Tuberculosis (TB) remains a substantial global health challenge, particularly in Nigeria, which has the highest TB incidence in Africa, with approximately 590,000 new cases annually. Multidrug-resistant TB (MDR-TB) complicates treatment and control efforts, necessitating a deeper understanding of drug resistance patterns. This study used a descriptive cross-sectional design to investigate resistance to first- and second-line anti-TB drugs among TB patients in Kwara State, Nigeria. A multi-stage sampling technique was used to recruit 272 participants from selected Local Government Areas. Data collection included questionnaires and laboratory testing using the Hain Line Probe Assay (LPA) and GeneXpert MTB/Rif system. Results showed that age was a statistically significant factor, with resistance rates notably higher among younger individuals aged 20-29 years (p = 0.044), while no significant associations were found for gender (p = 0.166), ethnicity (p = 0.984 for first-line drugs; p = 0.601 for second-line), or educational level (p = 0.131 for first-line; p = 0.260 for second-line). Notably, 84.7% of participants who adhered to Directly Observed Treatment Short-course (DOTS) were sensitive to anti-TB drugs, but adherence alone did not exhibit a statistically significant association with resistance (p = 0.278), questioning assumptions about DOTS effectiveness in this context. Alcohol consumption emerged as a significant predictor of drug resistance (p = 0.0423), with patients consuming alcohol being six times more likely to develop resistance (OR = 6.025, 95% CI = 4.950 - 13.632) than non-drinkers, underscoring the need to address alcohol-related non-adherence to improve outcomes. Conversely, smoking, incarceration, and contact with TB patients showed no significant association with resistance, challenging global assumptions about these risk factors in the Nigerian context. This study highlights the complex nature of TB drug resistance, influenced by socio-demographic and behavioral factors unique to local contexts. The absence of statistically significant correlations for several known risk factors, such as smoking (p = 0.761) and prior TB contact (p = 0.2165), suggests that interventions in Nigeria should be localized and tailored to specific populations rather than relying on generalized global models. Comprehensive strategies targeting alcohol use and younger age groups, alongside strengthened healthcare delivery, are essential to curbing the spread of drug-resistant TB strains in Nigeria.

High-burden cholera outbreaks, spreading beyond the traditional cholera-endemic countries, have been reported since 2021 in the WHO African region. Member states in the region have committed to the global goal of cholera elimination by 2030. To track progress towards this goal, WHO-African countries adopted a regional cholera prevention and control framework in 2018. This study reports on 27 countries’ 5-year achievements in implementing the cholera regional framework for cholera prevention, and control. Data collected through a web-based self-assessment tool were analysed and visualised through Power BI. Data were provided by national teams of experts on cholera based on the milestones of the framework. Countries’ specific progress and regional progress were calculated. The overall regional progress was 53%, ranging from 19% in Mauritania to 76% in Ethiopia. Out of the 27 countries, 3 had made good progress while 14 had fair and 10 had insufficient progress. At the regional level, 4 milestones were on track, 7 were fair and 10 had insufficient progress. Cholera hot spot mapping had the highest score at 85%, while development of investment cases for cholera control scored the lowest at 14%. Although appreciable progress was noted in some milestones, the progress against critical milestones, including for water, sanitation and hygiene, that form the bedrock of cholera control, was insufficient. Effective implementation of the cholera prevention and control framework anchored on strong government commitment and ownership is essential to curb the current trend of cholera outbreaks and improve the likelihood of cholera elimination by 2030 in Africa.

