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This article makes three important arguments. The first is that one of the most crucial factors in explaining the various outcomes of UN peacekeeping cases over the past seventy-five years can be found in the role of contingencies: the idiosyncratic circumstances that have combined to enable success or failure. The second is that these peacekeeping missions critically demonstrate the importance of focusing attention on the significant role of key domestic, regional, and external actors. The third is that contingencies at these three important levels, rather than any established security patterns or theories, are often the most critical factors in explaining the outcomes of UN peacekeeping missions over the past seven and a half decades. The choices of national and regional actors as well as external great powers often shape how these missions start, develop, and end. Examining interests and motivations in detail thus helps explain how and why UN peacekeeping missions have succeeded or failed. Keywords peacekeeping--United Nations--domestic--regional--external--contingencies--great powers--spoilers, 1 Introduction (1) In this article, I make three key arguments. The first is that one of the most crucial factors in explaining the various outcomes of UN peacekeeping cases [...]

Prior to the discovery of Human Immunodeficiency Virus (HIV), the pattern of tuberculosis (TB) prevalence witnessed a gradual drawdown and the mode of presentation was usually pulmonary. This study assesses the mortality rates of TB and HIV co-infected patients in a directly observed therapy (DOT) centre in Nigeria. The retrospective study retrieved 18 months of data from 197 patients on the TB register of a centralized DOT centre in the Ogun State, Nigeria. Data collected included age, sex, and HIV status, with TB results obtained from Genexpert. The data obtained from 197 TB patients were analyzed using descriptive statistics and chi-square. Out of the 197 TB patients, 67.0% were males and 33.0% were females. A majority of the patients (41.6%) were within the age category of 43 years and above. This was followed by 35 – 42 years (25.4%) and 27 – 34 years (19.8%), while the lowest proportion of patients (0.5%) falls within the age brackets of 3 - 10 years. Furthermore, 92.9% of the patients were HIV negative. Using Chi-squared test, no significant difference was seen in TB occurrence to sex (p>0.05) while age contribute significantly to mortality. Co-infection of HIV/TB was 7.1% while mortality rate in this group was 28.6%. as observed in the age group 43 and above. Overall, the mortality rate in the TB patients was 2.0%. Results showed that the age was a significant contributor (p

Objectives This study assessed the associations of Internalised Homonegativity (IH) with HIV testing and risk behaviours of adult men who have sex with men (MSM) in sub-Saharan Africa (SSA) and effect modification by the legal climate.Design We used data from the cross-sectional 2019 Global Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI+) Internet survey study.Setting and participants Overall, the 2019 Global LGBTI Internet Survey collected data from 46 SSA countries. In this secondary analysis, we included data from 3191 MSM in 44 SSA countries as there were no eligible MSM responses in the 2 countries excluded.Outcome measures Our response variables were self-reported binary indicators of ever tested for HIV, recently tested in the past 6 months (from those who reported ever testing), transactional sex (paying for and being paid for sex in the past 12 months), and unprotected anal sex (that is without a condom or pre-exposure prohylaxis (PrEP)) with a non-steady partner (in the past 3 months).Results Our findings showed high levels of IH (range 1–7) in MSM across SSA (mean (SD)=5.3 (1.36)). We found that MSM with higher IH levels were more likely to have ever (adjusted OR (aOR) 1.18, 95% CI 1.03 to 1.35) and recently tested (aOR 1.19, 95% CI 1.07 to 1.32) but no evidence of an association with paying for sex (aOR 1.00, 95% CI 0.89 to 1.12), selling sex (aOR 1.06, 95% CI 0.95 to 1.20) and unprotected sex (aOR 0.99, 95% CI 0.89 to 1.09). However, we observed that a favourable legal climate modifies the associations of IH and paying for sex (aOR 0.75, 95% CI 0.60 to 0.94). Increasing levels of IH had a negative association with paying for sex in countries where same-sex relationships are legal. We found no associations of IH with unprotected anal sex in the population surveyed.Conclusions We confirm that IH is widespread across SSA but in countries that legalise same-sex relationships, MSM were less likely to engage in transactional sex compared with those in countries where homosexuality is criminalised.

BackgroundAnal precancers and cancers can be detected during screening with high-resolution anoscopy (HRA). The sensitivity of HRA depends on the burden and duration of human papillomavirus (HPV) among those screened as well as anoscopist proficiency, which is highly correlated with prior screening experience. Our objective was to compare the identification and type of HPV and the likelihood of HRA-detected precancer for men who have sex with men (MSM) undergoing their first HRA-screening in Nigeria.MethodsMSM were recruited from an HIV test-and-treat cohort, TRUST/RV368, into a new anal cancer screening program. Anal swabs obtained during screening underwent Ion Torrent next-generation sequencing using barcoded HPV PCR broad-spectrum primers 5+/6+ to detect up to 161 HPVs. All high-risk (HR) HPVs and the most abundant low-risk (LR)-HPVs were evaluated as type-specific infections with some categorized as belonging to a multiple infection. HRA screening results included benign, low-grade squamous intraepithelial lesions (LSIL), or HSIL as detected by cytology or histology. Multivariable logistic regression was used to assess the association of HPV and other cofactors with any SIL.ResultsAmong 342 MSM, 60% were HIV-infected, 89% were under 35 years of age, and 51% had 8 or more years since anal coital debut. Of those with SIL, 89% had LSIL and only 11% had HSIL. Prevalence of any HPV and high-risk (HR)-HPV was 92% and 74%, respectively. The most prevalent genotypes in rank order were HPV6 (31%), HPV16 (23%), HPV42 (20%), HPV11 (18%), HPV45 (18%), and HPV51 (17%). For multiple HR-HPVs, 31% had a single HR-HPV, 32% had 2-3, and 10% had 4 or more. Low-risk HPVs, type 6 and/or 11, were common (42%) and were significantly associated with SIL (adjusted odds ratio [aOR]:1.8, 95% confidence interval [CI]: 1.1-3.1) together with perianal warts (aOR:6.7, 95% CI: 3.3-13.5). In contrast, HR-HPV and multiple HR-HPVs were not significantly associated with SIL (all p > 0.05).ConclusionsDetection of HSIL was low. Although HR-HPV was abundant, HSIL development also depends on the duration of HR-HPV infections and the anoscopist's level of experience. As our cohort ages and the anoscopist becomes more skilled, detection of HSIL will likely improve.

The study investigated how ungoverned spaces promote herder-farmer conflict in Ondo state, South West, Nigeria. Descriptive research design was adopted for the study. Questionnaire, interview and focus group discussion were used to obtain primary data. Simple random sampling technique was employed in selecting 200 respondents. Eighteen in-depth interviews and two discussions were conducted. Quantitative and qualitative data were analysed using descriptive statistics and content analysis. Findings showed that herders used ungoverned spaces as hideouts to carry out attacks against the communities. Herder-farmer conflict led to loss of lives, destruction of property, disruption of socio-economic activities, food insecurity and distrust among ethnic groups. Amotekun security outfit plays crucial roles in monitoring and checkmating herders who use the unmanned forests as hideouts. Anti-grazing law is effective in restricting the movement of herders causing crop destruction. It recommended that the ungoverned spaces should be used for siting of local industries, tourist centres and mechanised farm settlements in order to create employment opportunities, boost food production and eliminate hideouts for the criminal elements. Drones can be deployed to monitor the operation of herders in the forests. Amotekun security outfit should be trained and adequately equipped with weapons for maximum delivery.