Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of TB screening and the existing gaps in Contact Investigation (CI). This descriptive qualitative study was conducted in 8 local government areas with high TB burdens in Oyo and Osun States, Nigeria. Twenty-four focus group discussions and 27 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents' ages ranged from 17-85 years with a mean of 42.08±14.9 years, and (4.0%) had a postgraduate degree. The unwillingness of the majority of TB contacts who tested negative for TB to be placed on TB preventive therapy because of the belief that only a sick person should take drugs and hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB were some of the existing gaps reported in TB contact investigations. The findings emphasize the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.

The study investigated dietary intake knowledge and reasons for food restriction during preg-nancy among pregnant women attending antenatal clinics in Ile-Ife, Nigeria. This cross-sectional survey involved 530 pregnant women visiting 35 primary health care (PHC) centers in Ile-Ife. Interview-er-administered questionnaire used to collect data included a 30-point knowledge scale and food restric-tion related questions. Data were analyzed using descriptive statistics and chi-square at P = 0.05. Mean age was 27.0 ± 5.3 years, 44.5% had tertiary education and 11.1% earned above ₦50,000 monthly (ap-proximately US$315). Mean knowledge score was 23.6 ± 4.2 and 75.5% had good knowledge. Higher education was significantly associated with good knowledge of dietary intake. Reasons for food restric-tion during pregnancy included cultural taboos (36.5%) and religious beliefs (12.1%). Major foods that were restricted or avoided for cultural reasons were protein and vitamin-rich foods such as snail (97.5%) and walnut (84.0%). Foods avoided based on religious beliefs included pork (87.4%) and dog (76.9%). A higher proportion (94.8%) of respondents who earn more than ₦50,000 avoided foods due to cultural taboos (94.8%) compared with those without monthly income (58.3%) (P≤0.05). The proportions of respondents who avoided foods due to cultural taboos with no formal, primary, secondary, and tertiary education were 95.5%, 93.8%, 79.8%, and 86.4% respectively (P≤0.05). Overall, respondents were knowledgeable about dietary intake. However, cultural taboos and religious beliefs were major reasons for food restriction among pregnant women and were more pronounced among women with low educa-tion and low monthly income. Nutrition education interventions are needed to address the phenomenon.

This paper presents a formative assessment for the implementation of mobile portable chest X-ray (PDX) machines for tuberculosis (TB) contact tracing in the Oyo and Osun states, Nigeria. This descriptive qualitative study was carried out in eight local government areas, and 24 focus group discussions and 30 key informant interviews were conducted using a four-stage sampling technique to select participants. Validated transcribed notes were entered and analyzed using Nvivo. The respondents’ ages ranged from 17 to 85 years, with a mean age of 42.08 ± 14.9 years, and 4.0% had a postgraduate degree. The majority of government officials stated that deploying the PDX machine for screening at the community level is the best means for implementation because it will offer a level of proximity convenience to the TB contacts and assuage concerns about the cost of transportation to the health facility. In addition, it was suggested that TB community screening should be carried out with screening for other health conditions such as high blood pressure and diabetes. This portable X-ray machine intervention, therefore, should be implemented at the community level for contact tracing to allow more TB contacts living with the index patient to be screened without proximity and transportation constraints.

Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of screening and investigation of contacts of patients with TB in Oyo and Osun State, Nigeria. This descriptive-qualitative study was conducted in eight Local Government Areas with high TB burdens. Twenty-four focus group discussions and 30 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents ages ranged from 17–85 years with a mean of 42.08 ± 14.9 years, and (4.0%) had a postgraduate degree. This study identified that the majority of TB contacts who tested negative for TB were unwilling to be placed on TB preventive therapy because of the belief that only a sick person should take drugs. Also, hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB was another existing gap reported in TB contact investigations. The findings emphasise the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.