Tuberculosis (TB), a disease that remains preventable and curable, continues to represent a significant global health burden, particularly in regions like Nigeria. In this context, the emergence of drug-resistant strains of Mycobacterium tuberculosis poses an escalating challenge. This study aimed to assess awareness of anti-TB drug resistance among TB patients in Kwara State, Nigeria. Utilizing a descriptive cross-sectional design, data were gathered from 272 TB patients across six local government areas (LGAs) using a multi-stage sampling technique. Respondents were selected through a pre-tested, semi-structured questionnaire, targeting crucial socio-demographic factors, awareness levels, and other factors associated with drug resistance. Results revealed that 51.0% of the participants were male, and 64.5% lived in rural areas, with 43.3% having attained tertiary education. Alarmingly, over half of the respondents—62.8%—displayed poor awareness of anti-TB drug resistance, with only 4.1% demonstrating adequate knowledge of the concept. Additionally, merely 19.6% of the patients understood drug resistance, while only 6.5% were aware that multidrug-resistant TB (MDR-TB) is curable. These findings are concerning, especially since 10.2% of participants exhibited resistance to at least one first-line anti-TB drug, such as 2.9% to Isoniazid and 3.3% to Rifampicin. Furthermore, dual resistance to Rifampicin and Isoniazid was identified in 4.0% of respondents. Socio-demographic factors significantly affected TB prevalence, particularly among younger adults (40.8% of respondents were aged 30–39 years) and males (51.0%). However, there was no significant association found between resistance patterns and HIV status, as only 4.1% of respondents were HIV-positive. Contrastingly, behavioral factors such as alcohol consumption (17.1%) and history of close contact with TB patients (6.5%) were linked to increased drug resistance. Among those tested for second-line drug resistance, 4.1% displayed resistance, with specific cases involving combinations like Kanamycin and Protionamide. Notably, 27.8% had a history of incarceration, and 40% had been previously admitted to a hospital, both recognized as factors contributing to the spread of drug-resistant strains. Further analysis showed that only 10 (4.0%) of respondents experienced delayed treatment commencement, while 49.4% of participants reported never receiving any health talks or awareness about TB from their healthcare providers. Despite 86.9% of patients being informed about the lengthy treatment duration, there was a clear need for more comprehensive health communication. This study underscores the necessity for intensified public health interventions, emphasizing patient education, early diagnosis, and routine drug susceptibility testing prior to treatment initiation.

Introduction: The incidence of HIV/AIDS in Nigerian is on the decline, but with the trio of high inflation, high unemployment, and high terrorism in the country; lot of synergies are still needed to end the HIV scourge. Objective: The study was carried out to determine the status of HIV services in Niger state. Method: A cross-sectional survey, using a simple randomization sampling method, and the client’s viewpoint in health facilities across Niger state was undertaken to examine the challenges faced by HIV service providers. Data from 351 HIV providers, 361 clients were collected using questionnaires; IBM and Pearson correlation were used for descriptive and inferential statistics respectively. Results: The mean age of the providers was (M = 30.50, SD = 8.2). Challenges included poor salary (M = 2.44, SD = 1.16), staff shortage (M = 3.01, SD = 1.24), lack of recognition & incentives (M = 2.57, SD = 0.99; M = 2.63, SD = 1.08), others were infrastructural deficit, inadequate funding, training and materials; poor electricity and internet; lack of research and unionism among others. The non-enabling factors challenges were burnt out (M = 3.01, SD = 0.99), insecurity (M = 3.51, SD = 1.09), working extra hours (M = 3.02; SD = 0,98), migration desire (M = 3.87, SD = 1.06). Conclusion: It is highly overdue, that all HIV stakeholders in the country take complete custodian of all HIV service components; come up with a sustainable policy to steer toward HIV eradication program, by increasing the enabling factors, and reducing the non-enabling factors.

Malawi—one of the low-income countries in Africa—has witnessed a series of flood-related disasters in many years. The recent tropical cyclone Freddy (TCF) has indispensable effects on the unequal distribution of the social determinants of health with tendencies for increased disease outbreaks across the districts of the country. This narrative study aimed at unravelling the consequences of the TCF and its possible relationship with the already existing cholera epidemic in the fourteen affected districts. Additionally, it aimed to document the immediate humanitarian responses in the acute phase of the disaster. We identified, used and extracted information and data from relevant documents available from the government records, WHO and other multiagency documents, which were summarised along with the humanitarian actions and the associated implications of the entire event. Areas of TCF’s main effects included health, shelter, education, nutrition, water sanitation and hygiene, agriculture and livelihood, transport and logistics including food security. The notable immediate humanitarian responses are donations, camp creation for accommodations, emergency life-saving response and essential healthcare services. Nsanje and Chikwawa districts experienced an increase in cholera cases and deaths post-TCF. The highest proportion of the disaster-impacted and intervention beneficiaries were women and children. The effects of the TCF on the social determinants of health in the affected districts and the associated negative impacts should be considered by the government and disaster management experts in evidence-based policy-making towards disaster risk reduction in the flood-prone districts using an all-hazard approach. This step might be useful in improving the vulnerable population’s standard of living and achievement of related Sustainable Development Goals in Malawi.

