Lagos State University Teaching Hospital

INTRODUCTION:Nephrotic syndrome (NS), a common glomerular disease in children, is classified based on response to corticosteroid therapy as either steroid-sensitive nephrotic syndrome (SSNS), or steroid-resistant nephrotic syndrome (SRNS). However, there are no current reliable predictors of therapy response at initial clinical presentation. METHODS:To evaluate predictors, we conducted genome-wide association studies, developed polygenic risk scores (PRS) for therapy response and analyzed classical HLA alleles in 1,997 children (994 discovery and 1,003 replication/validation cohorts) previously unstudied children with NS and 3,558 ancestry-matched control individuals. RESULTS:A significant association with HLA loci defined by variants in HLA-DQB1, HLA-DRB1, and HLA-DQA1 were found for SSNS (but not SRNS), along with a second immune-related SSNS locus: CLEC16A. A PRS that discriminates between SSNS and SRNS was validated in two independent cohorts. The HLA haplotype HLA- DRB1∗07:01∼DQA1∗02:01∼DQB1∗02:02 was associated with about four times the risk of developing SSNS. A model incorporating HLA haplotype, PRS score, and age at disease onset was the best predictor of steroid responsiveness with an area under the curve of 0.68-0.70 and an overall classification accuracy of SSNS versus SRNS of 67-71%. CONCLUSIONS:Our findings confirm that SSNS, unlike SRNS, is an immune-mediated HLA-associated disorder. The PRS for therapy response and HLA haplotype can serve as biomarkers, provide a foundation for more accurate diagnoses and tailored individualized treatment.

BACKGROUND:Comorbid depression and anxiety represent a severe adolescent phenotype, yet their epidemiology remains under-characterised in sub-Saharan Africa. This study estimated the prevalence, correlates, and functional consequences of internalising comorbidity in a large Nigerian school-based sample. METHODS:A stratified probability sample of 9437 adolescents aged 11-17 years (50.4% female; mean age 15.61 years) was drawn from 47 public secondary schools across Lagos State. Diagnoses were assessed using the MINI-Kid via supported self-administration. Participants were classified as Neither Disorder, Depression-Only, Anxiety-Only, or Comorbid (depression plus ≥1 anxiety disorder). Multinomial logistic regression identified independent correlates. Suicidality and functional impairment were examined using adjusted logistic regression within a two-model framework distinguishing upstream confounders (primary) from potentially endogenous contemporaneous variables (sensitivity). An exploratory associational path model was estimated using generalised structural equation modelling with logit links. Primary analyses included 9041 complete cases. RESULTS:Any internalising disorder prevalence was 32.8% (95% CI 30.9-34.7); comorbidity was 4.5% (3.8-5.2) overall and 13.8% among those with any disorder. Among adolescents with major depressive disorder, 38.1% also met anxiety criteria. Domestic violence exposure, parental alcohol use, and social isolation were most strongly associated with comorbidity. Comorbidity was associated with more than a ten-fold increase in odds of suicidal ideation in primary models (OR 10.43; 7.21-15.08). Exploratory modelling showed statistical clustering of grade repetition, comorbidity, and suicidality. CONCLUSIONS:Although less prevalent than Western estimates, comorbid depression and anxiety confers disproportionate suicidality risk in Nigerian adolescents, supporting integrated school-based screening and family-level prevention strategies.

Introduction The mental health treatment gap in low- and middle-income countries, particularly Nigeria is profound. Religious leaders serve as de facto community gatekeepers for mental distress. This study, forming the quantitative and mixed-methods component of the CLErgy and Religious leader Involvement in Community mental health project, moves beyond acknowledging this role by systematically assessing the collaboration readiness of Nigerian religious leaders, identifying its predictors and classifying leaders into distinct implementation profiles to inform task-sharing initiatives.Methods A cross-sectional, explanatory mixed-methods study was conducted in Lagos State, Nigeria. Of 255 religious leaders approached, 207 Christian and Muslim leaders were enrolled (response rate 81.2%). A supplementary sample of 25 mental health professionals was recruited (response rate 71.4%). Surveys and focus group discussions were administered in English and Yoruba; the focus group sessions lasted 75–90 min. Collaboration readiness was assessed using a validated 10-item scale alongside the Mental Health Literacy Scale, the Community Attitude Towards Mental Illness Scale-16 and a structured barrier assessment. Analyses included multiple linear regression, structural equation modelling (SEM) and latent class analysis (LCA). Two focus groups (n=15) and open-ended healthcare professional survey responses were analysed thematically.Results Overall readiness was moderate (M=25.8/40), with 71.5% demonstrating moderate-to-high readiness. Notably, 48.8% had never made a medical referral, revealing a persistent know-do gap. Regression (R²=0.64) identified mental health literacy (β=0.41), education (β=0.26) and prior training (β=0.23) as strongest predictors. SEM confirmed education improves readiness primarily via literacy (indirect effect=0.13). LCA identified four implementation profiles: implementation ready (18.4%), conditionally ready (31.9%), reluctantly engaged (29.5%) and implementation resistant (20.2%). Four qualitative themes emerged: structural constraints, ideological conflict, trust barriers and conditional openness from healthcare providers. Knowledge gaps and trust deficits were bidirectional.Conclusions Substantial collaboration potential exists among Nigerian religious leaders and appears to be shaped by a combination of intervention-sensitive factors, such as mental health literacy and training exposure, and less directly modifiable structural characteristics, such as educational background and service access. A stratified, bidirectional implementation strategy tailored to distinct readiness profiles is essential to bridge the mental health treatment gap.