BACKGROUND:In 2019, the Nigerian Ministry of Health published the first operational guidelines for human immunodeficiency virus self-testing (HIVST) to improve access to human immunodeficiency virus (HIV) testing services among undertested populations in the country. Also, as part of the campaign to increase HIV testing services in Nigeria, the Nigerian Ministry of Health developed standard operating procedures for using HIVST kits.AIM:To systematically review the acceptability and strategies for enhancing the uptake of HIVST in Nigeria.METHODS:The systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Different databases were searched to get the necessary materials needed for this review. Standardized forms developed by the authors were used for data extraction to minimize the risk of bias and ensure that the articles used for the study were properly screened. Identified articles were first screened using the titles and their abstracts. The full papers were screened, and the similarities of the documents were determined. Qualitative, quantitative, and mixed-method studies were evaluated using the Critical Appraisal Skills Programme and Critical Appraisal Framework criteria.RESULTS:All the publications reviewed were published between 2015 and 2022, with 33.3% published in 2021. Most (77.8%) of the studies were cross-sectional, 43.3% were conducted in Lagos State, and 26.3% were conducted among young people. The study revealed a high level of acceptability of HIVST. Certain factors, such as gender, sexual activity, and previous testing experience, influence the acceptability of HIV self-testing, with some individuals more likely to opt-out. The cost of the kit was reported as the strongest factor for choosing HIVST services, and this ranged from 200 to 4000 Naira (approximately United States Dollar 0.55-11.07), with the majority willing to pay 500 Naira (approximately United States Dollar 1.38). Privately-owned, registered pharmacies, youth-friendly centres, supermarkets, and online stores were the most cited access locations for HIVST. The least influential attribute was the type of specimen needed for HIVST. Strategies addressing cost and preferred access points and diverse needs for social media promotion, local translation of product use instructions, and HIVST distribution led by key opinion leaders for key populations were found to significantly enhance HIVST uptake and linkage to care.CONCLUSION:HIVST acceptability is generally high from an intention-to-use perspective. Targeted strategies are required to improve the acceptability of HIV self-testing, especially among males, sexually active individuals, and first-time testers. Identified and proposed uptake-enhancing strategies need to be investigated in controlled settings and among different populations and distribution models in Nigeria.

BACKGROUND:Implementation of Isoniazid Preventive Therapy (IPT) among People Living with HIV (PLHIV) continues to be a significant challenge, and there is a shortage of effective interventions. This scoping review aimed to determine barriers and facilitators of IPT implementation including its uptake and completion among PLHIV in Nigeria.METHODS:PubMed, Medline Ovid, Scopus, Google scholar, web of science and Cochrane Library were searched for articles published between January 2019 to June 2022 that addressed barriers and facilitators of IPT uptake and completion in Nigeria. The study used the PRISMA checklist to ensure the quality of the study.RESULTS:The initial search revealed 780 studies, of which 15 studies were finally included in the scoping review. The authors inductively organized IPT barriers among PLHIV into patients-, health system-,programmatic- and provider-related barriers. Facilitators of IPT were sub-categorized into programmatic (Monitoring and Evaluation or logistic), patient-related and provider-related (capacity building) and health systems sub-categories. Most studies highlighted more barriers than facilitators, and across all studies, IPT uptake was 3% - 61.2% while IPT completion was 40 - 87.9% but these figures are higher in quality improvement studies.CONCLUSION:Identified barriers include health system, and programmatic-across, and in all the studies, IPT uptake was 3%-61.2%. Cost-effective and locally developed interventions addressing context-specific barriers should be developed to address patient, provider, programmatic, and health systems-specific findings in our study with a clear understanding that there may be other barriers limiting uptake and completion of IPT at the level of community and caregivers.