Global burden of disease (GBD) studies plays an important role in assessing the variability of risk factors, injuries, and diseases worldwide, providing essential evidence for policy-making and healthcare planning. This study presents a review of current literature on GBD studies, aiming to analyze the trends, challenges, and future directions in this field. We conducted a review of published GBD studies from inception to date, utilizing major scientific databases and relevant sources. Our findings reveal several noteworthy trends in GBD studies. Over the years, GBD studies have expanded to cover a wider range of diseases and risk factors, providing a more comprehensive understanding of global health. Advances in data availability, technology, and modeling techniques have improved the accuracy of disease burden estimates. The inclusion of disability-adjusted life years (DALYs) has enabled comparisons as well as prioritization of interventions. However, challenges remain, such as limited data in middle and low-income countries and methodological complexities. The COVID-19 pandemic has emphasized the need for responsive methodologies. Future directions include strengthening data collection, utilizing machine learning, big data analytics, ethical use of artificial intelligence and promoting collaboration for consistent GBD studies.

The World Health Organization Regional Office for Africa (WHO/AFRO) faces members who encounter annual disease epidemics and natural disasters that necessitate immediate deployment and a trained health workforce to respond. The gaps in this regard, further exposed by the COVID-19 pandemic, led to conceptualizing the Strengthening and Utilizing Response Group for Emergencies (SURGE) flagship in 2021. This study aimed to present the experience of the WHO/AFRO in the stepwise roll-out process and the outcome, as well as to elucidate the lessons learned across the pilot countries throughout the first year of implementation. The details of the roll-out process and outcome were obtained through information and data extraction from planning and operational documents, while further anonymized feedback on various thematic areas was received from stakeholders through key informant interviews with 60 core actors using open-ended questionnaires. In total, 15 out of the 47 countries in WHO/AFRO are currently implementing the initiative, with a total of 1,278 trained and validated African Volunteers Health Corps-Strengthening and Utilizing Response Groups for Emergencies (AVoHC-SURGE) members in the first year. The Democratic Republic of Congo (DRC) has the highest number (214) of trained AVoHC-SURGE members. The high level of advocacy, the multi-sectoral-disciplinary approach in the selection process, the adoption of the one-health approach, and the uniqueness of the training methodology are among the best practices applauded by the respondents. At the same time, financial constraints were the most reported challenge, with ongoing strategies to resolve them as required. Six countries, namely Botswana, Mauritania, Niger, Rwanda, Tanzania, and Togo, have started benefiting from their trained AVoHC-SURGE members locally, while responders from Botswana and Rwanda were deployed internationally to curtail the recent outbreaks of cholera in Malawi and Kenya.

Gender-based violence (GBV) is a growing problem in Nigeria, with reports of cases increasing across different regions of the country. This menace has been identified to be associated with different public health challenges and problems. GBV encompasses various forms of abuse, including physical, sexual, and psychological, and it disproportionately affects females, including minors. Understanding GBV among students is vital in addressing the issues relating to GBV because of the influence of education in addressing social challenges. This study, therefore, investigates the prevalence, of GBV, and identifies the causes, and perpetrators of GBV among students of tertiary institutions in Abuja, Nigeria. The study adopts a descriptive cross-sectional survey research design to study the prevalence of all forms of GBV among the study population. The study was conducted among students of tertiary institutions in Abuja, representing the three major types of tertiary institutions in the location. The sample size of 440 respondents was calculated using a scientific sample size formula for cross-sectional studies and stratified sampling was used to ensure adequate representation. A pre-tested well structured standardized questionnaire with open and closed-ended questions was used to collect data, which was analysed using simple descriptive statistics. The prevalence of gender-based violence (GBV) among tertiary institutions in Abuja, Nigeria was found to be high, with 61.9% for physical abuse, 56.4% for psychological abuse, and 25.3% for sexual abuse. The most prevalent form of physical abuse is slapping, while the most prevalent form of sexual abuse is forceful kissing, and the most prevalent form of psychological abuse is insults/criticism. Teachers/instructors were found to be the most significant perpetrators of physical abuse, while non-relatives are the most significant perpetrators of sexual abuse, and fellow students/learners are the most significant perpetrators of psychological abuse. The major causes of GBV are gender norms which include traditional beliefs and practices, religious beliefs and practices, and the belief that males are superior to females. This study highlights the need for a comprehensive strategy to combat GBV effectively. It recommends an urgent approach to combat the prevalence of GBV among the study population, engaging major stakeholders and policymakers.

