BackgroundMaternal anemia remains a significant public health challenge in Nigeria, affecting approximately 25-46% of pregnant women and contributing to adverse maternal and neonatal outcomes. Intravenous (IV) iron provides a promising alternative to conventional oral iron supplementation for managing moderate to severe maternal anemia; however, its implementation in resource-limited settings faces numerous challenges. This study aimed to understand how the implementation of IV iron became embedded in everyday practice, including factors influencing skilled healthcare providers' (SHPs) engagement, workflow integration processes, and sustainability.MethodsThis was a qualitative study embedded within the Implementation Research for Intravenous Iron Use in Pregnant and Postpartum Women in Nigeria (IVON-IS) project across six healthcare facilities in Lagos, Nigeria. Eighteen key informant interviews were conducted with purposively sampled SHPs across the six IVON-IS facilities. The data were analyzed deductively based on the Normalization Process Theory (NPT) constructs (coherence, cognitive participation, collective action, and reflexive monitoring), and inductively to identify themes related to each of these constructs.ResultsOur study revealed strong coherence among SHPs regarding the purpose and benefits of IV iron compared to traditional treatments. Cognitive participation varied across facilities, with leadership support and patient-centred motivation emerging as critical facilitators. Collective action was faced with challenges, including workflow disruptions, staffing constraints, and space limitations, despite adequate resource provision. Reflexive monitoring processes were robust, with providers continuously evaluating effectiveness through clinical outcomes and patient feedback while expressing concerns about long-term sustainability.ConclusionThe implementation of IV iron for maternal anemia in Nigeria demonstrated variability across NPT constructs, with strong coherence and reflexive monitoring but challenges in cognitive participation and collective action. Critical success factors included strong leadership support, adequate resource provision, continuous quality improvement processes, and proactive sustainability planning. The findings from this study provide valuable guidance for scaling up IV iron use as part of comprehensive maternal health services in Nigeria and similar resource-constrained settings.

Background: The world still grapples with alarming maternal mortality rates, particularly in developing nations, including Nigeria. Annual global deaths exceed 500,000, predominantly in developing countries (99%) and sub-Saharan Africa (over 50%), where the lifetime risk of maternal death is 1 in 26. Millions of women of reproductive age and their children could be saved from poor outcomes through the utilization of available effective affordable maternal healthcare services. Objective: This study assessed the patterns and predictors of maternal healthcare service utilization among women of reproductive age in Lagos state, Nigeria. Methods: A cross-sectional study was conducted among 453 women of reproductive age selected through multistage sampling between July 2022 and March 2023. Data collection employed interviewer-administered questionnaires, and analysis was performed using SPSS V.25 software. Statistical analysis included bivariate and multivariate analyses, with a significance level set at p < 0.05. Findings: Nearly all participants (99%) were familiar with antenatal care (ANC), while 63% knew about postnatal care services, and 82% understood modern family planning methods. Most respondents (86%) accessed ANC in healthcare facilities; however, the majority (70.7%) booked during the second trimester. The majority (97%) attended ANC more than four times, and 77% gave births in healthcare facilities. Notably, 86% attended postnatal care services primarily for child vaccination. Christian religion (adjusted odds ratio (AOR): 1.810; confidence interval (CI): 0.989-3.313), self-employment status of spouses (AOR: 2.949: CI: 1.413-6.153), and household monthly income above 60,000.00 naira (AOR: 2.015; CI: 1.002-4.005) were predictors for ANC use. Similarly, Christian religion (AOR: 2.326; CI: 1.426-3.796), self-employment status of spouses (AOR: 3.111; CI: 1.633- 5.929), and having health insurance (AOR: 5.327; CI: 1.229-23.080) were predictors for use of healthcare facilities for childbirth. Conclusion: This study reveals high awareness and utilization of maternal health services but highlights room for improvement in early antenatal care registration and postnatal care beyond the child's immunization.

