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5 result(s) for "Abdullahi, Fatima L"
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Cost-effectiveness of different tuberculosis diagnostic approaches in Nigeria based on decision analytical modelling
BackgroundTuberculosis (TB) remains a leading cause of morbidity and mortality in Nigeria, particularly among people living with HIV (PLWH), who face significantly higher risks of developing active TB. Conventional diagnostic methods such as sputum smear microscopy and chest radiography often fail to detect TB accurately in this population due to smear-negative presentations and atypical radiographic findings. Recent diagnostic innovations, including the Xpert MTB/RIF Ultra, TB lipoarabinomannan (TB-LAM) and TB loop-mediated isothermal amplification (TB-LAMP) tests, offer improved sensitivity and specificity, but their cost-effectiveness in resource-limited settings remains unclear.MethodsIn this economic evaluation, we combined a decision tree with cost-effectiveness analysis to compare three TB diagnostic algorithms tailored for PLWH in Nigeria: (1) Xpert MTB/RIF Ultra following chest radiography (chest X-ray; CXR), (2) TB-LAM following CXR and (3) TB-LAMP following CXR. Data on test accuracy, costs and TB prevalence were obtained from systematic reviews and meta-analyses, with costs adjusted for inflation and local purchasing power. We estimated the incremental cost-effectiveness ratios (ICERs) for the three diagnostic approaches. Sensitivity analyses were conducted to assess the robustness of results across varying input parameters.ResultsTB/LAM was found to be the most cost-effective option at a cost of US$17 per TB case detected when compared with US$20 and US$22 per TB case detected for the baseline strategy of Xpert MTB/RIF Ultra and TB-LAMP, respectively. These ICERs are consistent with willingness-to-pay thresholds set at three times Nigeria’s gross domestic product (GDP) and remained robust over a wide range of costs and epidemiological parameter inputs.ConclusionAmong PLWH in Nigeria, the TB-LAM algorithm represents the most cost-effective diagnostic strategy. However, the Xpert MTB/RIF Ultra may provide additional value in settings with sufficient infrastructure and funding. This study underscores the need for tailored diagnostic approaches that balance accuracy, scalability and affordability to enhance TB detection and management in vulnerable populations.
Knowledge, risk perception and uptake of COVID-19 vaccination among internally displaced persons in complex humanitarian emergency setting, Northeast Nigeria
Background Owing to crowded and unsanitary conditions, internally displaced persons (IDPs) have an increased risk of COVID-19 infection. Adoption of COVID-19 preventive measures among this population is premised on accurate information, adequate knowledge, and risk perception. We assessed COVID-19 knowledge and risk perception and investigated the association between risk perception and COVID-19 preventive measures, including vaccination among IDPs in Northeast Nigeria. Methods We conducted a cross-sectional study during July–December 2022 and sampled 2,175 IDPs using stratified sampling. We utilized a 12-point assessment tool to evaluate COVID-19 knowledge. Participants who scored ≥ 6 points were considered to have adequate knowledge. We used a 30-item Risk Behavior Diagnosis Scale to assess COVID-19 risk perception and evaluated each item on a 5-point Likert scale. Participants were divided into risk perception categories by the median of Likert scale scores. We performed weighted logistic regression analysis to identify factors associated with risk perception. Pearson’s chi-squared with Rao-Scott adjustment was used to determine the relationship between risk perception and COVID-19 preventive measures. Results Of 2,175 participants, 55.7% were 18–39 years old, 70.9% were females, and 81.7% had no formal education. Among the IDPs, 32.0% (95% CI: 28.8 – 35.0) were considered to have adequate COVID-19 knowledge, and 51.3% (95% CI: 47.8 – 54.8) perceived COVID-19 risk as high. Moreover, 46.3% (95% CI: 42.8 – 50.0) had received one dose of COVID-19 vaccine, and 33.1% (95% CI: 29.8 – 36.0) received two doses. Adequate knowledge (Adjusted Odds Ratio (AOR) = 2.10, [95% CI: 1.46 – 3.03]) and post-primary education (AOR = 3.20, [95% CI: 1.59 – 6.46]) were associated with risk perception. Furthermore, high risk perception was significantly associated with wearing face masks (χ 2  = 106.32, p -value < .001), practicing hand hygiene (χ 2  = 162.24, p -value < .001), physical distancing (χ 2  = 60.84, p -value < .001) and vaccination uptake (χ 2  = 46.85, p -value < .001). Conclusions This study revealed gaps in COVID-19 knowledge, risk perception, and vaccination uptake but demonstrated a significant relationship between risk perception and COVID-19 preventive practices. Health education and risk communication should be intensified to improve knowledge, elicit stronger risk perception, and enhance COVID-19 preventive practices.