The WHO Regional Office for Africa (AFRO) COVID-19 Incident Management Support Team (IMST) was first established on 21 January 2020 to coordinate the response to the pandemic in line with the Emergency Response Framework and has undergone three modifications based on intra-action reviews (IAR). An IAR of the WHO AFRO COVID-19 IMST was conducted to document best practices, challenges, lessons learnt and areas for improvement from the start of 2021 to the end of the third wave in November 2021. In addition, it was designed to contribute to improving the response to COVID-19 in the Region. An IAR design as proposed by WHO, encompassing qualitative approaches to collecting critical data and information, was used. It employed mixed methods of data collection: document reviews, online surveys, focus group discussions and key informant interviews. A thematic analysis of the data focused on four thematic areas, namely operations of IMST, data and information management, human resource management and institutional framework/governance. Areas of good practice identified, included the provision of guidelines, protocols and technical expertise, resource mobilisation, logistics management, provision of regular updates, timely situation reporting, timely deployment and good coordination. Some challenges identified included a communication gap; inadequate emergency personnel; lack of scientific updates; and inadequate coordination with partners. The identified strong points/components are the pivot for informed decisions and actions for reinvigorating the future response coordination mechanism.

The issue of COVID-19 vaccination is an important step in the control of the COVID-19 infection in the community. There have been different adopted strategies in the control of the infection and the best public intervention has been getting vaccinated for now. The most likely solution to ending the current pandemic remains through achieving a better community reach, and the frank acceptance of the availed WHO-approved COVID-19 vaccine in communities. In this study, the reason for the COVID-19 vaccine uptake was evaluated across 3 geopolitical zones in Nigeria with differential political affiliation. This study utilized a qualitative sample collection methodology to qualify the prevalence of different views on COVID-19 vaccine acceptability, access, and political trust. The data was gathered utilizing pre-tested in-depth interviews, which were transcribed and analyzed thematically through the transcripts obtained from the open-ended key informant interviews. The findings from the qualitative studies indicated that the fear of the side effects, apathy/lack of interest, scarce logistics, people's opinion, and self-denial were more of the pertinent issue around the poor COVID-19 vaccine uptake among the respondents. Government needs to ensure that health interventions rolled are adequately accessible to the targeted people and should consider the community culture while rolling out health interventions.

This study sought to explore risk perception, health seeking behaviours and adherence to preventive behaviours towards COVID-19 infection among undergraduate students at CHRESO University in Lusaka, Zambia. A total of 181 students aged between 18 and 45 years from all faculties at Chreso University whose COVID-19 status was not known were selected via simple random sampling technique to participate in this study. Data was collected from the respondents using a structured interview questionnaire with closed ended questions. Data was analyzed using Statistical Package for Social Sciences (SPSS version 20) and was presented by Tables. The correlations between predictors and end results variables were categorized by multivariate logistic regression analysis. The study uncovered that, most of the respondents (76%) had an adequate level of knowledge on COVID-19 as most of them knew that the causative organism of COVID-19 was not bacteria. Sex and age were found to have a statistically substantial relationship with the level of knowledge about COVID-19 infection preventive measures among students (p<0.05). The study also shows that the vast majority of the participants (32%) had moderate risk perception of COVID-19 infection while 37% of study participants had low risk perception due to lack of vaccination. Marriage was found to have a strong statistical association with the level of risk perception of COVID-19 infection among students (P < 0.05). The majority of the participants also had poor adherence to COVID-19 preventive measures because many of them were able to put on their masks (45%) and use hand sanitizer (37%) only when advised to do so. The results also show that the participants had poor health seeking behaviors in that 59% of the respondents had never accessed COVID-19 screening facilities while 52% did not even know if at all there was a cost associated with testing. Religion and marital status were found to have a significant statistical relationship with the level of adherence to COVID-19 preventive measures among students (P < 0.05). Nevertheless, it is strongly recommended that university Students should be sensitized on COVID-19 infection prevention and control measures and encouraged to regularly engage in health-seeking behaviours. The university authority through the Ministry of Health should develop risk communication policies aimed at helping students understand the gravity of COVID-19 infection and the potential repercussions of not adhering to preventive measures.

