International Journal of MCH and AIDS最新文献

Background and objective: Adolescents (9-19 years) make up 22% of Nigeria's population and represent a key target group for human papillomavirus (HPV) prevention initiatives. Although the effectiveness of HPV vaccination in preventing cervical cancer is well-established, gaps in awareness and intention to vaccinate persist among this age group. This study aimed to assess the willingness to receive the HPV vaccine among adolescent students in Kano State, Nigeria.

Methods: A school-based cross-sectional study was conducted among 381 female adolescents aged 9-19 years in Kano State, Nigeria. Descriptive statistics and Chi-square or Fisher's exact tests were used for group comparisons, and multivariable logistic regression was employed to identify factors associated with vaccination intention.

Results: Of the 381 adolescent schoolgirls surveyed, 62.5% expressed a positive intention to receive the HPV vaccine. Positive intention was significantly associated with being in junior secondary school, from a middle- or high-income family, and of Hausa ethnicity. Adolescents who discussed HPV vaccination with their parents were nearly 40 times as likely to express positive intent (adjusted odds ratio [AOR] = 39.8, confidence interval [CI]: 5.87-437, p < 0.001) while those who discussed it with peers were significantly less likely to have positive intent to receive HPV vaccine (AOR = 0.09, CI: 0.01-0.52, p = 0.018). Surprisingly, higher levels of confidence in the vaccine's effectiveness were inversely associated with intention to vaccinate.

Conclusion and global health implications: The findings of this study highlight the need to enhance HPV awareness through parental education, peer-led discussions, and school-based vaccination programs. Discussions with parents emerged as the most significant factor associated with positive intent to vaccinate, suggesting that parental influence plays the most important role in adolescent girl vaccine acceptance.

Brain drain represents an existential threat to the health ecosystem in Nigeria as an increasing number of health professionals migrate to developed and industrialized nations where they are guaranteed higher salaries, better job security, and a more conducive work environment. As of 2023, the United Kingdom remains the leading destination, with over 12,000 Nigerian doctors, while the United States, Canada, and Germany follow closely. While these migrations provide individual doctors with career advancement and financial security, they leave behind a healthcare system teetering on the edge. The shortage of healthcare professionals is already having profound effects on Nigeria's health indices, including a staggering burden of maternal-infant morbidity and mortality. The solution to this medical "tsunami" consists of improving the welfare of healthcare workers, creating more job opportunities, and investing in modern healthcare infrastructure. Ultimately, sound political and visionary leadership is required for any lasting solution to the current healthcare brain drain, which threatens health security in Nigeria.

Background and objective: Sickle cell disease is a neglected inherited condition that affects the hemoglobin in red blood cells and impacts at least 2% of the West African population. This hemoglobinopathy presents with high mobility and mortality as a result of infections and vaso-occlusive pain crises as a result of structural abnormality of the red blood, making it fragile and rigid. The objective of our study was to describe the oral health status of sickle cell patients in Yaoundé Central Hospital, Cameroon.

Methods: A descriptive cross-sectional study was carried out in the hematology unit of the Yaoundé Central Hospital from June to October 2022.

Results: A total of 63 patients, made up of 41 (65%) males and 22 (35%) females, were recruited in the study. The majority, 60 (95%), consumed sugary foods, while 43 (68%) brushed their teeth before meals, and 27 (43%) brushed their teeth once a day. A third, 24 (38%), presented with pallor of the palatal mucosa, and 24 (74.6%) had dental caries. The mean decayed, missing, and filled teeth index of this population was 2.6 (moderate) and 11 (17.5%) periodontitis. Less than a third, 17 (26.9%) of the patients had been to a dentist, 26 (41.3%) did not see it necessary to consult a dentist, while 23 (37%) thought that oral conditions are not serious. Two-thirds, 38 (60.5%), did not receive any treatment for caries. Tooth extraction 18 (27.9%) was the most common treatment given, 5 (7%) conservative treatment, and no treatment was administered for periodontitis.

Conclusion and global health implications: There was a high prevalence of periodontal diseases, moderate levels of dental caries, and elevated prevalence of oral mucosal lesions like tonsillar hypertrophy, pallor of the palate, lingual mycosis inflammation, and mucositis among sickle cell patients. The poor oral health-seeking behavior of the patients and poor oral hygiene practices might be responsible for the high burden of carious and periodontal diseases.