Introduction: Increased utilisation of Antenatal Care (ANC) and delivery with a skilled birth attendant helps to prevent or effectively manage the majority of complications of pregnancy and delivery. This will improve the maternal mortality ratio nationally and globally. This study assessed the choice of healthcare facilities for ANC, child delivery services and satisfaction with the care received by mothers of infants attending child immunization clinics at selected Primary Healthcare Centres (PHCs) in Lagos, Nigeria. Materials/Methods: A descriptive cross-sectional study was conducted among mothers who attended antenatal care (ANC) in a health facility during pregnancy, delivered at the same facility, and brought their infants for immunization at the selected PHCs in Lagos, Nigeria. A total of 355 respondents were recruited from the five selected PHCs. Data were collected with an interviewer-administered questionnaire. Descriptive and inferential statistics were conducted and the level of significance (p) was set at less than or equal to 5% (p≤0.05). Results: Less than half of the respondents 170 (47.9%) registered for ANC in the first trimester, 206 (58.0%) of the respondents utilised private hospitals only while very few 55 (15.5%) utilised PHCs for ANC and delivery. Most of the respondents (59.1%) had between 9 to 15 ANC visits during pregnancy, with a mean attendance of 11.3 ± 4.7. Some of the reasons given for the choice of ANC and delivery centre by the respondents were quality service 325 (91.6%), availability of skilled healthcare staff 276 (77.7%), clean environment 236 (66.5%), and good staff attitude 234 (65.9%) among others. The majority of the respondents 349 (98.3%) were satisfied with the overall care received in the health facilities utilised for ANC and delivery services during pregnancy. Statistically significant associations were found between respondents’ monthly income, spousal’s level of education, enrolment in health insurance scheme and the choice of health facility used for ANC and delivery (p<0.05). Conclusion: Continuous health educational programs are recommended for women of reproductive age and their spouses on the benefits and importance of antenatal care in pregnancy at healthcare facilities and skilled birth attendants at delivery. Improved funding for government hospitals may enhance public trust in healthcare facilities and increase utilization.

Background: Quality improvement (QI) models have been applied in healthcare systems with varying success, raising questions about their effectiveness. Despite growing evidence on effective interventions, a gap remains between proven strategies and actual practice, particularly in low- and middle-income countries (LMICs). Evaluating the efficacy of QI initiatives and understanding the contextual factors influencing their success is crucial. This study aims to investigate the roles and interrelationships of contextual factors in implementing the Diagnose-Intervene-Verify-Adjust (DIVA) approach for the Implementation Research for Intravenous Iron Use in Pregnant and postpartum Nigerian Women (IVON-IS) project, which seeks to enhance anaemia screening and treatment using intravenous ferric carboxymaltose (FCM). Methods: We used a mixed method approach with a sequential explanatory design. Adapting the Model for Understanding Success in Quality (MUSIQ), we quantitatively compared contextual factors affecting DIVA implementation across six health facilities participating in the IVON-IS project. Multi-stakeholder Implementation Management Team (IMT) members from the health facilities implementing the IVON-IS project completed a self-administered questionnaire. Qualitative interviews were conducted via in-depth interviews with 12 IMT members using an open-ended semi-structured interview guide. Quantitative data was analysed descriptively, and qualitative interviews were analysed using a framework analysis approach. Results: The IVON-IS implementing facilities scored between (87.6%) and (95.4%) out of 168 points on the MUSIQ scale, suggesting a reasonable likelihood of project success. All facilities demonstrated strong performance across MUSIQ domains, including external environment, QI team attributes, organizational capacity, microsystem, and QI support and capacity on the MUSIQ scale. Notably, external motivators scored lowest. Supportive leadership, strong microsystems and diversity of the QI team are contextual factors that facilitated the project. However, barriers such as the regulatory and policy environment and QI workforce were identified. Conclusion: Based on the MUSIQ assessment, the IVON-IS project exhibited a reasonable chance of success. Our study highlights the utility of MUSIQ in designing and implementing sustainable QI initiatives. The framework's structured approach facilitated identifying and managing key drivers of quality care, resulting in lasting improvements in healthcare processes.

