Evaluation of the Hypoglycemic and Hypolipidemic Potential of Extract Fraction of Quercus baloot Griff seeds in Alloxan-induced Diabetic Mice.

INTRODUCTION: The discovery and development of new phytomedicines can be greatly aided by plants because of their tremendous therapeutic benefits, efficiency, cost-effectiveness, lack of side effects, and cheaper therapies. In this regard, Quercus baloot, generally known as oak, is used in folkloric medicine for treating and preventing various human disorders, including diabetes. AIM: For this purpose, the present study aimed to evaluate crude methanolic extract and various fractions of Quercus baloot for antihyperlipidemic and antihyperglycemic potential followed by the analysis of active compounds. METHOD: The hypoglycemic and hypolipidemic activity was evaluated in Swiss male Albino mice by administering an oral dose of 150-300 mg/kg of Q. baloot extracts in alloxan induced diabetic mice for 14 days. RESULTS: The results revealed that crude methanolic extract at a dose of 300 mg/kg exhibited a significant reduction in the blood glucose level (198.50 ± 1.99 mg/dl) at day 14 and the same treatment significantly increased the body weight (31.26 ± 0.27g) at day 14 in comparison to the control group. Moreover, the biochemical parameters were investigated which presented an increase in high-density lipids (HDL) (30.33 ± 0.33 mg/dl), whereas Low-Density Lipids (LDL) showed a significant decrease (105.66 ± 0.26 mg/dl). Additionally, triglyceride levels 104.83 ± 0.70 mg/dl, and total cholesterol 185.50 ± 0.76 mg/dl are significantly decreased. In serum biochemical analysis creatinine and hepatic enzyme markers, like serum glutamate pyruvate transaminase (32.00 ± 0.36 U/mg), serum glutamate oxaloacetate transaminase (34.33 ± 0.61 U/mg), and alkaline phosphatase (157.00 ± 0.73 U/mg), were significantly reduced by the crude methanolic extract at a dose of 300 mg/kg as compared to the control group. The antioxidant enzymes like Superoxide dismutase (4.57 ± 0.011), peroxidases dismutase (6.53 ± 0.014, and catalase (8.38 ± 0.014) at a dosage of 300 mg/kg of methanolic extract exhibited a significant increase. The histopathological study of the diabetic heart, liver, and pancreas showed substantial restoration of damaged tissues in the methanolic extract 150 and 300 mg/kg treated group, which supports the effectiveness of Q. baloot seeds. The gas chromatography-mass spectrometry analysis of methanolic extract identified 10 antidiabetic active compounds in the Q. baloot seeds, validating the antihyperglycemic activity. Thus, methanolic crude extract at the doses 150 and 300 mg/kg of Q. baloot showed significant antihyperlipidemic and antihyperglycemic activities, which validate the folkloric utilization of Q. baloot as a remedy in diabetes. CONCLUSION: In conclusion, the 300 mg/kg methanolic extract of Q. baloot has notable hypoglycemic and hypolipidemic potential, supporting the plant's traditional medicinal usage in the treatment of diabetes and its complications. Further studies are needed for the purification, characterization, and structural clarification of bioactive compounds.

Biological and Photocatalytic Activities of Silver Nanoparticles Synthesized from the Leaf Extract of Euphorbia royleana Boiss.