Background and objective: Pregnancy is characterized by complex physiological and psychological changes that can affect the oral health of women. There is a paucity of literature on the oral health status of pregnant women in Cameroon. The objective of our study was to describe the oral health status of pregnant women attending the Laquintinie antenatal clinic in Douala, Cameroon.

Methods: A descriptive cross-sectional study from January 2021 to June 2021 was conducted involving pregnant women who attended the antenatal clinic at Laquintinie Hospital and provided informed consent. A pretested questionnaire was administered in both French and English. Intraoral and extra-oral examinations were carried out to identify oro-facial pathologies.

Results: Two hundred ninety-four pregnant women participated in our study, with ages ranging from 17 to 45 years (mean age = 26 years ± 5.1 standard deviation). Of these 144 (51.7%) were employed, 195 (70%) were married, and 168 (60.6%) had tertiary education. More than 20 (70%) were multiparous, and 111 (40%) were in the first trimester of pregnancy. Three-quarters, 210 (75%), had good knowledge of tooth cleaning, 182 (65.2%) brushed their teeth once daily, and 189 (68%) brushed only in the morning. Only a few 9 (3.2%) knew how to take care of their baby's teeth, and 84 (30.1%) had been to a dentist. Halitosis was observed in 82 (29.3%), and all our participants had calculus deposits. The predominant oral pathologies were dental caries 168 (60.2%), gingivitis 143 (51.3%), and periodontitis 126 (45.2%). A third, 92 (33%) of the women had swelling of the gums during pregnancy, while 68 (24.5%) did not experience any change. In addition, 62 (22.2%) experienced bleeding, 43 (15.4%) pain, 10 (3.6%) ulcerations, and 10 (3.6%) epulis (pyogenic granuloma). Three out of four 210 (75.3%) of the women needed restoration for carious lesions.

Conclusion and global health implications: The oral health status of pregnant women in the Laquintinie antenatal clinic was poor, with a higher prevalence of dental caries and periodontal diseases ranging from mild to severe gingivitis and gingival epulis.

Background and objective: Human Immunodeficiency Virus (HIV) care programs in resource-limited settings reserve counseling and referral for individuals with identified mental illness for those with HIV virological treatment failure (VTF). Adolescence is a period that may increase the likelihood of internalizing psychiatric disorders (IPDs). We assessed the relationship between HIV VTF and symptoms of IPDs among adolescents and young adults (AYA) living with HIV in Gaborone, Botswana.

Methods: A cross-sectional study was conducted in Botswana from December 2018 to December 2019 among AYA living with HIV aged 12-24 years. Logistic regression analysis was used to examine relationships between age, sex, and HIV VTF (≥400 copies/mL) and clinically relevant IPD symptoms, namely, depression (Patient Health Questionnaire-9 score of ≥10) and anxiety (Generalized Anxiety Disorder-7 score of ≥10).

Results: Of 553 participants, most were aged 16-19 years (53%) with an equal sex distribution; the minority had VTF using HIV viral load (VL) cutoff levels of ≥400 copies/mL (11%). Close to one-sixth (15%) had clinical depression symptoms; participants aged 16-19 years and 20-24 years were more likely to have clinically relevant depression symptoms when compared to participants who were aged 12-15 years (odds ratio [OR] 3.160, 95% confidence interval [CI] 1.094-9.123 and OR 4.748, 95% CI 1.624-13.877, p = 0.0117, for participants aged 15- 19 years and 20-24 years, respectively). Participants with clinically relevant anxiety symptoms (11%) or both clinically relevant anxiety and depression symptoms (8%) did not differ from those without these symptoms by age, gender, or VTF status. Similar results were observed using HIV VL cutoff levels of <1000 copies/mL.

Conclusion and global health implications: HIV VTF may be a poor proxy for mental well-being among AYAs receiving HIV. Universal screening should be considered for AYA receiving care for HIV.

Healthcare-associated infections (HAIs) pose critical threats to maternal and child health in low-resource settings, with Kano State, Nigeria, reporting 6.3% of national HAI burdens and 85% of diphtheria cases. Despite global infection prevention and control (IPC) advancements, implementation gaps persist. This study engaged 50 multidisciplinary stakeholders including Kano State CDC, WHO, UNICEF, healthcare leaders, and community representatives through a three-day participatory workshop to co-develop a context-specific IPC framework. Key outcomes included standardized state IPC guidelines, facility-level monitoring committees, enhanced healthcare worker training, post-exposure prophylaxis (PEP) protocols, and dedicated isolation centers. The initiative reduced HAIs by 42% (p < 0.01) in pilot facilities, with notable improvements in pediatric and maternal wards. Barriers such as inconsistent PPE access (reported by 68% of staff) were addressed through localized solutions, including community health worker engagement. Aligned with WHO's Strategic Goal Five and SDG targets for quality care and antimicrobial resistance (AMR) reduction, this model demonstrates how stakeholder-driven IPC strategies can mitigate outbreaks in high-burden settings. Findings advocate for scalable, participatory approaches to strengthen health systems, directly impacting maternal-child survival and AMR containment in Nigeria and similar regions.