BACKGROUND:Unskilled delivery, particularly the use of traditional birth attendants, is a major threat to reducing maternal mortality in Africa. Despite the associated risks, there is insufficient evidence on the major reasons why pregnant women in Nigeria continue to use traditional birth attendant (TBA) services, especially in rural areas. This study, therefore, assessed the perception, reasons for use, and utilization of only TBA services in current pregnancy among rural-dwelling pregnant women in Lagos, Nigeria.METHODS:A descriptive cross-sectional study was conducted among 347 pregnant women recruited from traditional birth attendant facilities at Ikorodu Local Government Area, Lagos. Data were collected with an interviewer-administered questionnaire and analyzed using SPSS version 25. Bivariate and multivariate analyses were conducted with a significance level set at p<0.05. The outcome measures included perception, utilization of only TBA services in current pregnancy, and reasons for use. Positive perception refers to positive thought, belief, or opinion held by the participants towards the TBA.RESULTS:All the respondents had a positive perception of TBAs, majority (70.3%) utilized TBA only while 29.7% combined TBA and healthcare facilities services in the current pregnancy. Recommendations from previous users (81.6%), welcoming and hospitable staff (77.2%), perceived spiritual protection (75.2%), and past use (68.6%), were some of the reasons cited by the respondents for utilizing only TBA services. Predictors of utilizing only TBA services were respondents' level of education, those with secondary (aOR = 0.261; 95% CI; 0.108-0.629) and tertiary (aOR = 0.352; 95% CI; 0.162-0.769) had lower utilization while the lack of health insurance coverage (aOR = 3.017; 95% CI; 1.476-6.166) were associated with higher utilization of TBAs.CONCLUSION:Respondents in this study had a positive perception of TBA services. Continuous training and an effective monitoring system of TBAs by the government and other healthcare stakeholders to improve women's birthing experiences is recommended.

Background: Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors. Methods: This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme. Results: The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep – <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients. Conclusion: A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.

Background: There are attendant socio-cultural challenges of social distancing in controlling COVID-19 in developing countries which must be overcome. The objectives of this study was to assess knowledge, attitude and practice on social distancing, to determine the socio-cultural challenges and assess the coping mechanisms to the socio-cultural challenges of social distancing as a means of COVID-19 control in Lagos state, Nigeria. Methods: This was a cross-sectional descriptive study that assessed the socio-cultural challenges of social distancing as a means of COVID-19 control in Lagos state, Nigeria. The study population included adults ≥18 years that have resided in Lagos state for more than six months. Respondents were recruited through the internet, using the social media platforms. A total of 500 responses were analysed. Quantitative analysis was done using IBM SPSS version 22. Results: Overall, about 98.2% of the participants had adequate knowledge of social distancing as a means of COVID-19 control, 51% of the participants had positive attitude towards social distancing as a means of COVID-19 control, and about 98.2% of the participants practised social distancing. About a quarter (27.2%) saw social distancing as a violation of human right and 97% agreed that it affected education in schools. Internet-based communication, teleworking, financial compensation, support groups, health education and special attention to the vulnerable were indicated coping strategies. Conclusions: The findings showed significant socio-cultural challenges in implementing COVID-19 mitigating measures such as social distancing and recommended mass health education plus a good socio-economic support system will help promote the adoption of preventative guidelines.

BACKGROUND AND OBJECTIVES:Globally, COVID-19 has greatly impacted humans physically, socially, mentally, and economically. No doubt, healthcare workers seemed to bear the greatest impact. The study therefore assessed the impact of COVID- 19 on the primary healthcare workers' daily activities in Ekiti, Southwest, Nigeria.METHODS:The study was a cross-sectional study using a quantitative data collection method among 716 primary healthcare workers. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate/multivariate analyses were conducted using t-tests and ANOVA statistics. The level of statistical significance was set at p<0.05.RESULTS:The mean age of respondents was 44.4+6.4SD with less than half (47.1%) between 41-50 years age group. The majority of the respondents (89.4%) were female and almost all (96.2%) were married. Ninety percent (90%) had ever heard of Coronavirus and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on the majority (89.7%) of healthcare workers with a mean score of 22+4.8.CONCLUSION:COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers which reflected in their psychological, physical, social and economic well-being. Disease outbreaks are unlikely to disappear soon, hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save their lives.