INTRODUCTION: Silver nanoparticles (AgNPs) have gained significance due to their practical use in the medicinal field, especially in the treatment of tumors and cancer. The current article explores a green synthetic method for the preparation of AgNPs using leaf extract of Euphorbia royleanas. METHODS: The synthesis was conducted at different parameters like concentration of AgNO3, pH, salt concentration, temperature and time to optimize best results for their biochemical applications. It was validated through UV-V spectroscopy (400-450 nm) with 1:3 (concentration ratio of leaf ethanolic extract and 1 mM AgNO3 solution) at a pH value of 8 at 35oC, which were the best optimization conditions. The FTIR spectral bands showed the presence of C-N and -OH functional groups, indicating that -OH stretching and the aliphatic -C-H stretching were involved in the reduction of Ag ions. The XRD pattern showed the face-centered cubic structure of silver nanoparticles. The results of SEM revealed that AgNPs were predominantly spherical in shape, mono-dispersed, and arranged in scattered form. EDX analysis testified the presence of metallic silver along with other elements like Cl, C, and O. RESULTS: The investigation of biochemical parameters showed that AgNPs were influential in the discoloration of dye wastewater (methylene blue ), where 80% of dye color was removed in 20 min, followed by the significant (p < 0.05) analgesic activity with an inhibition percentage of 86.45% at a dose of 500 mg/kg. CONCLUSION: Similarly, the antioxidant activity with the highest percent inhibition was 55.4% (p < 0.0001), shown by the AgNPs at 500 µg/mL. AgNPs showed a 30 mm zone of inhibition at 100 µl/mL against Aspergillus niger. It was concluded that AgNPs provide a baseline in medical technology for the treatment of simple to chronic diseases.

Addressing neurosurgical challenges in war conflict countries.

The Russo-Ukrainian war caused significant humanitarian and healthcare issues in the Russo-Ukrainian region, which were further aggravated by the escalation of the conflict on February 2022. Because of this ongoing confrontation between the two nations, which has its roots in geopolitical conflicts and historical events, there have been nearly 4 million refugees in only the first month, and 906 healthcare institutions have sustained significant damage. Consequently, the demand for medical services has increased, adding onto the burden of the pre-existing problems within the region's healthcare system, such as inequities, budget shortages, and corruption. With nearly 500,000 military deaths and an estimated 27,1499 civilian casualties, the war's immediate health effects are devastating. Due to inadequate disease surveillance and difficulties with immunization, the risk of infectious illnesses, particularly HIV/AIDS and tuberculosis, increased. Although there were originally few mental health problems, the long-term effects are yet unknown. Some of the indirect effects are the severe refugee situation, the burden on public infrastructure, and problems with the security of food and water. Unprecedented obstacles confronted neurosurgery in the Russo-Ukrainian region, including increased patient loads from war-related cases, resource limitations, and facility devastation. Many countries stepped up to aid in managing neurosurgeries however, the some of the problems still persisted, such as insufficient sterility and power outages. Strengthened security standards, financial incentives, telemedicine services, and cooperation with international medical organizations are the main points of recovery recommendations. Rebuilding the region's healthcare system and guaranteeing ongoing foreign support after the conflict require a comprehensive strategy that addresses both short- and long-term issues.

Global prevalence and correlates of mpox vaccine acceptance and uptake: a systematic review and meta-analysis.

BACKGROUND: Vaccination has been recommended as one of the most potent ways of controlling the mpox (formerly, monkeypox) outbreak, particularly among high-risk groups. Here, we evaluated the prevalence of mpox vaccine acceptance and uptake globally. METHODS: We searched multiple databases for peer-reviewed studies published in English from May 2022 to 25th November 2023 that evaluated mpox vaccine acceptance and/or uptake. We fit a random-effects model meta-analysis to calculate the pooled mpox vaccine acceptance and uptake rates, with their 95% confidence intervals (CI) across population outcomes. We performed subgroup analyses among the six World Health Organization (WHO) regions (Africa [AFR], Region of the Americas [AMR], South-East Asia Region [SEAR], European Region [EUR], Eastern Mediterranean Region [EMR], and the Western Pacific Region [WPR]), as well as among select population subgroups. RESULTS: Of the 2531 studies screened, 61 studies, with a cumulative sample size of 263,857 participants from 87 countries were eligible for inclusion. The overall vaccine acceptance and uptake rates were 59.7% and 30.9% globally. Acceptance and uptake rates among the LGBTQI+ community were 73.6% vs 39.8% globally, 60.9% vs. 37.1% in AMR, 80.9% vs. 50.0% in EUR, and 75.2% vs. 33.5% in WPR. Among PLHIV, vaccine acceptance and uptake rates were 66.4% vs. 35.7% globally, 64.0% vs. 33.9% in AMR, 65.1% vs. 27.0% in EUR, and 69.5% vs. 46.6% in WPR. Among healthcare workers, vaccination intention was 51.0% globally. CONCLUSIONS: Tailored interventions are needed to bolster confidence in the mpox vaccine, maximize vaccine uptake, and increase vaccine access to close the gaps between acceptance and uptake especially among key populations residing in regions with low rates of acceptance and uptake.

