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IntroductionPersistent oral infections with high-risk human papillomavirus (HR-HPV) are a potential cause of most oropharyngeal cancers (OPCs). Oral HR-HPV infection and persistence are significantly higher in people living with HIV (PLWH). Most data on oral HR-HPV in PLWH come from developed countries or adult cohorts. This study aims to investigate oral HR-HPV susceptibility and persistence among children and adolescents living with HIV (CALHIV) and to understand the roles of perinatal HIV exposure, infection, antiretroviral treatment, and the oral microbiome.Methods and analysisThis prospective cohort study is ongoing at the University of Benin Teaching Hospital (UBTH), Nigeria, involving mother-child pairs followed at 6-month intervals for 2 years. Participants include children aged 9–18 and their mothers aged 18 and above. The study targets 690 adolescents in three groups: 230 CALHIV, 230 HIV-exposed but uninfected and 230 HIV-unexposed and uninfected. Oral rinse, saliva, buccal swabs and supragingival plaque samples are collected at each visit. Blood samples are tested for HIV, Hepatitis B virus (HBV) and Hepatitis C virus (HCV), with CD4, CD8 and full blood counts performed. Oral HPV is assessed for incidence, persistence, and clearance. Statistical analyses to look for associations between cohort baseline characteristics and findings will be conducted using univariable and multivariable models for repeated data and high-dimensional microbiome data. All statistical tests will be two-sided; a p value <0.05 will indicate significance. Multiple comparisons will be adjusted using the False Discovery Rate (FDR) correction to control for Type I error.Ethics and disseminationThe study was approved by Rutgers State University (Pro2022000949) and the UBTH (ADM/E22/A/VOL. VII/14813674). Informed consent was obtained from all parents/guardians.

Background HIV infection and its management confer a substantial health burden to affected individuals and have been associated with increased risk of oral and dental diseases. In this study, we sought to quantify HIV-associated differences in the prevalence and severity of dental caries in the primary and permanent dentition of 4–11-year-old Nigerian Children. Methods We used clinical, laboratory, demographic, and behavioral data obtained from an ongoing cohort study of age-matched HIV-infected (HI, n = 181), HIV-exposed-but-uninfected (HEU, n = 177), and HIV-unexposed-and-uninfected (HUU, n = 186) children. Measures of dental caries experience (i.e., prevalence and severity) were based on dmft/DMFT indices recorded by trained and calibrated clinical examiners. Differences in primary and permanent dentition caries experience between HI, HEU, and HUU were estimated using multivariable logistic and negative binomial regression modeling. Results HI children had significantly higher caries experience (33%) compared to HEU (15%) and HUU (22%) children. This difference persisted in fully adjusted analyses [odds ratio (OR) = 1.6; 95% confidence interval (CI) = 1.0–2.6], was most pronounced in the permanent dentition (OR = 3.4; 95% CI = 1.2–9.5), and mirrored differences in caries severity. While molars were predominantly affected in both primary and permanent dentitions, caries lesion patterns differed between dentitions. Caries severity was significantly associated with hypoplastic primary teeth, gingival inflammation, and lower CD4 counts. Conclusions We found that the higher prevalence and severity of dental caries among HI children was driven by increased burden of permanent dentition caries compared to their uninfected counterparts. The dentition-specific associations identified in this study highlight the need to design and implement age-specific caries prevention strategies. These may include intensified oral hygiene regimens aimed at mitigating the cariogenic impact of hyposalivation among HI children. Similarly, the long-lasting impacts of developmental defects of the enamel in the primary and permanent dentitions must not be ignored.