Promoting the genomic revolution in Africa through the Nigerian 100K Genome Project
To leverage the genetic diversity in Nigeria, we established the Non-Communicable Diseases Genetic Heritage Study (NCD-GHS) consortium to help produce a comprehensive catalog of human genetic variation in Nigeria and assess the burden and etiological characteristics of non-communicable diseases in 100,000 adults in Nigeria.
Cost-effectiveness of introducing a maternal vaccine or long-acting monoclonal antibody to prevent infant respiratory syncytial virus disease in Nepal
The World Health Organization recommends two passive immunisation strategies to prevent respiratory syncytial virus (RSV) disease in young infants. Both are being introduced in high-income settings, but their affordability and cost-effectiveness have not been evaluated in many low- and middle-income countries. Preliminary estimates of cost-effectiveness are needed to guide immunisation policy and planning in Nepal. We estimated the potential health impact and cost-effectiveness of introducing a maternal vaccine (RSVpreF) or long-acting infant monoclonal antibody (mAb) (nirsevimab) over the period 2025-34 in Nepal. We compared both interventions to the status quo (no intervention) and to each other. Model inputs included health care cost estimates from a recent prospective cost-of-illness study in Kathmandu, as well as the latest efficacy data from clinical trials. The primary outcome measure was the incremental cost (2023 USD) per disability-adjusted life year (DALY) averted from a governmental health perspective. We conducted a range of deterministic analyses, including scenarios that incorporated a societal perspective and a seasonal approach. Additionally, we performed probabilistic uncertainty analyses to assess decision uncertainty and estimated the likelihood of cost-effectiveness for each intervention across a range of willingness-to-pay thresholds. Introducing a maternal vaccine (USD 5/dose, 81% coverage, 69% efficacy, 6 months protection) or long-acting infant mAb (USD 5/dose, 97% coverage, 77% efficacy, 5 months protection) could prevent >2300 deaths and >50 000 hospital admissions over ten years. The discounted immunisation programme costs were estimated to be USD 30 and USD 35 million, respectively. Compared to the status quo, the maternal vaccine and the long-acting infant mAb were estimated to cost USD 387 and USD 486 per DALY averted, respectively, which is around 0.3 times and 0.4 times the national gross domestic product (GDP) per capita. There was a 95% probability that the maternal vaccine would be cost-effective at USD 5 per dose, assuming a willingness-to-pay threshold of 0.5 times the national GDP per capita. With our base case assumptions, the maternal vaccine dominated the mAb (i.e. generated more health benefits at a lower cost). However, the results (and the rank order of interventions) were sensitive to the dose price, efficacy, duration of protection, and RSV disease burden estimates. Cost-effectiveness of the mAb improves with timely administration or when a seasonal approach is implemented. New passive immunisation strategies have the potential to prevent a substantial number of RSV-related hospitalisations and deaths in Nepal. Cost-effectiveness and product choice will heavily depend on the price negotiated for each product.
Mushroom Bioactive Molecules as Anticancerous Agents: An Overview
Mushrooms have long been used in Traditional Chinese medicine (TCM), where they play an important role in promoting overall health and well‐being. However, the therapeutic benefits of mushrooms have made this group of macrofungi a significant part of traditional medicine, particularly in Southeast Asia and China. Across the globe, cancer is the leading cause of death. Powerful anti‐cancer medications known as traditional chemotherapeutic agents treat this dangerous disease. However, patients are always accompanied by immunosuppression, increasing the risk of tumor return and mortality. Identifying, separating, and transferring bioactive macromolecules naturally present in tumor‐genic foods could be a promising option. Mushrooms are a source of macromolecules such as ergosterol, p‐hydroxybenzoic acid, linoleic acid, β‐glucan, α‐glucan, resveratrol, concanavalin A, Cibacron blue affinity protein, and others. Numerous studies have demonstrated that oyster mushroom extracts are full of macromolecules like β‐glucan and other polysaccharides that inhibit the proliferation of cancer cell types without affecting healthy cells. The genera Phellinus, Pleurotus, Agaricus, Ganoderma, Clitocybe, Antrodia, Trametes, Cordyceps, Xerocomus, Calvatia, Schizophyllum, Flammulina, Suillus, Inonotus, Inocybe, Funlia, Lactarius, Albatrellus, Russula, and Fomes are the mushrooms that have been linked to success against cancer. The anticancerous substances are essential because they create reactive oxygen species, inhibit mitotic kinase, prevent mitosis, inhibit angiogenesis, and topoisomerase, which ultimately stop cancer growth. This review provides the most recent results on the pharmacologically active chemicals, their potential as antitumor agents, and the underlying mechanism of biological activity. This review discusses the molecular mechanisms through which these compounds inhibit cancer progression, including the induction of reactive oxygen species, inhibition of mitotic kinase and angiogenesis, and suppression of topoisomerase activity. By providing the latest insights on these anti‐tumor agents and their pharmacological actions, our review aims to contribute valuable information to the field of cancer research and support the development of novel therapeutic strategies.