Mpox is an infection caused by the monkeypox virus and is transmitted through direct contact with infected animals or people, or indirectly through contact with contaminated materials. An unprecedented mpox outbreak spanning all continents occurred in 2022. Vaccination against the infection by high-risk groups, including the LGBTQI+ community and frontline healthcare workers has been recommended by the WHO as essential to outbreak control. To investigate the rates and factors associated with mpox vaccine acceptance and uptake across population subgroups (LGBTQI+ community, healthcare workers, people living with HIV, and the general public), we undertook this global systematic review and meta-analysis of the available evidence. Our results reveal substantial global and regional variations in the rates of mpox vaccine acceptance and uptake across population groups, with wide acceptance-uptake gaps, indicating the need for behavioral interventions to increase mpox vaccine confidence and uptake.

Global Neurosurgical Challenges: A Focus on Central Asia.

OBJECTIVE: To evaluate the current state of neurosurgical care in Central Asia, identify the challenges and advancements, and propose recommendations to improve neurosurgical capabilities and access in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. METHODS: A comprehensive review of the neurosurgical infrastructure, availability of neurosurgeons, technological advancements, and healthcare policies in the five Central Asian countries. Analysis included published literature, healthcare reports, and expert opinions to assess the state of neurosurgical care and identify areas for improvement. RESULTS: Significant variation in neurosurgical care was observed across the region. Kazakhstan showed notable advancements, including an increased number of neurosurgeons and progress in specialized fields such as vascular neurosurgery and brain tumor management. Other countries, like Uzbekistan, Tajikistan, and Kyrgyzstan, made strides in improving neurosurgical care but still faced substantial challenges. Common issues included a shortage of neurosurgeons, limited facilities, and inadequate access to modern technology. The lack of research data further highlighted the need for urgent intervention. CONCLUSIONS: To enhance neurosurgical care in Central Asia, a multipronged approach involving targeted investments, policy reforms, international collaborations, and knowledge sharing is recommended. This includes establishing specialized neurosurgical training programs and fellowships, investing in infrastructure and technology, fostering international collaborations for training and research, introducing early neurosurgery education in medical schools, improving access to online education resources, and promoting telemedicine for consultations and follow-up care. These measures are necessary to expand access to essential neurosurgical care and improve outcomes in the regions.

Migratory Fish Bone in the Hyoglossus: Catch Me if You Can.

Foreign body ingestion is one of the most frequently encountered cases in otorhinolaryngology and most of the cases can be managed non-operatively. If left untreated, migration of foreign bodies can occur and presents a significant challenge in patient management. We hereby describe the case of an elderly gentleman who had a preceding history of fish bone ingestion and complained of dysphagia for two days. Clinical examination revealed swelling of the right vallecula with minimal pus discharge. Computed tomography (CT) of the neck confirmed the diagnosis of a migratory foreign body in the neck. He underwent open neck exploration and foreign body removal under intraoperative fluoroscopy guidance. A high index of suspicion of a migratory foreign body is warranted in cases of persistent, unresolved symptoms with the failure of endoscopic evaluation to detect the foreign body. Migratory foreign body of the neck may cause life-threatening complications and requires early surgical intervention.

Axillary Metastasis as the Initial Presentation of Recurrent Nasopharyngeal Carcinoma.

The recurrence of nasopharyngeal carcinoma (NPC) is either at the local primary site or at regional or distant metastases. However, an axillary metastasis is a rare entity in NPC. We highlighted a case of recurrent NPC that presented with axillary swelling as the main initial complaint. Clinical examinations showed enlarged left axillary lymph nodes and left cervical lymph nodes. Histopathological examination of the axillary lymph node biopsy confirmed the recurrence of NPC. The patient underwent palliative chemotherapy in view of the advanced stage of recurrent disease. A thorough clinical history and examination during surveillance are crucial for early diagnosis and better survival outcomes.