Background The oral microbiome consists of distinct microbial communities that colonize various ecological niches within the oral cavity, the composition of which are influenced by nutrient and substrate availability, host genetics, diet, behavior, age, and other diverse host and environmental factors. Unlike other densely populated human-associated microbial ecosystems (e.g., gut, urogenital), the oral microbiome is directly and frequently exposed to external influences, contributing to its relatively lower stability over time. In individuals with compromised immunity, such as those living with HIV, the composition and stability of the oral microbiome may be especially vulnerable to disruption. Cross-sectional studies of the oral microbiome in children living with HIV capture a glimpse of this temporal dynamism, yet a full appreciation of the relative stability, robusticity, and spatial structure of the oral environment is necessary to understand the role of microbial communities in promoting health or disease in the context of HIV. Here, we investigate the spatial and temporal stability of the oral microbiome over three sampling time points in the context of HIV infection and exposure. Individual teeth were sampled from a cohort of 565 Nigerian children with varying levels of tooth decay severity (i.e., caries disease). We collected 1960 supragingival plaque samples and characterized the oral microbiome using a metataxonomic approach targeting an approximately 478 bp region of the bacterial rpo C gene. Results Both HIV infection and exposure have significant, if subtle, effects on the stability of the supragingival plaque microbiome. Specifically, we observed (1) a slight but significant reduction in taxonomic turnover among HIV-exposed and infected children; (2) an association between HIV infection and a more homogenized oral community across the anterior and posterior dentition in children living with HIV; and (3) a relationship between impaired immunity, lower taxonomic turnover over time, and an elevated frequency of cariogenic taxa, including Streptococcus mutans , in children living with HIV. Conclusions Despite the influence of various contributing factors, we observe an effect of HIV status on both the temporal and spatial stability of the oral microbiome. Specifically, the results presented here indicate that the oral microbiome shows less community change over time in children living with or exposed to HIV, which we hypothesize may be linked to a reduced capacity to adapt to environmental changes. The observed taxonomic rigidity among children living with HIV may signal community dysfunction, potentially leading to a higher incidence of oral diseases, including caries, in this cohort. -7X2s65mtVxV_hGnFfTU7i Video Abstract

Objective Sharp injuries constitute important occupational exposure in hospital environment, and perhaps the newly graduated medical and dental students, known as House Officers, in the first twelve months of their practice, are the most vulnerable of all health workers. This study was designed to examine the nature and prevalence of occupational injuries among medical and dental house officers and factors associated with reporting these injuries. Materials and Methods A self-administered questionnaire was used to obtain information on demography, types of exposure, and barriers to official reporting of occupational injuries. One hundred and forty-four medical and dental house officers in 3 government owned hospitals in Edo State, Nigeria participated in the study, between April and May, 2010. Descriptive and multivariable analyses were performed. Results The overall response rate was 96%. Out of all participants, 69.4% were male; 82.6% were medical house officers. Prevalence of percutaneous injury was 56.9%; where needlestick injury constituted one-third of all injuries. Mean frequency of injury was 1.86±2.24, with medicals having more injuries (p = 0.043). The ward was the most common location for the injury and 14.8% of exposures occurred as a result of lapse in concentration. At least 77.0% did not formally report their injury and perceived low injury risk was the most common reason given (51.67%). Conclusion This study shows that a substantial number of House Officers are exposed to occupational injuries and that the majority of them does not formally report these. Safer work environment may be achieved by implementing adequate educational programs tailored specifically to house officers, and policies encouraging exposure reporting should be developed.