Background: Evidence has shown that non-fixed-dose combination (non-FDC) anti-TB drugs could promote the spread of drug-resistant tuberculosis (DR-TB). We aimed to determine anti-TB medication stocking and dispensing practices among patent medicine vendors (PMVs) and community pharmacists (CPs) and their determinants. Method: This was a cross-sectional study using a structured, self-administered questionnaire among 405 retail outlets (322 PMVs and 83 CPs) across 16 Lagos and Kebbi local government areas (LGAs) between June 2020 and December 2020. Data were analyzed with Statistical Program for Social Sciences (SPSS) for Windows version 17 (IBM Corp., Armonk, NY, USA). Chi-square test and binary logistic regression were used to assess the determinants of anti-TB medication stocking practices at a p-value of 0.05 or less for statistical significance. Results: Overall, 91%, 71%, 49%, 43% and 35% of the respondents reported stocking loose rifampicin, streptomycin, pyrazinamide, isoniazid and ethambutol tablets, respectively. From bivariate analysis, it was observed that being aware of directly observed therapy short course (DOTS) facilities (OR 0.48, CI 0.25–0.89, p < 0.019) and having previous training on TB (OR 0.32, CI 0.14–0.73, p < 0.005) reduced the odds of stocking anti-TB medication, while operating more than 1 shop (OR 3.32, CI 1.44–7.57, p = 0.004), having 3 or more apprentices (OR 5.31, CI 2.74–10.29, p < 0.001) and seeing over 20 clients/day (OR 3.02, CI 1.18–7.71, p = 0.017) increased the odds of stocking loose anti-TB medications. From multivariate analysis, it was observed that only the variable having three or more apprentices (OR 10.23, CI 0.10–0.49, p = 0.001) significantly increased the odds of stocking anti-TB medications. Conclusions: The stocking of non-FDC anti-TB medications was high and largely determined by the number of apprentices among PMVs and CPs in Nigeria, and this may have serious implications for drug resistance development. However, the results linking the stocking of anti-TB to the number of apprentices should be interpreted cautiously as this study did not control for the level of sales in the pharmacies. We recommend that all capacity-building and regulatory efforts for PMVs and CPs in Nigeria should include not just the owners of retail premises but also their apprentices.

Aims: To review the induction and treatment of polycystic ovarian syndrome (PCOS) with plant extract in rats in light of the rising incidence of the condition, its accompanying physical and mental issues, and the role that sex hormone alterations play in its development. Methodology: An extensive literature search was carried out using relevant publications, which were published between 2012 and 2022 and indexed in Google Scholar, PubMed, Elsevier, Scientific Information Database, and Science Direct were investigated. Results: This review shows that the majority of research examined the levels of sex hormones in the serum, the induction of PCOS, and the treatment of animal models. The review also found that 43.75% of the studies induced PCOS with Letrozole, 31.25% with estradiol valerate, 6.25% with Testosterone Enanthate (TE), and 6.25% of the studies induced PCOS with Testosterone Propionate (TP). Conclusion: This study showed that Letrozole, Estradiol valerate, Dhea, Testosterone Enanthate, and Testosterone Propionate effectively induce PCOS in rats. Also, `plant extracts are effective in treating PCOS. More research into the mechanisms of action for plant extracts is required to complete our understanding of the reproductive endocrinological effects of plant extract treatment for PCOS.

BACKGROUND:Nigeria is one of the thirty high burden countries with significant contribution to the global childhood tuberculosis epidemic. Tuberculosis annual risk for children could be as high as 4% particularly in high tuberculosis (TB) prevalent communities. Isoniazid (INH) Preventive Therapy has been shown to prevent TB incidence but data on its implementation among children are scarce. AIM:To determine the completion of INH among under six children that were exposed to adults with smear positive pulmonary TB in Lagos, Nigeria. METHODS:This was a hospital-based retrospective cross-sectional review of 265 medical records of eligible children < 6 years old enrolled for INH across 32 private hospitals in Lagos, Nigeria. The study took place between July and September 2020. Data was collected on independent variables (age, gender, type of facility, TB screening, dose and weight) and outcome variables (INH outcome and proportion lost to follow up across months 1-6 of INH treatment). RESULTS:About 53.8% of the participants were female, 95.4% were screened for TB and none was diagnosed of having TB. The participants' age ranged from 1 to 72 mo with a mean of 36.01 ± 19.67 mo, and 40.2% were between the ages of 1-24 mo. Only 155 (59.2%) of the 262 participants initiated on INH completed the six-month treatment. Cumulatively, 107 (41.0%) children were lost to follow-up at the end of the sixth month. Of the cumulative 107 loss to follow-up while on INH, largest drop-offs were reported at the end of month 2, 52 (49%) followed by 20 (19%), 17 (16%), 11 (10.2%) and 7 (6.5%) at months 3, 4, 5 and 6 respectively. The analysis showed that there was no significant association between age, gender, type of facility and completion of INH treatment (P > 0.005). CONCLUSION:This study demonstrated suboptimal INH completion rate among children with only 6 out of 10 children initiated on INH who completed a 6-mo treatment in Lagos, Nigeria. The huge drop-offs in the first 2 mo of INH calls for innovative strategies such as the use of 60-d INH calendar that would facilitate reminder and early engagement of children on INH and their caregivers in care and across the entire period of treatment.