Pleomorphic Adenoma in a Posterior Cervical Soft Tissue Mass: A Diagnostic Conundrum.

Diagnosing a soft tissue tumor in the head and neck region can be challenging due to its complex anatomy and diverse histological spectrum. This case report highlights the case of a woman who presented with a painless neck lump in the posterior triangle of the neck. Various pathological and imaging studies were suggestive of pleomorphic adenoma, which arises from the left prevertebral space. The patient underwent complete surgical excision via the transcervical approach. Pleomorphic adenoma in the posterior triangle of the neck is extremely rare and causes a diagnostic dilemma in managing soft tissue tumors of the neck.

Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach.

This study hypothesizes that depression mediates the association between exposure to stigma and medication non-adherence in people living with HIV (PLHIV). We recruited 372 PLHIV from the Stigma, health-related Quality of life, antiretroviral Adherence, and Depression among people living with HIV (SQuAD-HIV) project, a multicenter cross-sectional study conducted between October 2021 and February 2022 among PLHIV attending six ART clinics in two geopolitical regions of northern Nigeria. A structural equation modeling (SEM) framework, utilizing the full information maximum likelihood estimator, was used to elucidate the pathways linking stigma, depression, and ART medication adherence, adjusting for sociodemographic characteristics. The total number of eligible participants analyzed (353) included 32.7% male PLHIV with a mean age (SD) of 39.42 (10.14). Being female was positively associated with adherence (ß, 95% CI 0.335, 0.163-0.523, p-value < 0.001) but negatively associated with stigma (ß, 95% CI - 0.334, - 0.561 to - 0.142, p-value = 0.001), while urban residence was negatively associated with stigma (ß, 95% CI - 0.564, - 0.804 to - 0.340, p-value < 0.001). Our analysis also indicated that a higher level of experienced stigma was associated with decreased medication adherence. This association was partially mediated by depression (indirect effect = (0.256) (- 0.541) = - 0.139; p-value < 0.01). The proportion of the association between stigma and medication adherence explained through mediation by depression was 35.6%. These findings underscore the need for targeted interventions aimed at lowering exposure to stigma among PLHIV to improve medication adherence.

Endoscope-Assisted Cochlear Implantation in Atretic Round Window.

Different techniques have been proposed for cochlear implant (CI) from its conventional transmastoid posterior tympanotomy approach. Endoscopy role in the otologic field is still relatively new, but it provides a better surgical view with improved image clarity, especially in the challenging anatomical visualization of the critical structures in CI surgery. A 3-year-old girl with bilateral progressive profound hearing loss was scheduled for left cochlear implant surgery. The pre-operative high-resolution computed tomography (HRCT) of the temporal bone and magnetic resonance (MR) of internal acoustic meatus reported no significant abnormality of the middle and inner ears structures bilaterally. The standard left postauricular cortical mastoidectomy and posterior tympanotomy were performed. However, the microscopic view could not visualize the round window (RW) niche despite a widened extended posterior tympanotomy and surgical field manipulation. Transfacial recess endoscopic examination was done and was able to identify the possibly atretic RW. With endoscopic guidance, CI electrodes were inserted via cochleostomy, and intraoperative impedance measurement and neural response telemetry were obtained both during surgery and the postoperative phase. No intra- and postoperative complications were observed in this case. Following activation, the CI was functioning well. In conclusion, atretic RW is a rare anomaly found intraoperatively during CI surgery. Endoscope-assisted electrode insertion offers excellent visualization of targeted middle ear structures, especially in limited or abnormal anatomy of RW, which could minimize the risk of surgical complications.

Better Safe Than Sorry: A Rare Case of a Laryngeal Foreign Body and the Unconventional Use of Cook® Airway.

