Healthcare workers (HCWs) face an unprecedented higher risk of COVID-19 infection due to their work and exposure. In this study, we aim to examine the associated risk factors for COVID-19 infection among HCWs in North-East Nigeria. We used data collected retrospectively among a cohort of clinical and non-clinical HCWs in six healthcare facilities in Adamawa State, Nigeria. We estimated the marginal probability of COVID-19 infection among HWCs using alternating logistic regression via the generalized estimating equations (GEE) approach. Among the 318 HCWs, 178 (55.97%) were males, mean (±SD) age was 36.81 (±8.98), 237 (74.76%) were clinical, and 80 (25.24) were non-clinical staff. The overall prevalence of COVID-19 was 16.67% among HCWs. After adjusting for other variables in the model, our results showed that clinical staff had a 5-fold higher risk of COVID-19 infection than non-clinical staff (aOR = 5.07, 95% CI: 1.32–19.52). Moreover, significant exposure risk factors for COVID-19 infection for HCWs increase with age, time spent attending to patients, caring for COVID-19 patients, and having worked with COVID-19 samples, while the risk decreases with the use of an N95 mask. Our findings suggested that the burden of COVID-19 infection is higher for clinical staff than non-clinical staff, and increasing age contributed to the increased risk.

Adherence to Highly Active Antiretroviral Therapy (HAART) medication is an important predictor of a successful treatment and improvement of quality of life among People Living with Human Immunodeficiency Virus (HIV) / Acquired Immunodeficiency Syndrome (AIDS) (PLWHA). In the seven years before this study, several measures were taken to improve adherence to HAART among PLWHA at the study site, but no work has been published to establish the impact of the measures. We conducted a cross-sectional study among HIV-positive patients attending the antiretroviral clinic of State Specialist Hospital Yola, Adamawa State, Nigeria, in October-December 2019. Adherence was measured using self-report and was defined as taking at least ≥95% of the prescribed doses of Antiretroviral Therapy (ART) in the seven days preceding the survey. A total of 431 PLWHA participated in the study. There was an 88.4% adherence rate, and forgetfulness (62.2%) was the most common reason for missing HAART dosages. Adherence was found to be 92.1% (p=0.017) among those who have been on HAART for ˃2 years, 92.3% (p=0.01) among those not afraid of stigma, and 92.9% (p=0.002) among those who practice Islamic faith. Other factors associated with higher adherence included age less than 34 years, 91.2% (p=0.167), income of ˂₦30,000 per month, 88.6% (p=0.858), and less educated, 90.5% (p=0.852). The study showed adherence prevalence was 88.4%. Forgetfulness was found to be the most common reason for missing HAART dosages. We therefore recommend the introduction of medication adherence reminders into the HIV programs.

In March 2021, the Nigerian Government approved Coronavirus 2019 (COVID-19) vaccines, including CHAd0x1 nCov-19, Ad26.Cov2.S, mRNA-1273 and BNT162b2. Many, including healthcare workers, expressed hesitancy due to potential adverse effects. We conducted an observational study to assess the adverse effects of post-vaccination. We followed vaccinated and unvaccinated cohorts daily for 7 days and then weekly for 3 weeks. We compared adverse effects between groups. Vaccinated participants were 21 times more likely to experience an adverse effect (Relative Risk, RR=21.30; 95% Confidence Interval, 95%CI=8.107-56.012) and 4 times more likely to experience systemic adverse effects (RR=3.97; 95%CI=1.70-9.27) when compared to unvaccinated participants. Female participants were significantly associated with the development of both local and systemic adverse effects, X2=77.9% (p≤0.001) and X2=47.1% (p=0.0037), respectively. Up to 81.6% of second-dose vaccine recipients compared to 68.4% of first-dose vaccine recipients developed at least one adverse effect, X2=5.25 (p=0.071). None of the vaccinated participants developed severe adverse effects during the study period. Adverse effects from COVID-19 vaccination are common, but generally safe and tolerable. Females play a significant role in reporting adverse effects. Both systemic and local adverse effects are expected to resolve within a few days post-vaccination.

Advanced chronic liver disease is frequently complicated by hepatic encephalopathy (HE), hepatorenal syndrome, and spontaneous bacterial peritonitis; predictors of poor prognosis that significantly reduce survival. While orthotopic liver transplantation (OLT) remains the definitive treatment, it is often inaccessible in resource-limited settings. We present the case of a 70-year-old retired hospital attendant with hypertension who developed decompensated liver cirrhosis secondary to chronic hepatitis C virus HCV infection. She presented with portal hypertension, grade 4 HE, hepatorenal syndrome, and spontaneous bacterial peritonitis. She remained in grade 3 to 4 HE for approximately three months and in grade 2–3 HE for an additional two months. Despite profound hepatic decompensation and a high Model for End-Stage Liver Disease-Sodium (MELD-Na) score of 48 (indicating a 71% three-month mortality) and a Child-Pugh score of 15 (Class C), she responded remarkably to intensive conservative management. After six months of inpatient care, which included direct-acting antiviral therapy, anti-failure therapy, and seizure management, she recovered from hepatic coma. She received a six-month course of direct-acting antivirals (DAAs)daclatasvir and sofosbuvir and achieved sustained virologic response. Over six and a half years later, she remains in good health with preserved cognition and normal blood pressure and has been under annual surveillance for hepatocellular carcinoma. This case underscores the transformative potential of DAAs in improving survival even among severely decompensated HCV-related cirrhotic patients. It highlights the need for expanded access and subsidization of DAAs in low-resource settings, where liver transplantation is not feasible, and emphasizes the role of aggressive, supportive management in bridging the treatment gap.

Background: Dolutegravir (DTG)-based antiretroviral therapy (ART) is widely used as first-line treatment for HIV because of its high efficacy and resistance barrier. However, increasing evidence suggests an association between DTG use and adverse metabolic outcomes, particularly among people living with HIV (PWH) of African descent. This study assessed the relationship between DTG-based therapy, central obesity, and insulin resistance among PWH in northeastern Nigeria. Methods: A multicentre comparative cross-sectional study was conducted among adults aged ≥18 years receiving DTG-based ART (TLD), those on ritonavir-boosted atazanavir (ATV/r), and HIV-negative controls at two tertiary hospitals. Sociodemographic, clinical, and metabolic data were collected. Insulin resistance was defined as prediabetes or diabetes based on fasting plasma glucose using American Diabetes Association criteria. Multivariable logistic regression was used to identify associations. Results: Among 845 participants, people living with HIV (PWH) receiving dolutegravir-based therapy (TLD) had a markedly higher prevalence of central obesity (83.7%) compared with those on atazanavir/ritonavir (64.4%) and HIV-negative controls (30.6%; p<0.001). Insulin resistance was significantly more common in PWH than controls (11.5% vs 2.1%). After adjustment, HIV infection was associated with an eightfold increased odds of insulin resistance, with dolutegravir exposure conferring the highest risk. Female sex predicted excessive weight gain. Male sex, previously identified by as a risk factor for DTG-emergent diabetes, was similarly observed in our study Conclusion: the new-entrant DTG-based ART is associated with a high burden of central obesity and insulin resistance among PWH in northeastern Nigeria. Routine metabolic screening and lifestyle interventions should be integrated into HIV care, and prospective studies are needed to clarify causality.