Objective To determine the knowledge and cultural beliefs about the etiology and management of orofacial clefts in Nigeria's major ethnic groups. Design Questionnaires designed to elicit respondents’ knowledge and cultural beliefs about the etiology and management of orofacial clefts. Setting Northern and southern Nigerian communities where the major ethnic groups reside. Participants Consenting, randomly selected individuals. Results There were 650 respondents (350 women and 300 men) from 34 of Nigeria's 36 states; 65.5% were aged 21 to 40 years and 52.5% were married. There were Yoruba (33.7%), Igbo/Bini/Urhobo (40.5%), and Hausa/Fulani (25.8%), with most having attained primary and secondary education. Of those responding, 75% had seen an individual with an orofacial cleft. A significant level of ignorance about the cultural beliefs was found. The Hausa/Fulani considered it mostly an act of God; whereas, the Igbo/Bini/Urhobo and Yoruba groups displayed a greater variety of cultural beliefs. The latter groups implicated witchcraft, evil spirit or devil, the mother, and occasionally the child. Of respondents, 40% knew that surgery was a possible solution, and 22% would recommend a visit to the hospital. Respondents with higher educational attainment produced significantly more scientifically related etiologic factors and accurate treatment options. Conclusion Of respondents, 75% were aware of the existence of orofacial clefts, and a fair knowledge of treatment of orofacial clefts was elicited. Diverse cultural beliefs often may present an obstacle to treatment. Improved awareness about the etiology and management of orofacial clefts is required.

To document the etiology and clinical data of patients with fractures of the zygomatic complex seen in two university teaching hospitals in Nigeria and to compare the findings with other studies in the literature. A six-year retrospective study involving 134 patients with zygomatic complex fractures. These patients were selected from a pool of 960 patients who sustained maxillofacial fractures during the period under review. Recorded were demographic, etiologic and clinical data as well as radiologic findings, treatment and postoperative complications. The Chi-squared test was used to test for significance and p values < 0.05 were regarded as significant. 76.1% were males and 23.9% females. Most (46.3%) patients were aged 21-30 years and road traffic accidents (82.1%) caused the most injuries (p < 0.05). Regarding the site of fracture, 88.8% of the patients had fractures of the zygomatic bone, 8.2% had fractures of the arch, and 3.0% had fractures of both the zygomatic bone and arch. The most frequently associated maxillofacial fracture was mandibular (21.0%). The commonest clinical feature was subconjunctival ecchymosis (63.4%), while the commonest radiologic findings were fractures at the zygomatico-frontal and zygomatico-maxillary sutures (38.8%). The Gillies approach (23.4%) was the commonest method of reduction. This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Urgent enforcement of road traffic legislation is therefore necessary to minimize zygomatic complex fractures due to road traffic accidents. It also showed a low utilization of technological advances in the imaging and treatment of these fractures. These may play a role in the frequency of postoperative complications.

Whole metagenome shotgun sequencing (WMS) is widely used to profile microbial function. However, technical variability in sequencing and analysis often obscures true biological patterns. Large-scale studies are particularly susceptible to batch effects, such as differences in sequencing depth and platform and annotation strategies, as well as sample-to-flow-cell assignments. However, the relative effects of these factors on functional inference in such studies have yet to be systematically evaluated.We analyzed oral-rinse WMS data from a study cohort including 671 Nigerian youths aged 9-18, sequenced on two Illumina platforms. Microbial molecular functionality encoded in these data were annotated using the mi-faser/Fusion pipeline, to capture the broad functional repertoire, and HUMAnN 3/EC numbers pipeline to characterize curated enzymatic activities. We then quantified how technical factors and batch effects shaped the recovery of microbial functionality. Three findings of our work were most salient. First, we observed that the choice of annotation strategy traded off between breadth and specificity of functional coverage. Second, we found that low-prevalence functions were disproportionately lost at shallow sequencing depths, indicating that in e.g. case-control studies with few representatives of the minor class, sequencing depth could critically impact study resolution. Finally, using our newly developed model relating sequencing depth to functional recovery, we demonstrated that increasing sequencing depth does not directly or proportionally improve functional recall. That is, at as little as 10% of this study's sequencing depth, 30% of the estimated complete microbiome functional repertoire was detectable. However, even at the full depth used in this study, we were only able to recover an estimated 60% of that complete functional repertoire. Together, these findings and our depth-to-function mapping framework provide practical guidelines for the design and interpretation of WMS studies. Coordinating sequencing depth planning with annotation strategy, experimental design, and rigorous batch control is thus essential for robust detection of microbial functions and for ensuring reproducible microbiome insights.