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Introduction: Antenatal care (ANC) is crucial for positive pregnancy outcomes, but it is underutilised in Nigeria, suggesting unmet needs, and potentially contributing to the country's high burden of maternal and neonatal mortalities. This study comprehensively assesses ANC utilisation and receipt of its components in Nigeria, focusing on disparities between rural and urban areas. Methods: We used the data disaggregation approach to analyse the Nigeria Demographic and Health Survey 2018. We estimated ANC utilisation, assessed the receipt of ANC components, and identified factors associated with eight or more (≥ 8) ANC contacts nationally and across rural and urban residences. Results: Nationwide, only 20.3% of women had ≥ 8 ANC contacts, with a significant disparity (P < 0.001) between urban (35.5%) and rural (10.4%) areas in Nigeria. The North-East region had the lowest ANC utilisation nationally (3.7%) and in urban areas (3.0%), while the North-West had the lowest in rural areas (2.7%). Nationally, 69% of mothers received iron supplements, 70% had tetanus injections, and 16% received medicines for intestinal parasites, with urban residents having higher proportions across all ANC components. Maternal and husband education, health insurance, and maternal autonomy were associated with increased ANC odds at the national, rural, and urban residences. However, differences exist, with all ethnicities having higher ANC odds than the Hausa/Fulanis in urban areas and the Yorubas demonstrating greater odds than other ethnicities in rural settings. Internet use was significant only in the national context, watching television only in urban settings, while maternal working status, wealth, birth type, religion, and radio listenership were significant in rural areas. Conclusion: Our study reveals significant disparities in ANC utilisation and components across Nigeria, with rural residents, particularly in northern regions, as well as socioeconomically disadvantaged and teenage mothers facing notable challenges. A multifaceted approach prioritising the interplay of intersectional factors like geography, socioeconomic status, education, religion, ethnicity, and gender dynamics is essential. Key strategies should include targeted interventions to promote educational opportunities, expand health insurance coverage, leverage internet and context-specific media, and foster socioeconomic empowerment, with priority for underserved populations. [ABSTRACT FROM AUTHOR]

Background Whilst information has been published on the impact, severity and causes of incidents involving medicines in care homes, it has not been systematically described. This review explored whether coroners' Preventing Future Death (PFD) reports involving medicines for people living in care homes could add to this evidence base. Methods PFD reports made publicly available between 2017 and 2021 classified as 'care home-related deaths' were reviewed. Reports describing medicines and/or medicines processes were identified. Contributory factors within these reports were then identified. Results Within the timeframe, 156 reports were published, and 25 described medicines (n = 27) or medicines processes (n = 5) concerning people living in care homes. The impact of medicines and/or medicines processes was quantified as no impact (n = 7), contributory (n = 6) and direct (n = 14) per report. Two key themes emerged. Four deaths had an association between their falls risk, prescribed anticoagulants, and the failure of the service to seek timely emergency care following a fall and two deaths concerned endocrine medicines, where people refused insulin or blood sugar monitoring and staff did not seek timely advice. Conclusion This study demonstrated PFD reports provide an insight into the potential association between medicines, and other aspects of the person's care in causing harm. [ABSTRACT FROM AUTHOR]