Foreign body (FB) inhalation in the pediatric population is a common emergency referral in otolaryngology practice. Mismanagement can lead to significant morbidity or even mortality. Anesthesiologists conventionally use the Cook® airway exchange catheter (CAEC) during endotracheal tube exchange in the intensive care unit, but its usage as an oxygen conduit is beneficial in other airway procedures. A healthy two-year-old boy was brought to casualty for allegedly choking on a boneless chicken meat bolus during mealtime. The initial presentation showed that the child was comfortable with soft audible stridor without signs of respiratory distress. Bedside video laryngoscopy revealed a whitish FB in the proximity of the vocal cord. The patient was subjected to emergency direct laryngoscopy and bronchoscopy to retrieve the FB. Under general anesthesia, the true nature of FB was revealed, which was an embedded chicken bone into the laryngeal ventricle, causing a significant reduction of the rima glottis opening. CAEC was used to maintain oxygenation during the complex extraction process, and the child was discharged without any morbidity. Eyewitness history is an essential component in diagnosing FB inhalation in the pediatric population. Despite that, identifying potential difficulty is important to provide backup, especially in the case of unexpected events during managing airway emergencies.

A systematic review and meta-analysis of the global prevalence and determinants of COVID-19 vaccine acceptance and uptake in people living with HIV.

People living with HIV (PLHIV) are at higher risk of poor outcomes of SARS-CoV-2 infection. Here we report the pooled prevalence of COVID-19 vaccine acceptance/uptake and determinants among this vulnerable population of PLHIV based on a systematic review and meta-analysis of studies published by 25 August 2023. Among the 54 included studies (N = 167,485 participants), 53 (N = 166,455) provided data on vaccine acceptance rate, while 27 (N = 150,926) provided uptake data. The global prevalences of COVID-19 vaccine acceptance and uptake were 67.0% and 56.6%, respectively. Acceptance and uptake rates were 86.6% and 90.1% for the European Region, 74.9% and 71.6% for the Region of the Americas, 62.3% and 78.9% for the South-East Asian Region, 64.6% and 19.3% for the Eastern Mediterranean Region, 58.0% and 35.5% for the African Region, and 57.4% and 44.0% for the Western Pacific Region. The acceptance rate increased from 65.9% in 2020 to 71.0% in 2022, and the uptake rate increased from 55.9% in 2021 to 58.1% in 2022. Men, PLHIV aged ≥40 years and those who had recently received the influenza vaccine were more likely to accept and receive the COVID-19 vaccine. Factors associated with lower uptake included Black race, other races (Latinx/Hispanic/mixed race), low education level and being unemployed. Vaccine-related factors associated with higher acceptance included belief in vaccine effectiveness, vaccine trust, perceived high susceptibility to SARS-CoV-2 infection and fear of potential COVID-19 effect in PLHIV. Sustained efforts and targeted interventions are needed to reduce regional disparities in COVID-19 vaccine uptake among PLHIV.

COVID-19 vaccine wastage in Africa: A case of Nigeria.

The World Health Organization has launched campaigns to boost immunisation rates to 70 percent globally by the middle of 2022. However, despite the global success of about 64% COVID-19 vaccination coverage, there is a big gap in Nigeria. To date, only 13.8% of the population has received the recommended dose. This demonstrates a significant disparity between the vaccinated and the unvaccinated. Amidst the wide gap in vaccination, COVID-19 vaccine wastage still occurs in Nigeria. At the end of 2021, it was estimated that over a million doses of the COVID-19 vaccine had been wasted. It is anticipated that there will be more COVID-19 vaccine wastage in Nigeria, because of the combined factors that threaten vaccination uptake including vaccine accessibility, lack of appropriate storage facilities, poor electricity supply, insecurity challenges, and inadequate health promotion. This results in concomitant financial and opportunity losses. In this paper, we discuss COVID-19 vaccine wastage in Nigeria including causes, and solutions that can be applied to mitigate this wastage.

Assessment of Legibility of Handwritten Prescriptions and Adherence to W.H.O. Prescription Writing Guidelines in Ahmadu Bello University Teaching Hospital Zaria - Kaduna State, Nigeria.