Background:Neonatal sepsis is an invasive infection of the bloodstream in neonates and a leading cause of morbidity and mortality among them.Aim:To investigate the role of procalcitonin (PCT) and C-reactive protein (CRP) in the management of neonatal sepsis.Materials and Methods:This was a prospective case-control study over one-year period using convenience sampling. Blood samples for PCT and CRP were taken from all neonates, while blood culture and white blood cell count samples were additionally taken from babies with neonatal sepsis. PCT and CRP were repeated at 24 and 48 hours. The continuous variables were found to have a nonparametric distribution. They were presented as median and interquartile range, and compared using Wilcoxon signed rank and Friedman test as appropriate.Results:The blood culture analysis yielded a prevalence of 12.7% with Staphylococcus aureus being the commonest organism. Baseline concentrations of PCT (1.28 ng/ml) and CRP (17.31 mg/L) in neonates with sepsis were higher than that of controls (PCT-0.63 ng/ml, CRP-5.40 mg/L). PCT concentrations decreased after two days of antibiotic treatment, while CRP concentrations decreased after a day. The concentration of both decreased to normal levels after two days of treatment.Conclusion:This study showed that CRP was more reliable in monitoring antibiotic therapy, unlike other studies which suggested PCT. In cases where the management of neonatal sepsis may be limited by a low blood culture yield, therapeutic monitoring may be aided by CRP and/or PCT.

BackgroundTreatment success rate is an important indicator to measure the performance of the National Tuberculosis Program (NTP). There are concerns about the quality of outcome data from private facilities engaged by NTP. Adherence of private providers of tuberculosis care to NTP guideline while assigning treatment outcomes to patients is rarely investigated. We aimed to determine whether Lagos private for-profit (PFP) and private not-for-profit (PNFP) facilities adhere to domestic TB guideline while assigning treatment outcome and the availability of periodic sputum acid-fast bacilli (AFB) results.MethodA retrospective review of facility treatment register and treatment cards of TB patients managed between January and December 2016 across 10 private directly observed treatment short-course (DOTS) facilities involved in the public–private mix (PPM) in Lagos, Nigeria. The study took place between January and June 2019.ResultsOf the 1,566 patients, majority (60.7%) were male, >30 years (50.2%), HIV-negative (88.4%), and attended PNFP (78.5%). The reported treatment success rate (TSR) was 84.2% while the actual TSR was 53.8%. In total, 91.1, 77.6, and 70.3% of patients had sputum acid-fast bacilli (AFB) at 2/3, month 5, and month 6, respectively, while 68.6% had all the three sputum AFB in the register. Healthcare workers (HCWs) were adherent in assigning treatment outcome for 65.6% of TB patients while 34.4% of patients were assigned incorrect treatment outcomes. Most variations between reported and actual treatment outcomes were found with cured (17%) and completed (13.4%). Successful and unsuccessful outcomes were overreported by 30.4% and 4.1%, respectively. DOTS providers in private facilities with available TB guideline (OR 8.33, CI 3.56–19.49, p < 0.0001) and PNFP facility (OR 4.42, CI 1.91–10.3, p = 0.001) were more likely to adhere to National TB Guideline while assigning TB treatment outcome.ConclusionFrontline TB providers in Lagos private hospitals struggled with assigning correct treatment outcome for TB patients based on NTBLCP guideline. Increased access to all the periodic follow-up AFB tests for TB patients on treatment and availability of National TB Guideline for referencing could potentially improve the adherence of private TB service providers while assigning TB treatment outcomes.