Background and objective: Obstetric pain is one of the most severe forms of pain a woman may experience during childbirth. Due to the debilitating effects of excruciating labor discomfort, pain management continues to be an important issue that requires attention. This study assessed the knowledge and utilization of obstetric analgesia in labor-management among midwives in public healthcare facilities in the north-central region of Nigeria.

Methods: This study used a descriptive cross-sectional design. One hundred twenty-three respondents who met the inclusion criteria were selected using the purposive sampling technique. Data were collected using a pretested structured questionnaire. The data were analyzed using descriptive and inferential statistics at a 0.05 level of significance.

Results: The results revealed that the respondents' overall knowledge of obstetric analgesia was adequate. The findings also revealed that more than half of the midwives have previously utilized obstetric analgesia to manage labor pain. However, the frequency of utilization of obstetric analgesia was low. A significant association was found between utilization of obstetric analgesia in labor and knowledge (χ² = 16.582, p < 0.001) as well as years of experience (χ² = 17.280, p < 0.015) and nursing rank (χ² = 36.579, p < 0.000); since the p-value < 0.05 significance.

Conclusion and global health implications: Therefore, it was recommended that midwives should be encouraged to frequently utilize obstetric analgesia to manage labor pain in order to improve the birth experience and outcome and to prevent the adverse effects that come with severe labor pain. Furthermore, the government should create policies that favor the utilization of obstetric analgesia in parturition, and midwives should incorporate the benefits of obstetric analgesia into the health education of pregnant women during antenatal counseling to promote its usage.

Long-acting antiretroviral (LAARV) agents have the potential to enhance treatment and prevention by eliminating the need for daily oral medications and increasing available options. This paper reviewed recent evidence on LAARVs and explores the opportunities and challenges of implementing these innovative prevention and treatment strategies in Sub-Saharan Africa (SSA). Several clinical trials and studies on the effectiveness, drug-drug interactions, and resistance of LAARVs in key populations in SSA are ongoing or recently completed. While the effectiveness, efficacy, and cost-effectiveness of LAARVs compared to existing oral therapies have been established, these products are not yet widely used in SSA. Significant logistical challenges in integrating LAARVs into clinic workflows under the poor health systems that are common in SSA necessitate a multi-sectoral, patient-centered approach, including the use of non-traditional healthcare delivery models.

Background and objective: Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) remains a significant public health challenge globally, with key populations (KPs) such as female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs) being disproportionately affected. Despite the availability of various HIV prevention services, including pre-exposure prophylaxis (PrEP) and community-based antiretroviral therapy (ART), the willingness of KPs to access these services remains a critical concern. This study aims to assess the prevalence of HIV and the willingness to access HIV preventive services among KPs in three selected local government areas (LGAs) in Nigeria.

Methods: A cross-sectional study was conducted in 2023 across three LGAs, Gwale, Fagge, and Tarauni, in Kano State, Nigeria, using a snowball sampling technique. A total of 1,320 participants, recruited from brothels and nightclubs, were tested for HIV using self-test kits. Willingness to access HIV services was assessed using a structured questionnaire. Data were analyzed using descriptive statistics and binary logistic regression.

Results: The overall HIV prevalence among KPs was 10.8%. MSM and PWIDs exhibited higher HIV prevalence rates compared to FSWs. Willingness to access HIV preventive services was recorded at 57.7%, with significant influences from geographical location and sexual practices. Participants from Tarauni were more willing to access services, and those engaging in vaginal sex were more likely to seek preventive services. HIV self-testing had a high uptake of 95.9%, while PrEP uptake was 68.0%. Major barriers included stigma, lack of comprehensive services, and limited knowledge of service providers.

Conclusion and global health implications: This study highlights the critical need for targeted interventions addressing the specific barriers faced by KPs in these regions. Enhancing service accessibility and addressing stigma is essential for reducing HIV transmission and achieving epidemic control in Nigeria by 2030.