Introduction: In Nigeria, immunisation with coronavirus disease 2019 (COVID-19) vaccines commenced in March 2021. COVISHIELD from AstraZeneca (AZ), a viral vector vaccine, was the brand administered in the first phase of vaccinations for pre-determined eligible adults 18 years and above. As more brands of COVID-19 vaccines have been introduced in Nigeria, identifying effective and safe vaccine brands is essential to pharmacovigilance and public health. The current study assessed the safety of the AZ-AZD1222 (ChAdOx1) COVID-19 vaccine in adults during the first phase of the vaccination exercise in Nigeria. Methodology: We conducted a descriptive analysis of safety data from selected vaccination sites across six states in Nigeria between June 2021 and September 2021. Respondents were monitored over 3 months for local and systemic reactions, as well as hospitalisation and mortality. Measures obtained from respondents include age, sex, pre-existing comorbidity, local and systemic reactions to vaccines, timing onset of reactions, hospitalisation and mortality. Bivariate and multivariable regression models were used to assess factors associated with vaccine reactogenicity. Results: A total of 1284 individuals were enrolled in the cohort study from the six selected states (Anambra, Borno, Edo, Katsina, Lagos and Plateau) representing the geopolitical zones of Nigeria. A total of 675 individuals or 52.6% of enrolees reported non-serious adverse effects, and only one individual or 0.08% reported a serious adverse event following immunisation in the first 7 days after vaccination. None of the enrolled participants reported adverse events requiring hospitalisation. The most common self-reported symptoms amongst vaccine recipients were tenderness at the injection site 20.9% and fever 20.3%. A majority of symptoms (55.5%) occurred on or before the 3rd day after vaccination. Multivariable logistic regression model showed that age 60 years or above (vs. 18–24 years) was significantly associated with a lower likelihood of a vaccine-related symptomatic reaction (adjusted odds ratio: 0.35; 95% confidence interval: 0.20–0.61). There was no reported mortality amongst all the enrolled and followed-up vaccine recipients. Conclusion: Our findings suggest that the safety profile of the AZ vaccine is acceptable, and the observed symptoms were mild and mostly within the first 3 days following vaccination. Vaccine recipients will benefit from counselling about potential transient reactions, and improving public awareness can potentially encourage the uptake of vaccines and reduce the spread of the COVID-19 pandemic.