Aims: This study sets to discover the socio-environmental factors as determinants of social well-being of adolescents in foster homes in Southwestern Nigeria. Study Design: This study was a descriptive survey. Study Area: The study was carried out in the six States in Southwestern Nigeria. Methodology: Study participants were selected among adolescents in foster homes using stratified, proportionate and simple random sampling techniques, the data collection was done using Questionnaire (which contained three separate standardized instruments: Socio-Environmental Factors Scale (SEFS), Social Well-Being Scale (SWBS) and Adolescent Fostering Questionnaire (AFQ). Data were analyzed using descriptive and inferential statistics. Result: The results showed that peer influence, academic performance and attitude of the foster family were significant to social wellbeing of the adolescents. This result shows that although all the components of social factors correlated with the social well-being of the fostered adolescents, there is an insignificant relationship between social well-being and environmental factors of the fostered adolescents. Some (24.5%) of the adolescents saw their neighbors as very supportive and friendly and are welcoming to them. 13.7% were unable to decide on their neighbor’s character towards them 7.7% noticed their neighbors pitying them always, although most of them cannot say their minds out. Conclusion: Fostered adolescents undergo more challenges within the child welfare system that may further compromise their social well-being. Adolescents in foster care, are exposed to risk factors such as poverty and maltreatment, which negatively affect their social skills. Providing safe, stable, and nurturing homes for the adolescents may wane the deleterious effects of their experiences by exposing them to protective factors that can encourage resilience.

INTRODUCTION:TB diagnosis and treatment practices among private providers not affiliated with the Nigeria National TB Program (NTP) have implications for TB control efforts. Studies evaluating these practices among non-NTP providers are scarce. We aimed to investigate TB diagnosis and treatment practices among non-NTP private providers in urban Lagos State, Nigeria. METHODS:We conducted a cross-sectional study among doctors and nurses operating private facilities not formally affiliated with the NTP for TB case notification. Between May 2018 and January 2019, we implemented a survey using a pretested questionnaire among 152 doctors and nurses attending TB sensitization seminars in Lagos, Nigeria. We used descriptive statistics to summarize the sociodemographic information and proportion of non-NTP providers with different self-reported TB diagnostic, prescription, and monitoring practices. RESULTS:Private non-NTP doctors and nurses self-reported diagnosing TB using 8 different types of tests. Acid-fast bacilli was the most common (39.8%) means of diagnosing TB. Private non-NTP providers also self-reported prescribing 23 different TB regimens, including streptomycin, to treat TB. Only 32.4% of providers self-reported using the correct combinations of anti-TB drugs to treat TB. Additionally, 58.3% of providers prescribed the standard 6-month treatment duration for pulmonary TB patients, and the remaining 41.7% either undertreated or overtreated TB. CONCLUSION:A large proportion of private doctors and nurses not formally affiliated with the NTP in Nigeria were not following the NTP guidelines in the diagnosis and treatment of TB. Overtreatment and undertreatment were common. Engagement of these practitioners by the NTP in the form of supervision, on-the-job mentorship, and other strategies can mitigate the negative effects of their current practices on TB case notification and the spread of drug-resistant strains in Nigeria.

Studies specifically evaluating tuberculosis knowledge among private non-NTP providers using the International Standards for Tuberculosis Care (ISTC) framework are scarce. We evaluated the knowledge of ISTC among private non-NTP providers and associated factors in urban Lagos, Nigeria. We performed a cross-sectional descriptive study using a self-administered questionnaire to assess different aspects of tuberculosis management among 152 non-NTP providers in Lagos, Nigeria. The association between the dependent variable (knowledge) and independent variables (age, sex, qualifications, training and years of experience) was determined using multivariate logistic regression. Overall, the median knowledge score was 12 (52%, SD 3.8) and achieved by 47% of the participants. The highest knowledge score was in TB/HIV standards (67%) and the lowest was in the treatment standards (44%). On multivariate analysis, being female (OR 0.3, CI: 0.1–0.6, p < 0.0001) and being a nurse (OR 0.2, CI: 0.1–0.4, p < 0.0001) reduced the odds of having good TB knowledge score, while having previously managed ≥100 TB patients (OR 2.8, CI: 1.1–7.2, p = 0.028) increased the odds of having good TB knowledge. Gaps in the knowledge of ISTC among private non-NTP providers may result in substandard TB patient care. Specifically, gaps in knowledge of standard TB regimen combinations and Xpert MTB/RIF testing stood out. The present study provides evidence for tailored mentorship and TB education among nurses and female private non-NTP providers.

