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Background The cholera outbreak in 2018 in Nigeria reaffirms its public health threat to the country. Evidence on the current epidemiology of cholera required for the design and implementation of appropriate interventions towards attaining the global roadmap strategic goals for cholera elimination however seems lacking. Thus, this study aimed at addressing this gap by describing the epidemiology of the 2018 cholera outbreak in Nigeria. Methods This was a retrospective analysis of surveillance data collected between January 1st and November 19th, 2018. A cholera case was defined as an individual aged 2 years or older presenting with acute watery diarrhoea and severe dehydration or dying from acute watery diarrhoea. Descriptive analyses were performed and presented with respect to person, time and place using appropriate statistics. Results There were 43,996 cholera cases and 836 cholera deaths across 20 states in Nigeria during the outbreak period, with an attack rate (AR) of 127.43/100,000 population and a case fatality rate (CFR) of 1.90%. Individuals aged 15 years or older (47.76%) were the most affected age group, but the proportion of affected males and females was about the same (49.00 and 51.00% respectively). The outbreak was characterised by four distinct epidemic waves, with higher number of deaths recorded in the third and fourth waves. States from the north-west and north-east regions of the country recorded the highest ARs while those from the north-central recorded the highest CFRs. Conclusion The severity and wide-geographical distribution of cholera cases and deaths during the 2018 outbreak are indicative of an elevated burden, which was more notable in the northern region of the country. Overall, the findings reaffirm the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera in Nigeria.

In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017–18 human monkeypox outbreak in Nigeria. We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. None.

IntroductionThe use of data science for health research produces complex ethical, legal and social challenges that traditional ethical oversight mechanisms struggle to address. In Nigeria, the current ethical guidelines were not designed for these challenges which include pervasive data environments, consent for secondary data use, algorithmic decision-making and bias, privacy risks, involvement of commercial entities, data colonisation, inequitable benefit-sharing and commercial data holdings. To address these gaps, we developed a draft guideline incorporating principles like trust, veracity, global justice and alternative ethical approval mechanisms. Here, we describe the protocol for a study aimed at validating the guideline through stakeholder consensus on the content, feasibility and acceptability of this subcode for national implementation.Methods and analysisWe describe the use of a modified e-Delphi approach to iteratively synthesize expert opinions about ethical oversight for data science health research (DSHR) led by a multidisciplinary working group from the Bridging Gaps in the ELSI of Data Science Health Research in Nigeria (BridgELSI) team. We will invite 65 experts, including health researchers, ethics committee members, data scientists, health policymakers, funders and key opinion leaders in Nigeria to participate. Participants will rate 13 core principles, including global justice, algorithmic bias, data governance and related governance provisions on importance, desirability for inclusion in national guidelines, feasibility and confidence in implementation, using 5-point Likert scales, with optional free-text comments. We will summarise responses using descriptive statistics, assess consensus and polarity using pre-specified thresholds for the mean and IQR, and iteratively refine statements between rounds using qualitative content analysis of comments.Ethics and disseminationEthical approval was obtained from the Nigerian National Health Research Ethics Committee and the University of Maryland IRB, and participants will provide informed consent. Results will be shared with the expert panel and national regulators and disseminated via publications and conferences.

Purpose Biochar and inorganic fertilizer when co-applied have been reported to increase crop yield and enhance soil fertility. However, studies on this complementary effect on soil properties and rain-fed upland rice performance in Sub-Saharan Africa are still scanty. Methods Field factorial studies conducted over 2 years was set up to investigate the interactions between rice husk biochar and inorganic nitrogen (N) fertilizer on a sandy clay loam Alfisol. A two-factor (4 × 4) in RCBD where rice husk biochar was incorporated at four doses, 0, 3, 6, and 12 t/ha −1 , inorganic N fertilizer (urea) at four rates, 0, 30, 60 and 90 N kg/ha −1 , and their combinations was adopted. Results Results showed that combination of biochar and N fertilizer exerted significant ( P  > 0.05) interactive effect on rice harvest index, grain and straw yield and N-use efficiency. Interaction between biochar and N fertilizer increased agronomic efficiency by 140% and grain nutrient recovery by 191% over 2 years. Combination of biochar and N fertilizer reduced soil bulk density, increased water holding capacity and soil chemical status such as pH, N, P, K, Corg, Ca, ECEC and base saturation, all within the top 10 cm depth of the soil. Conclusions Overall, the results established that rice husk biochar can be used as a soil conditioner to enhance upland rice yield on an Alfisol. The combined dose of 3–6 t/ha −1 biochar and 30 kg/ha −1 of N fertilizer is thus recommended for upland rice farmers in the study area.

