Background: Nigeria is among the top five countries that have the highest gap between people reported as diagnosed and estimated to have developed tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high risk of TB transmission and targeted active case finding (ACF) interventions. Leveraging community-level data together with granular sociodemographic contextual information can unmask local hotspots that could be otherwise missed. This work evaluated whether this approach helps to reach communities with higher numbers of undiagnosed TB. Methodology: A retrospective analysis of the data generated from an ACF intervention program in four southwestern states in Nigeria was conducted. Wards (the smallest administrative level in Nigeria) were further subdivided into smaller population clusters. ACF sites and their respective TB screening outputs were mapped to these population clusters. This data were then combined with open-source high-resolution contextual data to train a Bayesian inference model. The model predicted TB positivity rates on the community level (population cluster level), and these were visualised on a customised geoportal for use by the local teams to identify communities at high risk of TB transmission and plan ACF interventions. The TB positivity yield (proportion) observed at model-predicted hotspots was compared with the yield obtained at other sites identified based on aggregated notification data. Results: The yield in population clusters that were predicted to have high TB positivity rates by the model was at least 1.75 times higher (p-value < 0.001) than the yield in other locations in all four states. Conclusions: The community-level Bayesian predictive model has the potential to guide ACF implementers to high-TB-positivity areas for finding undiagnosed TB in the communities, thus improving the efficiency of interventions.

Adolescent sexual and reproductive health (ASRH) is a key public health issue because of its impact on health and development. Adolescent SRH is linked to available information which often determines sexual behaviours. The use of mobile phones for health (mHealth) has shown success in delivering health education and behaviour change interventions for young people for smoking cessation, nutrition and in SRH. This article explores the possible prospects and barriers to the use of mHealth for ASRH promotion in Nigeria. This paper reviews secondary data from international and local literature obtained from database search. A conceptual framework and an applicability and transferability (A&T) tool guided the analysis of ASRH issues and feasibility of mHealth use in ASRH in Nigeria. The prospects of mHealth use for ASRH in Nigeria include the widespread coverage of mobile phone services and the acceptability of its use for health by Nigerian adolescents, unmet need in ASRH information provision and the similarity of some characteristics of Nigerian adolescents to other study populations where mHealth has been successfully used. Other prospects include the Nigerian government’s focus on ICT solutions and the availability of essential technical and organisational expertise for implementation. Possible barriers to the successful use of mHealth include poor funding for ASRH and inadequate information on implementation costs and cost-effectiveness which may make it difficult to present a business case. In conclusion, the use of mHealth in ASRH promotion in Nigeria is feasible and can be effective, however, measures must be taken to address specific barriers identified.

Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of screening and investigation of contacts of patients with TB in Oyo and Osun State, Nigeria. This descriptive-qualitative study was conducted in eight Local Government Areas with high TB burdens. Twenty-four focus group discussions and 30 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents ages ranged from 17–85 years with a mean of 42.08 ± 14.9 years, and (4.0%) had a postgraduate degree. This study identified that the majority of TB contacts who tested negative for TB were unwilling to be placed on TB preventive therapy because of the belief that only a sick person should take drugs. Also, hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB was another existing gap reported in TB contact investigations. The findings emphasise the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.

Factors affecting treatment practices of patent medicine vendors for malaria in under-five children: implications for malaria control in Nigeria

Background: Street hawking is one of the commonest forms of child labor in Nigeria. This study aimed at determining the social implications and factors associated with street hawking among children in Uyo, South-South Nigeria. Materials and Methods: This was a cross-sectional descriptive study carried out in Uyo in April, 2015. The instrument of data collection was a self designed, interviewer administered semi- structured questionnaire. All consenting children aged 5-17 years hawking along major traffic light intersections within Uyo Metropolis during the days of data collection were included in the study. Data was analyzed using SPSS version 20.Level of significance was set at 0.05. Results: A total of 225 respondents participated in the study; 119 (52.9%) were males and 106 (47.1%) females. The mean age of respondents was 13.27 (2.52) years. Only 157 (73.03%) were presently in school, while 48 (21.3%) had dropped out and 10 (4.4%) never went to school. Up to 66 (29.3%) could not communicate fluently in English. Fifty six (35.7%) of those in school reported worsening of their grades since hawking began. A greater number, 168 (74.7%) lived with their parents. The most common singular occupation of respondents’ mothers, 139 (61.8%) and fathers, 52(23.1%) respectively was trading. Up to 42 (18.7%) had lost their fathers. While hawking, 112 (49.8%) were robbed, 82 (36.4%) were involved in fights, 101 (44.9%) were physically harassed by older adults and 6 (2.7%) had been targets of attempted kidnapping. Majority, 145 (64.4%) hawked to augment family income, while 63 (28.8%) hawked to earn a living. More than half, 131 (58.2%) were unhappy with the work and desired to quit. Conclusion: In view of the numerous negative effects of hawking on children, government should implement and enforce the legislation addressing child street hawking in Nigeria and also set up poverty alleviation programmes.