1. Federal Ministry of Health. Draft Annual TB Report. www.health.gov.ng/doc/Draft-20... (access:2021.05.01). Google Scholar

Aim: This study investigated the occurrence of antibiotic and heavy metal co - resistance in bacteria indigenous to mechanic workshops. Study Design: The study is an experimental study. Place: Samples were collected at mechanic workshop. Methodology: Soil samples were collected from three mechanic workshops and tested for the presence of heavy metals. Hydrocarbon-utilizing bacteria was also isolated from the soils using Bushnell Haas medium supplemented with 1% engine oil or petrol. Isolates obtained were subjected to antibiotic resistance test and those that showed extensive drug resistance to the tested antibiotics were further tested for heavy metal resistance. Selected isolates were then identified using 16S rRNA gene sequence. Results: The soil samples contained excessive amounts of Lead, Iron, Copper and Zinc, while the concentrations of Nickel, Cobalt, Cadmium and Chromium were within WHO permissible limit. A total of 10 hydrocarbon-degrading isolates were obtained from the soil samples, seven of which were gram negative and three were gram positive. Three of the isolates showed extensive drug resistance to 14 of the tested antibiotics. Three isolates were then subjected to heavy metal resistance test and all of them showed resistance to the tested heavy metals. They were identified and given ascension numbers as Stenotrophomonas maltophilia MW392903, Achromobacter xylosoxidans MW392904 and Pseudomonas aeruginosa MW392905. Conclusion: It was observed that heavy metal resistance and antibiotic resistance can be selected for simultaneously as organisms adapt ways to cope with man’s activities in the environment, and while traits like hydrocarbon utilization and heavy metal resistance make the organisms promising in bioremediation, the inadvertent possession of antibiotic resistance by these environmental isolates poses a challenge to the health sector.

BACKGROUND AND OBJECTIVES:Schizophrenia accounts for 78% of cases managed in Behavioural Sciences in Nigeria, and treatments with antipsychotic drugs may contribute to the onset of coronary heart disease (CHD) due to dyslipidaemia - associated complications. The prevention of CHD is preferable and less expensive than its management; thus, early identification and treatment may offer the possibility of reducing the devastating sequel. The aim of this study was to investigate the pattern of dyslipidaemia and cardiovascular risk (CVR) associated with duration of antipsychotic therapy inorder to improve awareness on early diagnosis, treatment and CVR reduction.METHODS:This was a longitudinal (prospective) study involving 44 participants recruited through systematic random sampling. Each participant served as their own control. Four blood samples were obtained from each participant, starting with a baseline before the onset of antipsychotic therapy and subsequently at monthly intervals for three consecutive months from commencement of therapy. Parameters of routine and advanced lipid profiles were assayed and the atherogenic indices were calculated.RESULTS:Both the routine and advanced lipid profiles werewithin reference limits at baseline. A significant increase in monthly levels was observed with dyslipidaemia noticed by the second month of antipsychotic therapy. There was an association established between the duration of therapy and a high CVR. The TC/HDL-C ratio performed better than apo B-100 and individual routine lipid profile fractions in the evaluation of CVR.CONCLUSIONS:Dyslipidaemia associated with high CVR may develop with antipsychotic therapy. Calculation of atherogenic indices was a good indicator of CVR.

