Investigating the emigration intention of health care workers: A cross-sectional study.

AIMS: To (1) explore the intramigration experience of HCWs within Nigeria, (2) explore the migration intention of health care workers (HCWs) in Nigeria and (3) identify the predictors of migration intention among HCWs in Nigeria. DESIGN: Cross-sectional study. METHODS: The online survey was used to collect data from 513 HCWs in Nigeria between May and June 2023. Crude and adjusted logistic regression were used to identify factors associated with emigration intention. Analyses were performed on SPSS version 26 at a 95% confidence interval. RESULTS: The study found that 34.4% had intramigration experience, and the rate of intention to emigrate to work in another country was 80.1%. The United Kingdom was the most preferred destination (109 HCWs), followed by Canada (92 HCWs) and the United States (82 HCWs). At the multivariate level, emigration intention was associated with the experience of burnout and duration of practice as a HCW. Nurses had higher emigration intentions than medical doctors. CONCLUSIONS: Many HCWs in Nigeria appear to have emigration intent, and nurses are more likely to be willing to migrate than doctors. The Nigerian government may want to explore strategies to reverse the emigration intent of the HCWs in Nigeria.

Effectiveness of Linkage to Care and Prevention Interventions Following HIV Self-Testing: A Global Systematic Review and Meta-analysis.

Over 38.4 million people were living with HIV globally in 2021. The HIV continuum includes HIV testing, diagnosis, linkage to combined antiretroviral therapy (cART), and retention in care. An important innovation in the HIV care continuum is HIV self-testing. There is a paucity of evidence regarding the effectiveness of interventions aimed at linking self-testers to care and prevention, including pre-exposure prophylaxis (PrEP). To bridge this gap, we carried out a global systematic review and meta-analysis to ascertain the effectiveness of interventions post-HIV self-testing regarding: (1) linkage to care or ART, (2) linkage to PrEP, and (3) the impact of HIV self-test (HIVST) interventions on sexual behaviors. We searched PubMed, Web of Science, SCOPUS, Cochrane Library, CINAHL Plus (EBSCO), MEDLINE (Ovid), Google Scholar, and ResearchGate. We included only published randomized controlled trials (RCTs) and quasi-experiment that compared HIVST to the standard of care (SoC). Studies with sufficient data were aggregated using meta-analysis on RevMan 5.4 at a 95% confidence interval. Cochrane's Q test was used to assess heterogeneity between the studies, while Higgins and Thompson's I2 was used to quantify heterogeneity. Subgroup analyses were conducted to identify the source of heterogeneity. Of the 2669 articles obtained from the databases, only 15 studies were eligible for this review, and eight were included in the final meta-analysis. Overall, linkage to care was similar between the HIVST arm and SoC (effect size: 0.92 [0.45-1.86]; I2: 51%; p: 0.04). In the population subgroup analysis, female sex workers (FSWs) in the HIVST arm were significantly linked to care compared to the SoC arm (effect size: 0.53 [0.30-0.94]; I2: 0%; p: 0.41). HIVST interventions did not significantly improve ART initiation in the HIVST arm compared to the SoC arm (effect size: 0.90 [0.45-1.79]; I2: 74%; p: < 0.001). We found that more male partners of women living with HIV in the SoC arm initiated PrEP compared to partners in the HIVST arm. The meta-analysis showed no difference between the HIVST and SoC arm regarding the number of clients (effect size: - 0.66 [1.35-0.02]; I2: 64%; p: 0.09) and non-clients FSWs see per night (effect size: - 1.45 [- 1.45 to 1.38]; I2: 93%; p: < 0.001). HIVST did not reduce the use of condoms during insertive or receptive condomless anal intercourse among MSM. HIVST does not improve linkage to care in the general population but does among FSWs. HIVST intervention does not improve linkage to ART nor significantly stimulate healthy sexual behaviors among priority groups. The only RCT that linked HIVST to PrEP found that PrEP uptake was higher among partners of women living with HIV in the SoC arm than in the HIVST arm. More RCTs among priority groups are needed, and the influence of HIVST on PrEP uptake should be further investigated.

Does adherence to antiretroviral therapy differ by place of residence in Nigeria? A systematic review and meta-analysis protocol.