Background Women in low- and middle-income countries (LMIC) remain at high risk of developing cervical cancer and have limited access to screening programs. The limits include geographical barriers related to road network characteristics and travel behaviors but these have neither been well studied in LMIC nor have methods to overcome them been incorporated into cervical cancer screening delivery programs. Methods To identify and evaluate spatial barriers to cervical cancer prevention services in Ondo State, Nigeria, we applied a Multi-Mode Enhanced Two-Step Floating Catchment Area model to create a spatial access index for cervical cancer screening services in Ondo City and the surrounding region. The model used inputs that included the distance between service locations and population centers, local population density, quantity of healthcare infrastructures, modes of transportation, and the travel time budgets of clients. Two different travel modes, taxi and mini bus, represented common modes of transit. Geocoded client residential locations were compared to spatial access results to identify patterns of spatial access and estimate where gaps in access existed. Results Ondo City was estimated to have the highest access in the region, while the largest city, Akure, was estimated to be in only the middle tier of access. While 73.5% of clients of the hospital in Ondo City resided in the two highest access zones, 21.5% of clients were from locations estimated to be in the lowest access catchment, and a further 2.25% resided outside these limits. Some areas that were relatively close to cervical cancer screening centers had lower access values due to poor road network coverage and fewer options for public transportation. Conclusions Variations in spatial access were revealed based on client residential patterns, travel time differences, distance decay assumptions, and travel mode choices. Assessing access to cervical cancer screening better identifies potentially underserved locations in rural Nigeria that can inform plans for cervical cancer screening including new or improved infrastructure, effective resource allocation, introduction of service options for areas with lower access, and design of public transportation networks.

Background Virological outcome is a critical determinant of care in HIV management, as highlighted in the third portion of the UNAIDS 95–95-95 fast-track targets, emphasizing viral load suppression as an essential strategy for epidemiological control of HIV by 2030. There have been various reports regarding Nigeria's recent position, particularly concerning viral load suppression. This study aimed to determine the virological outcomes and associated predictors among HIV-infected individuals on highly active antiretroviral therapy (HAART) in three treatment facilities in Osogbo, Southwest Nigeria. Methodology This descriptive cross-sectional study involved 830 HIV-infected participants recruited from three treatment facilities in Osogbo, Nigeria, over eight months. The participants completed a proforma documenting their sociodemographic and clinical details as well as their responses to questions about HIV care (independent variables). Blood samples were collected for HIV viral load assays, with results defined as good (< 1000 copies/ml) or poor (≥ 1000 copies/ml) virological outcomes. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Associations between dependent (good and poor virological outcomes) and independent variables were assessed using bivariate analysis (Pearson’s chi-square test). Multivariate analysis (binomial regression) was employed to determine predictors of virological outcomes. Statistical significance was set at a P value < 0.05, and confidence intervals were calculated at 95%. Results The prevalence rates of poor and good virological outcomes were 15.54% and 84.46%, respectively. Predictors of virological outcomes included residential status, socioeconomic status (middle), adherence to HAART, knowledge of HIV medications and their side effects, comorbidity status, depression, pill quantity, disclosure status, family support, stigma, and discrimination ( p  < 0.05). Conclusion Although the good virological outcome (suppression) prevalence still fell short of the advocated 95%, improving adherence counseling, increasing financial empowerment to ease transportation costs to clinics, and eliminating stigmatization and discrimination in care are needed to enhance and sustain the HIV response.

Data science health research (DSHR) uses novel computational methods and high-performance computing to analyze big data from conventional and nonconventional health and related sources to generate novel insights and communications. DSHR creates assets but generates ethical, legal, and social challenges. Key gaps in current ethical oversight of DSHR include blurred boundaries between research and nonresearch data use, inadequate protection of data donors, power imbalances that risk extractive research practices, algorithmic biases, and regulatory inadequacies. Nigeria, a typical low- and middle-income country with rapidly expanding DSHR, exemplifies this environment and concerns. This study will elicit answers from Nigerian DSHR stakeholders and contribute to understanding the ethical, legal, and social implications (ELSI) of DSHR and developing novel ethical oversight frameworks. Between October 2024 and January 2025, we conducted Key Informant Interviews with 65 stakeholders of 87 individuals. The Key Informant Interview guide comprised 11 construct-based question domains addressing awareness of policies and laws, ethical oversight processes, ELSI considerations in policy development, experiences addressing DSHR challenges, organizational and procedural frameworks, ideal oversight components, stakeholder roles, research impact on ethics and policy, regulatory influences on research practices, equity-enhancing policies, and balanced regulations. The interviews lasted 60-90 minutes and were transcribed. We analyzed the transcripts using a hybrid deductive-inductive approach. A priori codes derived from research objectives provided the analytical framework while allowing for the identification of emergent concepts. The iterative 3-level coding process involved initial code generation, evaluation, and refinement, with codes grouped into thematic families and semantic networks representing hierarchical concept relationships. Query tools and Boolean operators were used to interrogate the codes to extract findings. Of 87 invited individuals, 22 (25%) were unable to participate. The 65 participants (age: mean 47.9, SD 7.9 years; 50/65, 77% male) included data science health researchers (25/65, 39%), biomedical researchers (17/65, 26%), Health Research Ethics Committee members (12/65, 19%), and policymakers (11/65, 17%). Most held doctoral degrees (38/65, 57%) and were affiliated with academic institutions (45/65, 69%) and government organizations (26/65, 40%), and had received general research ethics training (50/65, 77%). However, only 12% (8/65) had received predominantly short-duration ethics-specific DSHR training, while 92% (60/65) acknowledged the need for specialized DSHR ethics education. As of January 2025, the interview transcripts have been generated, with checking completed, with qualitative analysis scheduled for completion by March 2025 and completion of primary manuscripts by the end of 2025. This study will generate stakeholder-informed recommendations for ethical oversight of DSHR that address issues relating to broad consent, ELSI, data ownership, benefit-sharing, and donor protection in resource-limited settings. Our findings will inform global DSHR and research ethics communities on the development of contextually appropriate oversight mechanisms that promote equitable partnerships, co-ownership, and tiered data governance. DERR1-10.2196/78557.