Background: Diabetes Mellitus has emerged as one of the most challenging public health problems in the 21st century, it is a serious public health problem that threatens the quality of life of patients which can lead to acute and chronic complications. This study, therefore, assessed knowledge and level of diabetes management compliance among clinic attendees at Jericho specialist hospital, Ibadan, Nigeria Methods: A descriptive cross-sectional study that employed a two-stage sampling technique was designed to fill this gap. The records revealed that the ratio of males to females was 1:3, the respondents were stratified by gender, so the proportion of females and males selected was based on the aforementioned ratios. Systematic random sampling was then used in selecting respondents who chose to participate in the study using the list of males and females in the hospital register who was at the clinic on the day of the interview as sampling frames. A pre-tested semi-structured questionnaire was used to obtain information on two hundred and twenty respondents. Knowledge scores of ≤7, >7 was rated poor and good respectively. Data were analyzed using descriptive and inferential statistics. Results: The mean age was 49.7±10.29 years which many (72.2%) were female. Almost all the respondents (98.2%) had good knowledge of compliance with the management of diabetes. Many (74.1%) ascertained that they sometimes forget to take their diabetes drugs. Meanwhile, most (82.5%) reported that taking medication every day is a real inconvenience for some people as they could get annoyed about sticking to their blood glucose treatment plan. Conclusion: There was generally good knowledge on the compliance to diabetes management which there is a need to consider the certain sociodemographic factors of the patients before recommending management.

Uptake of HIV testing services has been poor and statistics show that HIV has spread extensively in urban and rural areas of Nigeria with a person becoming infected with HIV every minute. Poor quality of care is one of the most common reasons why clients would not choose to use available health services. This study therefore explored the status of HIV testing services and competency level of HIV testers and counsellors in primary health care centres in Ibadan Metropolis, Oyo-State, Nigeria. This was a descriptive cross-sectional study. A four-stage sampling technique was used to select health workers from PHCs and semi-structured questionnaire and observational checklist were used for data collection. HCT sessions by counsellor testers were observed, and questionnaires were self-administered among other health care providers. Quantitative data were analysed using descriptive statistics. Respondents’ mean age was 36.14 ± 12.58 years. Observational checklist revealed that 93.3% of the respondents had poor interpersonal relationship, 100% had poor pre-test counseling practice and good HIV testing practice. Majority (80.0%) of the respondents had good handling and disposal of contaminated items practice and 80% had low competency level. From the questionnaire, it was reported that insufficient consumables, insufficient staff, no privacy, low quality services were some of the challenges affecting HIV testing services as stated by 56.4%, 25.5%, 12.8%, 10.6% of the respondents. This study revealed that primary health care centers have pre and post-test HIV counseling services but inadequate counseling rooms to effectively achieve the best result of the available counseling services. Majority of the HIV testers and counselors had low competency level. Government and non-governmental organisations should play active role in training HIV testers and counselors and provide all resources needed to ensure effective HIV counselling and testing services in Primary Health Care centers in Ibadan Metropolis.

Background: HIV testing services (HTS) act as a critical entry point to HIV care, treatment and prevention services, and offer the opportunity for specially-trained health care providers to encourage avoidance of high risk sexual behaviour among both HIV negative and HIV-positive individuals. However, there are some challenges that can hinder effective delivery of HIV Counseling and Testing services by health care providers. This study was therefore designed to investigate barriers to effective HIV testing services and strategies for its promotion at the primary health care facilities in Ibadan. Methods: This descriptive cross-sectional study was carried out among health care providers in primary health care facilities in five local government areas in Ibadan metropolis, Nigeria. A 4-stage sampling techniques was used to select 19 respondents and interviewed using key informant interview guide. Interviews were transcribed verbatim. Spot check of transcripts were conducted to ensure completeness of the transcription. The data were sorted, categorized, and analyzed using a qualitative data analysis computer software package (NVivo). Results: All the respondents interviewed reported that, there were pre and post-tests counseling including HIV testing services in their facilities. Some respondents added there were laboratory services and linkages to other care and support services for those tested positive to HIV. However, most of the respondents reported insufficient consumables, insufficient staff, no privacy, lack of infrastructures as barriers to effective HIV testing services. Many of the respondents recommended community sensitization, more provision for consumables, drugs and kits as strategies for promoting HIV testing services. Conclusion: This study revealed that the primary health centres have pre-test and post-test HIV counseling services but insufficient consumables and staff were the major barriers to HIV testing services in this study. It is therefore necessary for government to make provision for consumables and more personnel to boost the activities of the health facilities.