientific/academic publications. It was not limited to any region or date. The following databases were searched: Cumulative Index to Nursing and Allied Health Literature, Wiley online, HINARI, Science Direct, PubMed/Medline, Google Scholar, African Journals Online, and the WHO Repository. In total, 1295 articles were identified. After removing 357 duplicates, 938 articles were screened, and 71 articles were identified for inclusion, while 60 articles met the inclusion criteria.Results: Four broad causes and risk factors of male infertility identified were 1) biological/physiological/genetic causes, 2) behavioral/lifestyle risk factors, 3) environmental factors, and 4) socio-demographic risk factors. However, no substantive results on actual causes under each category were identified, leaving gaps for further research and experimentation.Conclusion: The results indicate limited knowledge of the actual causes of male infertility in published studies. The gaps in knowledge that need to be bridged to enable a fuller understanding of the actual causes of male infertility were highlighted.Keywords: male infertility, causes, risk factors, scoping review, spermatozoa defects

We investigated perceptions of the causes of maternal mortality by women attending referral hospitals in Nigeria. Focus group discussions were conducted with various categories of women. Our results showed that women were aware of the medical causes of mortality, although a few listed divine reasons. Delays in reaching hospitals or after women arrive in hospitals featured prominently as lead causes mentioned by women. Listening to women as end-users is an important approach to identify points of remediation in the provision of maternal health care. This should be taken into cognizance when policymakers or international agencies plan the prevention of maternal deaths in developing countries. [ABSTRACT FROM AUTHOR]