Background Schistosomiasis is a neglected tropical disease that disproportionately affects underprivileged populations, especially school-aged children and adolescents who are frequently exposed to infested water sources. Effective control requires combining treatment with preventive strategies such as health education. Methods This quasi-experimental study assessed the effect of context-specific health education and praziquantel treatment on knowledge, attitude, and risky practices (KAP) regarding schistosomiasis among primary school children in riverine communities of Osun State, Nigeria. Using multistage sampling, 201 and 203 pupils were recruited into intervention and control groups, respectively. A pre-tested facilitated self-administered questionnaire was used to collect data at baseline and post-intervention. The study was conducted from March to October 2024 in three phases: pre-intervention to identify prevalence of Schistosoma haematobium and Schistosoma mansoni and KAP towards Schistosomiasis, Intervention (health education sessions and treatment of positive cases), and post-intervention. Data were analyzed with IBM SPSS version 25, using Chi-square to test associations, with significance set at p < 0.05. Results The prevalence of schistosomiasis significantly declined in the intervention group, from 16.9% at baseline to 3.6% post-intervention, while no reduction was observed in the control group (15.8% at both baseline and post-intervention). Risky practices slightly decreased in the intervention group (88.1% to 87.0%, p > 0.05), whereas they increased in the control group (82.3% to 83.9%). Knowledge improved markedly from 27.9% to 99.5%, and favorable attitudes rose from 68.2% to 80.2% in the intervention group (p < 0.05). Conclusion Context-specific health education, combined with treatment of positive cases, significantly reduced schistosomiasis prevalence and improved knowledge and attitudes among school-aged children and adolescents. This approach is vital for effective schistosomiasis control in endemic communities.

BackgroundSchistosomiasis is a major public health problem in sub-Saharan Africa. Despite the World Health Organization’s recommendation for a widespread distribution of praziquantel, the prevalence of schistosomiasis continues to be alarmingly high. This study explored the barriers to the mass distribution of praziquantel from the perspective of the lived experience of health care workers and provided recommendations to improve the coverage and effectiveness of the mass distribution of praziquantel towards the control of schistosomiasis in Bauchi State, Nigeria.MethodsThis was a phenomenological study that explored the lived experiences of health care workers in the mass distribution of praziquantel. The study utilized focused group discussionss to collect data from health care workers in six local government areas in Bauchi State, selected via a multistage sampling technique. The data were collected via semistructured questions. The interviews were recorded and transcribed. Thematic analysis was performed via ATLASti software.ResultsThe study findings indicated that the fear of side effects, stigmatization, financial constraints, distance to health centers, lack of awareness or understanding of the drug, religious and cultural beliefs were community-related barriers to the mass distribution of praziquantel. Low drug stocks, lack sufficient trained health workers, transportation challenges, weak organization structure, financial and incentive limitations were identified as organizational barriers to the mass distribution of praziquantel.ConclusionsTackling issues associated with drug availability, the well-being of health care personnel, community education, and logistical challenges are important steps toward the successful mass distribution of praziquantel for the control of schistosomiasis.

Choline is an essential nutrient with many roles in brain development and function. Supplementation of choline in early development can have long-lasting benefits. Our experiments aimed to determine the efficacy of choline supplementation in a postnatal day (PND) 10 rat model of neonatal hypoxia ischemia (HI) at term using both male and female rat pups. Choline (100 mg/kg) or saline administration was initiated the day after birth and given daily for 10 or 14 consecutive days. We determined choline’s effects on neurite outgrowth of sex-specific cultured cerebellar granule cells after HI with and without choline. The magnitude of tissue loss in the cerebrum was determined at 72 h after HI and in adult rats. The efficacy of choline supplementation in improving motor ability and learning, tested using eyeblink conditioning, were assessed in young adult male and female rats. Overall, we find that choline improves neurite outgrowth, short-term histological measures and learning ability in males. Surprisingly, choline did not benefit females, and appears to exacerbate HI-induced changes.