Background: The study explored the perceptions of church members towards physical activity (PA), the consumption of fruits and vegetables (FV), and the church's role in health promotion prior to the development of a church-based intervention for physi-cal activity and fruit and vegetable consumption in Lagos, Nigeria.Method: Sixteen focus group discussions (FGD) and eleven key Informant Interviews (KII) were conducted. Eight FGDs among adults and four among the youth and the elderly church members. Key informant interviews were held among church lead-ers and members of the church medical advisory. Study findings were categorized under thematic headings. Based on the data anal-ysis, several key themes were identified: the knowledge of the con-cept of health and common health problems, opinions of physical activity, opinions of healthy eating and fruit and vegetable con-sumption, types and attitudes towards existing church-based health programs and the role of the church in health promotion and church-based health programs. Within each theme, several child -themes were noted such as the challenges with fruit and vegetable consumption, biblical support for physical activity and fruit & veg-etable consumption, the role of the church leaders, program sus-tainability and barriers to participation.Results: The participants perceived health not only as the absence of disease but as general well-being of the body and soul. Health was also related to the ability to perform religious activities. Common health problems included a mix of communicable and non-communicable diseases. They are aware that physical activity, fruits and vegetables are essential for healthy living. The youth saw it as a means of improving their physical appearance however the elderly expressed concerns about the possibility of associated trips and falls. Overall, they viewed fruits and vegetables as healthy foods while processed western foods were perceived as unhealthy. Fruits and vegetables were seen as beneficial primarily to aid food digestion, boost immunity, improve youthfulness, aid weight control and to prevent chronic disease. The study partici-pants agreed that the church, as an institution, has a significant role to play in promoting the health of her members. Instituted health committees embedded within existing church structures often lead church-based health-promoting activities and are imperative for sustainability. Types of health programs included health talks, screening programs for common NCDs, sport competitions, distri-butions of FV during church ceremonies such as harvests, Lenten seasons, Love feasts and church bazaars. Health outreaches were seen as a means of evangelism, and it was unanimously agreed that the Bible supports PA and healthy eating. Generally, the respon-dents had positive attitudes towards church-based health programs and they advised that future programs include the use of technolo-gy and should be integrated into existing church activities to improve participation. The participants also noted that the opinion of the church leaders influences the behaviours of church members and their support is critical in the development and implementation of church-based health programs.Conclusion: Church members are aware that physical activity and the consumption of fruits and vegetables are important for healthy living and expressed support for church-based health pro -grams. They believe that the Bible supports the promotion of PA and FV consumption as healthy behaviours. Program integration, the use of technology and support of church leaders and existing church medical advisory groups are imperative for developing and sustaining church-based health programs.

Background: Noncommunicable diseases (NCDs) have been highlighted as a major challenge for sustainable development and an alarming public health challenge of global concern. This study was aimed at assessing the PHC facilities' readiness to provide NCDs management services in Ekiti state, Nigeria. Methodology: A descriptive cross-sectional study was conducted among PHCs in Ekiti state between August and October 2020 in 177 PHC facilities using some components of the World Health Organization's Service Availability and Readiness Assessment tool. Analysis was done using STATA SE 12. Statistical significance was set at a P < 0.05. Results: Majority (95%) of the primary health-care facilities were located in rural areas. Approximately 19% were in Ekiti North II and Ekiti Central II constituencies, and the majority (95%) were health centers. Only 29.4% offer management of NCDs. Among the spacers for inhalers available in 1.7% of the facilities, none were functioning and only 1.4% had equipment for NCD management and control, and 6% had trained staff and guidelines for NCD management. NCD-specific service readiness index was just 11% among the health care, facilities studied. Health-care facilities in the urban areas and the Ekiti North I had statistically significant higher NCD service readiness compared to the rural areas and the other federal constituencies, respectively ( P < 0.05). Conclusion: The overall NCD-specific service readiness in Ekiti State was extremely low. The government should provide sufficient tools and equipment with trained workers that will offer adequate management of NCDs in the state.

Background: Child labour is a social phenomenon of global concern with serious consequences for child development, education and well-being. This study compared the pattern, attitude and child labour practices in urban and rural areas of Lagos State.Methods: This was a descriptive comparative cross-sectional study among mothers of children ages 5 to 17 years. A multistage sampling technique was used to recruit 400 participants. The data was collected using a pre-tested, standardized questionnaire on child labour for household surveys. The data was analysed using Statistical Package for Social Sciences IBM (SPSS) version 20 software and the level of statistical significance was set at p<0.05.Results: Urban mothers were older (43.8± 1.8 years) compared to rural mothers (41.9± 12.7 years), and a higher percentage of urban mothers (52.5%) had secondary education in contrast to rural mothers (25.5%). Child labour was more prevalent among children aged 5 to 10 years in rural areas (55.5%) compared to urban areas (44.5%). Within the past year, 33.8% of urban children and 66.2% of rural children were involved in labour and hawking was the most prevalent work in 31.0% and 69.0% of urban and rural children. The majority of rural child labourers (68.4%) and 31.6% of urban child labourers worked 8 to 10 hours daily, with a statistically significant difference (p <0.001), primarily due to family support.Conclusion: There is a need for increased and continuous awareness campaigns aimed at educating communities, parents, and children about the detrimental effects of child labour on their overall well-being.