Introduction: The issues of incorrectness and incompleteness for written prescriptions may result to dispensing errors and unintended outcomes of care. The objective of the study was to assess the legibility of handwritten prescriptions and adherence to W.H.O. prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria. Method: A cross-sectional prospective study design was used, and existing prescriptions were sampled from selected in-patient and outpatient pharmacy units of Ahmadu Bello University Teaching Hospital Zaria. This was approved by the ethics and research committee of the institution. The prescriptions were then evaluated for quality based on the layout, legibility, and clarity of the details in the prescriptions and screened for medication errors. Result: The extent of prescribing drugs by generic name was (68.37%), the legibility percentage was moderate and the percentage of prescriptions in which details of the drug, route of administration, and duration of treatment were complete was 85.23%, 80.80%, and 82.40%, respectively. The doctor's signature (84.87%) was present in the prescriptions. Many of the prescribers did not use to indicate patients' weight, age, and clinic on prescriptions, these are deviations from good prescribing practices while total medication error was 38.01%. Conclusion: Prescribers have a duty of care to their patient and a professional duty to their colleagues (pharmacists) to ensure drug prescriptions are readily identifiable. Interventional techniques such as the use of printed or electronic prescriptions can improve the ease of interpreting information and reduce medication errors.

Evaluation of job satisfaction among pharmacists working in public health facilities.

Background: The decline in healthcare workforce is a global trend that is alarming in low and middle-income countries (LMIC) in LMIC and many countries worldwide, pharmacists plays critical role in healthcare, many of which are not limited to patient care, research and development, health promotion. However, growing dissatisfaction among pharmacists working in public health facilities has become increasingly common and can have severe public health consequence. Job dissatisfaction ranks among the most significant factors influencing healthcare employees to seek career changes, reduce productivity, and possibly migrate to more promising opportunities, thereby posing a public health threat in the region.' Furthermore, healthcare professionals are crucial to the functionality of a healthcare system, with human resources standing as a critical element ensuring organizational success vis-a-vis other dependent factors to optimize efficiency and effectiveness. Objectives: To examine the job satisfaction of pharmacists working in public health facilities in Nigeria. Method: A descriptive, cross-sectional study on pharmacists' job satisfaction was carried out between march and July 2023, to determine the job satisfaction of pharmacists working in primary, secondary, and tertiary healthcare facilities in Nigeria. Data were gathered using an anonymous online validated questionnaire adapted from the Minnesota questionnaire short form and the Job Description Index (JDI) (Measuring Job Satisfaction - Tools, Scales, and Methods). Results: The study identified an overall low job satisfaction level of 65%. Major influencers included facility conditions, co-worker relations, and remuneration. The demographic data revealed a dominance of female pharmacists in general hospital settings, with a significant proportion aged between 23 and 36 years. Remuneration emerged as a universal concern across different age groups, reflecting Nigeria's prevailing economic challenges. Interestingly, satisfaction with the working facility decreased with age, suggesting that enthusiasm and optimism wane over time. Relationship dynamics with co-workers showed positive progression with age, whereas satisfaction with pay remained universally low. Conclusion: The study underscores the need for a comprehensive strategic review in the health sector, focusing on remuneration, working conditions, and inter-personal relationships to boost job satisfaction and retention. Further research might delve deeper into specific allowances and the impact of home ownership on satisfaction.

Description of the design of a mixed-methods study to assess the burden and determinants of malaria transmission for tailoring of interventions (microstratification) in Ibadan and Kano metropolis.

BACKGROUND: Rapid urbanization in Nigerian cities may lead to localized variations in malaria transmission, particularly with a higher burden in informal settlements and slums. However, there is a lack of available data to quantify the variations in transmission risk at the city level and inform the selection of appropriate interventions. To bridge this gap, field studies will be undertaken in Ibadan and Kano, two major Nigerian cities. These studies will involve a blend of cross-sectional and longitudinal epidemiological research, coupled with longitudinal entomological studies. The primary objective is to gain insights into the variation of malaria risk at the smallest administrative units, known as wards, within these cities. METHODS/RESULTS: The findings will contribute to the tailoring of interventions as part of Nigeria's National Malaria Strategic Plan. The study design incorporates a combination of model-based clustering and on-site visits for ground-truthing, enabling the identification of environmental archetypes at the ward-level to establish the study's framework. Furthermore, community participatory approaches will be utilized to refine study instruments and sampling strategies. The data gathered through cross-sectional and longitudinal studies will contribute to an enhanced understanding of malaria risk in the metropolises of Kano and Ibadan. CONCLUSIONS: This paper outlines pioneering field study methods aimed at collecting data to inform the tailoring of malaria interventions in urban settings. The integration of multiple study types will provide valuable data for mapping malaria risk and comprehending the underlying determinants. Given the importance of location-specific data for microstratification, this study presents a systematic process and provides adaptable tools that can be employed in cities with limited data availability.