INTRODUCTION: Retention in care is still a significant challenge in the HIV treatment cascade and varies extensively across regions, leading to poor adherence to antiretroviral therapy (ART). Several factors across different socioecological levels, such as health and community-level factors, inhibit ART adherence among people living with HIV (PLWH) in Nigeria. This review seeks to ask whether adherence to ART differs by place of residence in Nigeria. METHOD AND ANALYSIS: This systematic review and meta-analysis will follow the updated Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will search PubMed, SCOPUS, CINAHL, Web of Science, MEDLINE (Ovid) and Google Scholar from onset to 30 April 2023. We will include only quantitative observational studies or mixed-method studies that measured the association between place of residence (urban and rural) and adherence to ART among PLWH aged ≥15 years. Title and abstract screening, full-text screening, data extraction and quality assessment will be done by two reviewers independently. A third reviewer will resolve disagreements. We will extract the author's name and year of publication, study aim(s), participant's characteristics, sample size, sampling method, region and state, adherence definition and adherence level in urban and rural areas. Data will be analysed with Review Manager V.5.4. The Q statistical test will be used to assess between-study heterogeneity, while Higgins and Thompson's I2 will be used to quantify the heterogeneity level. Several subgroups and sensitivity analyses will be conducted. ETHICS AND DISSEMINATION: Ethical approval is not warranted for this study since primary published data will be utilised. The findings of this review will be published in a high-impact peer-reviewed journal and presented at a conference. PROSPERO REGISTRATION NUMBER: CRD42022371965.

Significant Others and Not Family or Friend Support Mediate Between Stigma and Discrimination Among People Living With HIV in Lagos State, Nigeria: A Cross-sectional Study.

ABSTRACT: Approximately 70% of the 37.7 million people living with HIV (PLWH) globally reside in sub-Saharan Africa and 10% of the global HIV burden is in Nigeria. PLWH encounter stigma and discrimination. Limited support from family, friends, and significant others increases stigma and discrimination among PLWH. This study sought to understand how support from family, friends, and significant others mediates stigma and discrimination in the Nigerian context. This descriptive cross-sectional study enrolled 396 PLWH from six health facilities between June and July 2021 in Lagos State, Nigeria. Stigma, discrimination, and social support were assessed. On average, participants were 32 years of age and female. Increased social support was associated with reduced stigma and discrimination. Support from participants' significant others was found to mediate the relationship between stigma and discrimination.

Injuries in male and female semi-professional football (soccer) players in Nigeria: prospective study of a National Tournament.

BACKGROUND: Research on the epidemiology of football injuries in Africa is very sparse despite its importance for injury prevention planning in a continent with limited sports medicine resources. The vast majority of studies available in literature were conducted in Europe and only a very few studies have prospectively reported the pattern of football injury in Africa. The purpose of this study was to evaluate the incidence and pattern of injuries in a cohort of male and female semi-professional football players in Nigeria. METHODS: A prospective cohort design was conducted, in which a total of 756 players with an age range of 18-32 years (356 males and 300 females) from 22 different teams (12 male and 10 female teams), were prospectively followed in a National Football Tournament. Physiotherapists recorded team exposure and injuries. Injuries were documented using the consensus protocol for data collection in studies relating to football injury surveillance. RESULTS: An overall incidence of 113.4 injuries/1000 h (95% CI 93.7-136.0) equivalent to 3.7 injuries/match and time-loss incidence of 15.6 injuries/1000 h were recorded for male players and 65.9 injuries/1000 h (95% CI 48.9-86.8) equivalent to 2.2 injuries/match and time-loss incidence of 7.9 injuries/1000 h were recorded for female players. Male players had a significantly higher risk of injuries [IRR = 1.72 (95% CI 1.23-2.45)]. Injuries mostly affected the lower extremity for both genders (n = 81, 70% and n = 31, 62% for males and females respectively). Lower leg contusion (n = 22, 19%) and knee sprain (n = 9, 18%) were the most common specific injury types for male and female players respectively. Most of the injuries were as a result of contact with another player (n = 102, 88%-males; n = 48, 96%-females). Time-loss injuries were mostly estimated as minimal (n = 11, 69%) for male players and severe (n = 4, 66%) for female players. CONCLUSION: The overall incidence of injuries among Nigerian semi-professional football players is high but most of the injuries do not result in time-loss. Pattern of injuries is mostly consistent with previous studies. More prospective studies are needed to establish injury prevention initiatives among African players.