Background: The incorporation of Haemophilus influenza type b and pneumococcal conjugate vaccines to infant routine immunization programme in Nigeria have been reported to reduce the frequency and severity of respiratory tract infections especially bacterial pneumonia. The aim of this study was to assess the prevalence of pneumonia and its determinants among under-five children attending Primary Health Care (PHC) clinic in Amuwo Odofin Local Government Area Lagos State, Nigeria. Methods: This was a descriptive cross sectional study. A two-stage sampling technique was used to select 330 under-ve children who presented to the Festac PHC clinic. Data was collected using a pretested, structured and interviewer administered questionnaire and analyzed using EPI INFO software version 7.0. Chi-square tests and logistic regression analysis were used to identify the determinants of the development of pneumonia. The level of statistically significant was set at p<0.05. Results: Of the 330 children, the median age (IQR) was 24 (10-26) months and the majority 186 (56.4%) were males. The prevalence of pneumonia was 42 (12.7%). There was no significant association between the development of pneumonia and the immunization status of children under five years of age (p=0.05). The odds of developing pneumonia was increased with prematurity [AOR=2.791, 95%CI (1.245 - 6.256), p=0.013]. Conclusion: About 1 in 8 under-five children in this study had pneumonia. Prematurity was the major determinant of pneumonia among under-five children. Health workers should create more awareness and sensitize mothers as well as the community members on the risk factors that can predispose children to pneumonia.

Background Pregnancy-related anaemia is a public health challenge across Africa. Over 50% of pregnant women in Africa get diagnosed with this condition, and up to 75% of these are caused by iron deficiency. The condition is a significant contributor to the high maternal deaths across the continent and, in particular, Nigeria, which accounts for about 34% of global maternal deaths. Whereas oral iron is the mainstay treatment for pregnancy-related anaemia in Nigeria, this treatment is not very effective given the slow absorption of the medication, and its gastrointestinal adverse effects which lead to poor compliance by women. Intravenous iron is an alternative therapy which can rapidly replenish iron stores, but fears of anaphylactic reactions, as well as several misconceptions, have inhibited its routine use. Newer and safer intravenous iron formulations, such as ferric carboxymaltose, present an opportunity to overcome some concerns relating to adherence. Routine use of this formulation will, however, require addressing misconceptions and systemic barriers to adoption in the continuum of care of obstetric women from screening to treatment. This study aims to test the options to strengthen routine screening for anaemia during and immediately after pregnancy, as well as evaluate and improve conditions necessary to deliver ferric carboxymaltose to pregnant and postpartum women with moderate to severe anaemia. Methods This study will be conducted in a cluster of six health facilities in Lagos State, Nigeria. The study will employ continuous quality improvement through the Diagnose-Intervene-Verify-Adjust framework and Tanahashi’s model for health system evaluation to identify and improve systemic bottlenecks to the adoption and implementation of the intervention. Participatory Action Research will be employed to engage health system actors, health services users, and other stakeholders to facilitate change. Evaluation will be guided by the consolidated framework for implementation research and the normalisation process theory. Discussion We expect the study to evolve transferable knowledge on barriers and facilitators to the routine use of intravenous iron that will inform scale-up across Nigeria, as well as the adoption of the intervention and strategies in other countries across Africa.