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major public health problem in Zambia affecting people in their prime and most productive years (15-49) of life. The cross sectional study was aimed at determining the factors contributing to HIV prevalence in Mwandi district of Zambia from 2016 to 2018. Two hundred and sixty-nine (269) participants were recruited using simple random sampling technique. The study disclosed that, a large proportion of study participants 50.6% (136) were females. The study also revealed that most of the respondents 43.5% (117) had attained some secondary level of education. The study further revealed that the majority 98.1% (264) of the respondents associated HIV transmission with unprotected sexual intercourse. The study also disclosed that most of the respondents 98.5% (265) and 98.1% (264) received health education on HIV/AIDS from hospital and clinics respectively while a considerable proportion of study participants 66.2% (178) acquired health education on HIV/AIDS through reading magazines. Also, this study exposed that, most 87.7% (236) of the respondents had adequate level of knowledge on HIV/AIDS. Level of education, occupation and number of children were found to have statistically significant relationship with level of knowledge on HIV/AIDS (P<0.05). Apart from that, this study also revealed that 78.8% (212) of study participants had good adherence to STI/HIV/AIDS treatment while 21.7% (57) had poor drug adherence. Level of education was also found to have statistically significant association with drug adherence on HIV/AIDS (P<0.05). The study also uncovered that 88.8% (239) of the respondents did not have access to the laboratory health services in the health facilities in Mwandi district of Zambia. Conversely, only 11.2% (30) of the respondents had access to the laboratory services in the health facilities. It is suggested that the Ministry of health should make it a policy for every health facility to have its own laboratory diagnostic facilities in order to enhance accessibility to diagnostic laboratory testing services in low-resource settings like Zambia.

Background: Invasive cervical cancer (ICC) is one of the most preventable and curable forms of cancer. In East Africa, primarily Uganda and Kenya, where HIV/AIDs are common, it is usually diagnosed late, resulting in a public health hazard due to its poor prognosis. ICC is the second most common malignancy causing maternal death. This study explored factors that impede access and utilization of ICC screening services among women living with HIV in low resource settings in Uganda and Kenya. Methods: A cross-sectional study design employing qualitative and quantitative techniques were conducted in six selected health facilities in Uganda and Kenya. A systematic cluster randomized sampling was used to select health facilities from which women living with HIV were invited to participate in the interviews, including focus group discussions, and triangulated this with in-depth interviews and literature. Data collection, coding, categorization, and statistical analysis of quantitative data were employed to rank correlation among the most critical factors that hinder access to ICC screening services.Findings: Two hundred thirty-two (232) out of 310 women completed the interviewer-administered questionnaire making the response rate 75%. The results uncovered a negative correlation between the perception of barriers to access the services. Two variables, the perceived risk for having ICC and the perceived severity, may impact the likelihood of undergoing ICC screening. There was a positive correlation between the perceived risk for ICC and the perceived severity. Statistical analysis shows that results are valid and reliable.Conclusion: The study uncovered the health system barriers affecting ICC screening services at health facilities in Kenya and Uganda. It highlights the strengths and challenges while providing recommendations to promote health to include the most vulnerable women with HIV/AIDS living in socially deprived areas.