Perceived changes in the mental well-being among Nigerians due to Ramadan Intermittent Fasting during the COVID-19 pandemic.

INTRODUCTION: Muslims fast every year during the month of Ramadan from dawn until dusk. This study examined mental well-being and correlating factors among Nigerian adults who observed Ramadan intermittent fasting (RIF). METHODS: A validated generalized anxiety disorder-2 and Patient Health Questionnaire-2, the four-item spiritual well-being index, and the Islamic intrinsic religiosity questionnaire were used to collect data about mental well-being (depression, anxiety), spirituality, and intrinsic religiosity through a web-based survey between the May 9, 2021 (27th of Ramadan, 1442) and the June 4, 2021 (29th of Shawwal, 1442). We studied the mental well-being of respondents over a period of 4 weeks before Ramadan (BR) and during the 4 weeks of Ramadan between the April 12, 2021 and the May 12, 2021(DR). Multinomial regression analysis was used to determine the factors associated with depression and anxiety. This research did not receive any grant or funding. RESULTS: A total of 770 adult Nigerians who observed RIF study were included in this cross-sectional study. When compared to mental well-being BR, observing RIF by Nigerian adult respondents was associated with a significant improvement in their mental well-being. A higher proportion of respondents felt less depressed DR (61.3% vs. 56.5%. < .001). Interest and pleasure in doing things improved DR than BR (p= 0.007) and respondents felt less nervous and anxious (60.7% vs. 57.1%, respectively; p <.001). Mental well-being was independently associated with sociodemographic characteristics, physical activity, and perceived relationships. CONCLUSIONS: This study found significant improvement in mental well-being DR compared to BR despite the ongoing COVID-19 pandemic. The effect of RIF on mental well-being needs further research with multicentric studies among different sets of ethnic populations.

COVID-19 vaccine hesitancy among people living with HIV in a low-resource setting: A multi-center study of prevalence, correlates and reasons.

BACKGROUND: Hesitancy to COVID-19 vaccine may worsen the burden of COVID-19 among people living with HIV (PLHIV), who are at a higher risk of COVID-19-related hospitalization and death, compared to HIV non-infected individuals. Therefore, we evaluate the predictors and reasons for COVID-19 vaccine hesitancy among unvaccinated PLHIV in six antiretroviral therapy (ART) clinics across northern Nigeria. METHODOLOGY: In this cross-sectional study, conducted between October 2021 and February 2022 in six hospitals across two geopolitical regions of Nigeria, we utilized interviewer-administered questionnaires to assess COVID-19 vaccine hesitancy among a convenience sample of 790 eligible adult PLHIV. Hesitancy was defined as answering 'no' or 'maybe' to a question asking participants their willingness to accept the COVID-19 vaccine. A multivariate logistic regression model was used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the factors associated with COVID-19 vaccine hesitancy among PLHIV. RESULTS: Of the total 660 unvaccinated participants included in the analysis (61.82% female, mean age [SD] of 39.76 [10.75]), 381 (57.72%) were hesitant to COVID-19 vaccine. Being 50 years and older (aOR: 0.43; 95% CI: 0.21-0.89), being unemployed (aOR: 0.57; 95% CI: 0.34-0.95), experiencing the adverse effects of ART (aOR: 0.36; 95% CI: 0.15-0.86), and perception of being at high risk of contracting COVID-19 (aOR: 0.22; 95% CI: 0.13-0.37) were associated with significantly lower odds of hesitancy. Conversely, being female (aOR: 1.64; 95% CI: 1.02-2.61) and attending ART clinics at state administrative capital cities (IIDH Kano [aOR: 2.40; 95% CI: 1.10-5.25], MMSH Kano [aOR: 5.59; 95% CI: 1.97-10.66], YSSH Damaturu [aOR: 9.88; 95% CI: 4.02-24.29] vs. GH Gashua) were associated with significantly higher odds of hesitancy. The most common reasons for hesitancy include fear of potential adverse effects, skepticism about vaccine efficacy, the rapid development of the COVID-19 vaccine, and the perceived lack of effort to develop a cure or vaccine for HIV/AIDS. CONCLUSION: Interventions aimed at combating misperceptions and misinformation regarding the COVID-19 vaccination program may reduce the prevalence of COVID-19 vaccine hesitancy among unvaccinated PLHIV.