Background: Skin lightening has become one of the strongest desires of Nigerian women and men, and its practice keeps increasing despite its numerous side effects. Objective: To determine the knowledge, attitude, and practices of skin lightening and the motivations for its use among the residents of Ikeja Local Government Area (LGA), Lagos State. Methods: A community-based, descriptive, cross-sectional study was conducted among 296 residents of Ikeja LGA, Lagos state, using a multistage sampling technique and an electronic, self-administered questionnaire in the Google form format. Results: The mean age of the respondents was 25.92±6.15 years, with 64.0% being females, 75.0% being single, and 75.2% had at least, a tertiary education. Most (98%) respondents demonstrated a high awareness of skin lightening; 66.9% had good knowledge, while 72% had a positive attitude. About half (52.7%) of the respondents had used various skin-lightening products, while most (71.8%) claimed the main reason for their use was to treat skin disorders. Age, gender and educational level were significantly associated with the use of skin-lightening products (p = 0.001). Conclusion: There was relatively good knowledge and a positive attitude towards skin lightening but a fair practice. The commonest reason for using skin-lightening products was for self-treatment of skin disorders. Healthcare providers should provide extensive public enlightenment on the adverse effects of skin lightening.

BACKGROUNDGlobally, more than 16 million adolescent girls give birth every year with additional 5 million abortions. Adolescent pregnancy has been associated with high maternal mortality rates in Nigeria. Therefore, this study was designed to assess sexual behaviour and contraceptive uptake among secondary school adolescents in an urban area in Nigeria.MATERIALS AND METHODSThe study was a descriptive cross-sectional study of students from twelve senior secondary schools in 2018. Respondents were interviewed using self-administered structured questionnaires. The questionnaire was pretested and analysis was done using SPSS version 17.0; descriptive data were presented as simple frequencies and percentages. The chi-square test was used for associations and the level of significance was set at p≤5%.RESULTSThe majority of the respondents (70.3 %) were within the age bracket of 13 to 16 years with a mean age of 15.95±1.43. Generally, there was 100% awareness of the methods of contraceptives by all, with 64.5% aware of condom usage as a method of contraception. The level of knowledge scored fairly (62.4%), and attitude was 48.9% amongst males and females who had responsibility for contraception. Peer pressure of 42.9% was stated as one of the major factors affecting the utilization of modern contraceptives.CONCLUSIONAwareness of contraception amongst adolescents was high. But with the level of knowledge identified, the government should ensure proper measures to promote sexual behaviour and uptake of contraception among adolescents in Nigeria.

Background: Diarrhoea is a leading cause of death among children under five years old globally. It remains a major cause of morbidity and mortality among this age group in Nigeria. Using simple home management, mothers play important roles in the prevention and control of diarrhoea among these children. Aim: This study aimed to assess mothers’ knowledge, attitude and practice in the prevention and home management of diarrhoeal diseases among children under five years old in Lagos, Nigeria. Setting: This study was conducted within the communities of Kosofe local government area of Lagos State, Nigeria. Methods: A descriptive cross-sectional study design was conducted using a multistage sampling technique. Data were collected using a structured interviewer-administered questionnaire and analysed using EPI info version 7.2.1. Chi-square statistic was used to test the association between variable at the level of significance of 5%. Results: A total of 360 respondents participated in this study. The mean age of the respondents was 32.5 ± 5.5 years. About 59.2% of respondents had good knowledge, 59.2% of them had positive attitude, and 53.1% of them had good practice towards prevention and home management of diarrhoea. Age (p = 0.007), occupation (p = 0.008) and level of education (p = 0.001) were significantly associated with practice of home management of diarrhoea among children under five years old. Conclusion: Educated, employed, and married mothers were more likely to have good prevention and home management practices towards diarrhoea in their children under five years old.