The novel Coronavirus disease 2019 (COVID-19), was first identified in Wuhan China in December 2019 and has rapidly spread to almost every region of the world. Also known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), COVID-19 causes significant morbidity and mortality. The infection has no immediate treatment and vaccine, World Health Organization (WHO) declared it a public health emergency of international concern on January 30, 2020, and further went on to declare it a worldwide pandemic on the 22nd of March 2020. The coronavirus disease (COVID-19) pandemic is associated with increased morbidity and mortality globally. Human behaviour and knowledge assessment during the crisis are vital to containing the outbreak. Therefore, the level of knowledge, attitudes, and practices concerning infection prevention and control measures among community members is very important during this COVID-19 pandemic. The purpose of this research will evaluate the level of knowledge, attitudes, and practices regarding the infection prevention and control measures among community members in Ikeja, Lagos State, Nigeria. This study is a descriptive cross-sectional web-based survey. The study population comprised of community members who reside in Ikeja, Lagos state. Ikeja is the state capital and administrative centre of Lagos State in southwestern Nigeria. Participants are aged 18 years and above who would understand the content of the study and agree to participate in the study and those who are community members of Ikeja, Lagos state. The findings of this study suggest that community members in Ikeja, Lagos did not demonstrate good knowledge nor positive attitudes towards COVID-19, however, they demonstrated good safety practices regarding COVID-19. Also, the poor attitude was more prevalent among the older adolescent and youth and this can pose a serious risk to other members of the community.

Optimal breastfeeding, which involves initiating breastfeeding within one hour of birth, giving colostrum, exclusive breastfeeding for six months, and introducing complementary food at six months, prevents under-five deaths in developing countries, saving millions of lives annually. The maximum effect of prolactin and oxytocin on milk production is dependent on insulin, insulin-like growth factors, cortisol, and the intake of nutrients and fluids. Stress affects these factors and processes, reducing the quantity and quality of milk for the growth and health of the baby. The supportive or non-supportive role of male partners affects the mothers' physical and emotional states. The researchers administered a structured questionnaire of 13 close-ended questions through scheduled interviews with 275 male parents of children younger than two years. The Statistical Package for the Social Sciences (SPSS) version 28.0 analyzed the data to generate frequencies, median, and interquartile range as measures of dispersion and central tendency, respectively. Spearman's rank correlation test did the calculations of correlations. Fathers helped with house works, responding to the baby's cries and bathing the baby (86%); taking care of other children or other house responsibilities (85%); taking care of the baby while the mother sleeps for a bit of time (85%) and smiling, holding and watching the mother as she breastfeeds (91%). Roles were correlated with education level (r=.308, p=0.000<0.05) and employment (r=-.155, p=.007<0.05) but not with hours of work (r=0.049, p=0.448>0.05).

The acquisition of MDR-TB results mainly from health system/service and patient-related factors. Previous studies showed that factors that affect health outcome can be human (patient, healthcare provider) and health system related. Poor quality of care provided to TB patients affects treatment outcome which could trigger development and spread of multidrug resistant TB. This study was conducted to assess treatment outcome of Multidrug resistant clients in Drug Resistant TB treatment centers in North Central Nigeria and assess also compliance of healthcare provider with the standard of MDR TB care and services they render. Data of 300 MDR TB clients were retrospectively collected after a review of the register and drug charts. Twenty-seven (27) participants were selected at random from the 3 states TB program and 18 health facility staff were also selected to answer questions related to compliance of facility and healthcare providers with MDR TB care/services. Response with scores zero (0) and 50% were seen as areas where compliance with the standard was lacking. Identification, training, supervision, and compensation for community treatment supporters, infection control, Socioeconomic and psychological support (including incentives, enablers), expert committee to routinely provide clinical/programmatic consultation prompt treatment initiation, use of electronic drug management system, support groups, adherence to standard operating procedures at facilities. The treatment outcome documented in the study were cured (61.7%), completed treatment (7.3%), still on treatment (17.7%), defaulted (1.3%), failed treatment (0.7%), Pre-XDR TB (4.7%), lost to follow up (1.3%), transferred out (0.7%) and died (9.7%). The study disclosed the treatment outcome of MDR TB clients and areas that compliance with standard is lacking. There is need for TB programmers to periodically assess their services and clients for continuous improvement of the program.