Prevalence, determinants, and reasons for malaria vaccine hesitancy among caregivers of under-five children in Nigeria: Results from a nationwide cross-sectional survey.

OBJECTIVE: Malaria contributes to an enormous global burden of disease and mortality, especially in children. Approximately one in every four global cases and deaths from malaria occurs in Nigeria. This study aims to evaluate the prevalence and correlates of community hesitancy to the malaria vaccine, including the reasons for the hesitancy, following the approval of the RTS,S malaria vaccine by the World Health Organization (WHO). METHODS: This was a nationwide cross-sectional online survey of Nigerian adults conducted from 20th October to 30th November 2021. Participants who replied 'no' or 'maybe' to a question assessing their willingness to accept the RTS,S malaria vaccine were considered "hesitant". We fit a multivariate logistic regression model to report the adjusted odds ratio (aOR) and 95 % confidence interval (CI) for the factors associated with vaccine hesitancy. FINDINGS: Among 3377 total respondents (1961 [57.86 %] males; mean age [SD]: 30[9.1]), 1010 (29.91 %) were hesitant. Receiving information about the RTS,S malaria vaccine initially from healthcare workers (vs. the internet) (aOR:0.55; 95 % CI:0.35-0.87) was significantly associated with lower odds of hesitancy. Conversely, earning a high income of over NGN100, 000 (vs. < NGN 30,000) per month (aOR: 2.10, 95 % CI: 1.36-3.24), belonging to other religious groups (vs. Islam) (aOR:3.25, 95 % CI:1.18-8.98), and having a family size of more than ten (vs. < 5) (aOR:1.84; 95 % CI:1.08-3.13) were significantly associated with a higher odds of hesitancy. The main reasons for vaccine hesitancy included fear of vaccine adverse effects (34.95 %), availability of other malaria preventive measures (33.96 %) and not seeing the positive effect of the vaccine in others first (32.97 %). CONCLUSION: The findings of this survey provide a valuable blueprint for the development of targeted interventions to facilitate caregiver acceptance of the RTS,S vaccine.

The effect of mobile phone utilization for enhanced adherence counselling intervention among persons with HIV.

The conduct of physical enhanced adherence counselling (EAC) for antiretroviral therapy (ART) non-adherers is often flawed by objectionable time lag from commencement to timely completion of the process. Therefore, we conducted a retrospective cohort study of 342 adults (≥18 years) with HIV on ART to determine the outcome of utilizing mobile phone based EAC intervention. Structural equation modelling framework, with full information maximum likelihood estimator was used to elucidate the pathways linking the relationship between individual characteristics, perceived barriers to ART adherence, and the applied interventions. A total of 321(93.9%) participants completed the required 3 EAC sessions over 60-days. The proportion of viral load (VL) re-suppression (<1000 copies/mL) after EAC intervention was 66.6%. The mean durations of EAC onset from time of high VL confirmation and completion of EAC were 6.26 ± 3.22 and 59.99 ± 5.14 days, respectively. In the simultaneous model (Comparative Fit Index = 0.89, Tucker-Lewis Index = 0.851, Root Mean Square (RMS) Error of Approximation = 0.049, Standardized RMS Residual = 0.059), the variables: forgot, knowledge/beliefs, side effect of drugs, lost/ran out of drugs, scheduling, and stigma were significant barrier factors contributing to poor ART adherence. The use of mobile phones for EAC intervention was effective for early initiation and timely completion of the sessions.