Background: Sickle cell disease accounts for significant morbidity and mortality in sub-Saharan Africa and the burden is expected to increase further by 2050. Nigeria is known to bear the highest burden of sickle cell disease in the world with about 2.69–5% of the population affected by the disease.Aim: This study determined awareness of sickle cell disease among caregivers and phenotype distribution of children presenting to children emergency in Lagos University Teaching Hospital (LUTH), Nigeria.Methods: The study was crosssectional and descriptive in design and data was collected using a pretested, structured intervieweradministered questionnaire among 250 caregivers and children. HemoTypeSC™ rapid test kit was used to determine the hemoglobin phenotype in whole blood of the respondents who were consecutively recruited following the caregiver’s consent. The Statistical Package for Social Sciences version 21 software was used for analysis.Univariate and bivariate analyses were carried out with a level of significance set at p ≤ 0.05.Results: The mean age of the children was 50.27±50.91 months. There were more females 141 (56.4%) than males. Almost all 242 (96.8%) caregivers did not know the children’s Hb phenotype. Most 173 (69.2%) of the children had HbAA;55(22.0%) were HbAS; 6(2.4%) were HbAC; 15 and 1 (6.0% and 0.4%) were HbSS and HbSCphenotypes respectively. Education was statistically significant with awareness of SCD (p=0.002) and awareness of SCD was statistically significant with knowledge of prevention (p<0.001) among the caregivers.Conclusion: Awareness of SCD among the caregivers of children was high, although the majority of them did not know the children’s Hb phenotype. Most of the children had HbAA with a high proportion of HbSS and HbSC phenotypes. A routine neonatal/early infant screening program for SCD is highly recommended in Nigeria for early diagnosis and prevention of SCD complications.

Introduction:young people living with HIV (YPLH) constitute a significant population towards ending the AIDS epidemic. About half of YPLH are undiagnosed and one-third of new infections occurring among them. Stigma and discrimination remaina predominant enigma in the social response to HIV.Methods:this was a descriptive cross-sectional study among 124 YPLH aged 15-24 years selected by non-probability sampling from four antiretroviral centres targeted at young people across Lagos State. Ethical approval and informed consent were obtained. Data analysis was done using Epi info software version 7 and the level of significance was set at p<0.05.Results:the mean age of the participants was 19.4±3.2 years. Among the stigma variants, public stigma was the highest (48.4%), followed by anticipated stigma (20.2%), internalized stigma (14.5%), and enacted stigma (10.7%) while 7.3% of respondents experienced all forms. Thirty-seven percent of respondents had experienced one form of discrimination, with the most common form being 'treated with hostility by strangers´ (14.5%). The disclosure level was 56.5%. The most predominant reasons for non-disclosure were fear of rejection by other people (57.3%). Diagnosis at an earlier age and living with a single parent were associated with lower disclosure levels (p‹0.001).Conclusion:overall stigma levels were found to be low, with differences in the individual stigma variants. The most common form of HIV-related discrimination reported in this study was being treated with hostility by strangers. Fear of rejection by other people was the main reason for non-disclosure among YPLH. The use of a multidisciplinary approach is needed to reduce the impact of stigma and discrimination among YPLH.

Objectives This study developed and compared the performance of three widely used predictive models—logistic regression (LR), artificial neural network (ANN), and decision tree (DT)—to predict diabetes mellitus using the socio-demographic, lifestyle, and physical attributes of a population of Nigerians. Methods We developed three predictive models using 10 input variables. Data preprocessing steps included the removal of missing values and outliers, min-max normalization, and feature extraction using principal component analysis. Data training and validation were accomplished using 10-fold cross-validation. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUROC) were used as performance evaluation metrics. Analysis and model development were performed in R version 3.6.1. Results The mean age of the participants was 50.52 ± 16.14 years. The classification accuracy, sensitivity, specificity, PPV, and NPV for LR were, respectively, 81.31%, 84.32%, 77.24%, 72.75%, and 82.49%. Those for ANN were 98.64%, 98.37%, 99.00%, 98.61%, and 98.83%, and those for DT were 99.05%, 99.76%, 98.08%, 98.77%, and 99.82%, respectively. The best-performing and poorest-performing classifiers were DT and LR, with 99.05% and 81.31% accuracy, respectively. Similarly, the DT algorithm achieved the best AUC value (0.992) compared to ANN (0.976) and LR (0.892). Conclusions Our study demonstrated that DT, LR, and ANN models can be used effectively for the prediction of diabetes mellitus in the Nigerian population based on certain risk factors. An overall comparative analysis of the models showed that the DT model performed better than LR and ANN.