Objectives: This study aimed to compare the central corneal thickness (CCT) findings between diabetics and non-diabetics, in patients attending the Lagos State University Teaching Hospital, Ikeja. Materials and Methods: This is a cross-sectional study in which 140 patients were recruited. 70 diabetics and 70 non-diabetics participants were recruited. All patients had an ocular examination, pachymeter measurement and the data were compared between the two groups and analysed with the use of IBM statistical package for the social sciences 25 software. Results: The mean age of the diabetic participants was 60.60 years (+12.4 standard deviation [SD]), and the non-diabetic group was 59.87 years (+13.2 SD). There were more females (72.9%) than males (27.1%). There was no significant difference in the CCT measurement between diabetics (520.74 + 48.8 µm) and non-diabetic (524.62 + 28.7 µm) participants. There was also no statistically significant correlation between the duration of diabetes, glycaemic control (using glycated haemoglobin) and CCT measurement. However, intraocular pressure (IOP) measurements were noticed to be significantly higher in people with diabetes than in non-diabetics. Conclusion: There was no difference in CCT measurements between diabetics and non-diabetics; however, people with diabetes have higher IOP. Therefore, IOP should be part of routine eye screening done for diabetic patients.

Sexual and Gender-Based Violence (SGBV) remains a major global public health and human rights concern with profound implications for women's safety, dignity, and quality of life. In Nigeria, SGBV is pervasive, particularly within tertiary institutions, where young women and adolescent girls face heightened vulnerability. This study explored the roles of key stakeholders and identified best practices in addressing SGBV within Nigerian higher education institutions to inform effective policies and interventions. A cross-sectional, sequential mixed-methods design was employed. Quantitative data were collected from 4,142 participants across tertiary institutions in Kaduna, Enugu, Osun, and the Federal Capital Territory (FCT) using multistage stratified random sampling. Qualitative data were obtained through 22 key informant interviews, 12 in-depth interviews, and 7 focus group discussions with relevant stakeholders. The study was anchored on the Socio-Ecological Model (SEM) and the Theory of Change (ToC), which facilitated a multi-level analysis of influences and linked diagnostic insights to actionable intervention pathways. Quantitative data were analyzed with SPSS version 25, while qualitative data were thematically analyzed using ATLAS.ti software. Findings indicated that most stakeholders addressing SGBV were non-state actors, including student associations (17.4%), parents (12.6%), academic staff (11.6%), and non-governmental organizations (13.5%). These groups were particularly active in Osun State (37.7%) and the FCT (18.3%). Qualitative findings corroborated these patterns, emphasizing the visible roles of NGOs and student-led organizations in awareness creation, advocacy, and survivor support. TFG, state actors such as the Ministry of Education (8.7%), law enforcement agencies (7.7%), the judiciary (4.8%), and institutional management (7.7%) were primarily recognized for policy formulation and enforcement, collectively accounting for 28.9% of total mentions. Although their formal authority was acknowledged, their operational presence within institutions appeared limited. Notably, effective collaborations observed in Osun and Abuja provided functional models of multi-stakeholder engagement and survivor-centered responses. The study concludes that SGBV prevention in Nigerian tertiary institutions is largely driven by non-state actors amid weak state engagement. Strengthening coordination, enforcing policies, and institutionalizing gender-responsive frameworks are critical to fostering sustainable, equitable, and violence-free campuses.