Objective To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. Methods Embase[R], PubMed[R] and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. Findings Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. Conclusion The evidence available suggests that almost one half of health-care workers in Africa were occupational exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers. Objectif Estimer la prevalence au cours de la vie et sur 12 mois de l'exposition professionnelle aux liquides organiques des agents de sante en Afrique. Methodes Nous avons systematiquement recherche dans les bases de donnees Embase[R], PubMed[R] et CINAHL des etudes publiees entre janvier 2000 et aout 2017 documentant la prevalence de l'exposition professionnelle au sang ou a d'autres liquides organiques des agents de sante en Afrique. La prevalence de l'exposition dans l'ensemble du continent a ete estimee a l'aide d'une meta-analyse a effets aleatoires. Resultats Sur les 904 articles reperes, 65 etudes menees dans 21 pays africains ont ete selectionnees. La prevalence combinee au cours de la vie et sur 12 mois de l'exposition professionnelle aux liquides organiques etait estimee a 65,7% (intervalle de confiance, IC a 95%: 59,7-71,6) dans le premier cas et 48,0% (IC a 95%: 40,7-55,3) dans le second, exposition etait en grande partie due a des lesions percutanees, la prevalence sur 12 mois etant estimee a 36,0% (IC a 95%: 31,2-40,8). La prevalence combinee sur 12 mois de l'exposition professionnelle etait de 46,6% (IC a 95%: 33,5-59,7) chez les medecins (a l'exception des chirurgiens), de 44,6% (IC a 95%: 34,1-55,0) chez les infirmiers (sages-femmes et infirmiers auxiliaires compris) et de 34,3% (IC a 95%: 21,8-46,7) chez le personnel de laboratoire (techniciens de laboratoire compris). Le risque d'exposition etait plus eleve chez les agents de sante n'ayant pas ete formes a la prevention des infections et chez ceux qui travaillaient plus de 40 heures par semaine. Conclusion D'apres les donnees disponibles, pres de la moitie des agents de sante en Afrique sont exposes chaque annee aux liquides organiques dans le cadre de leur travail. Le manque de donnees dans certains pays a neanmoins constitue une limite majeure. Les gouvernements nationaux et les etablissements de sante de l'ensemble du continent doivent donner un degre de priorite eleve aux efforts visant a minimiser l'exposition professionnelle des agents de sante. Objetivo Hacer una estimacion del tiempo de vida y la prevalencia de 12 meses de exposicion profesional a fluidos corporales entre los profesionales sanitarios en Africa. Metodos Se realizo una busqueda sistematica en las bases de datos Embase[R], PubMed[R] y CINAHL de estudios publicados entre enero de 2000 y agosto de 2017 que mostraran la prevalencia de la exposicion profesional a sangre u otros fluidos corporales entre los profesionales sanitarios en Africa. La prevalencia de la exposicion en todo el continente se estimo utilizando un meta-analisis de efectos aleatorios. Resultados De los 904 articulos identificados se incluyeron 65 estudios de 21 paises africanos. El tiempo de vida estimado en conjunto y la prevalencia de 12 meses de exposicion profesional a fluidos corporales fue de un 65,7% (intervalo de confianza, IC, 95%: 59,7-71,6) y 48,0% (95% IC:40,7-55,3), respectivamente. La exposicion se debia en su mayor parte a heridas percutaneas, con una prevalencia estimada durante 12 meses del 36,0% (95% IC: 31,2-40,8). La prevalencia durante 12 meses de exposicion profesional en conjunto entre los medicos (excepto los cirujanos), enfermeras (incluidas las matronas y las auxiliares de enfermeria) y el personal de laboratorio (incluidos los tecnicos de laboratorio) fue del 46,6% (95% IC: 33,5-59,7), 44,6% (95% IC: 34,1-55,0) y del 34,3% (95% IC: 21,8-46,7), respectivamente. El riesgo de exposicion fue mas alto entre los profesionales sanitarios sin formacion en el ambito de la prevencion de infecciones y entre aquellos que trabajaban mas de 40 horas a la semana. Conclusion Las pruebas disponibles sugieren que casi la mitad de todos los trabajadores sanitarios en Africa estan expuestos profesionalmente a fluidos corporales cada ano. Sin embargo, la falta de datos de algunos paises supuso una gran limitacion. Por lo tanto, los gobiernos nacionales y las instituciones sanitarias africanas deberian priorizar los esfuerzos para disminuir la exposicion entre los profesionales sanitarios., Introduction Worldwide, health-care workers risk occupational exposure to blood-borne pathogens through contact with human body fluids. Although about 60 blood-borne infectious pathogens have been identified, including Epstein-Barr virus, most occupation-related, [...]

Background Physical activity is crucial to preventing noncommunicable diseases. This study aimed to provide up-to-date evidence on the epidemiology of insufficient physical activity across Nigeria to increase awareness and prompt relevant policy and public health response. Methods A systematic literature search of community-based studies on physical inactivity was conducted. We constructed a meta-regression epidemiologic model to determine the age-adjusted prevalence and number of physically inactive persons in Nigeria for 1995 and 2020. Results Fifteen studies covering a population of 13 814 adults met our selection criteria. The pooled crude prevalence of physically inactive persons in Nigeria was 52.0% (95% CI: 33.7–70.4), with prevalence in women higher at 55.8% (95% CI: 29.4–82.3) compared to men at 49.3% (95% CI: 24.7–73.9). Across settings, prevalence of physically inactive persons was significantly higher among urban dwellers (56.8%, 35.3–78.4) compared to rural dwellers (18.9%, 11.9–49.8). Among persons aged 20–79 years, the total number of physically inactive persons increased from 14.4 million to 48.6 million between 1995 and 2020, equivalent to a 240% increase over the 25-year period. Conclusions A comprehensive and robust strategy that addresses occupational policies, town planning, awareness and information, and sociocultural and contextual issues is crucial to improving physical activity levels in Nigeria. [ABSTRACT FROM AUTHOR]

Background Unsafe injection practices contribute to increased risks of blood-borne infections, including human immunodeficiency virus, hepatitis B and hepatitis C viruses. The aim of this study was to estimate the prevalence of medical injections as well as assess the level of access to sterile injection equipment by demographic factors in low- and middle-income countries (LMICs). Methods We carried out a meta-analysis of nationally representative Demographic and Health Surveys (DHSs) conducted between 2010 and 2017 in 39 LMICs. Random effects meta-analysis was used in estimating pooled and disaggregated prevalence. All analyses were conducted using Stata version 14 and Microsoft Excel 2016. Results The pooled 12-month prevalence estimate of medical injection was 32.4% (95% confidence interval 29.3–35.6). Pakistan, Rwanda and Myanmar had the highest prevalence of medical injection: 59.1%, 56.4% and 53.0%, respectively. Regionally, the prevalence of medical injection ranged from 13.5% in west Asia to 42.7% in south and southeast Asia. The pooled prevalence of access to sterile injection equipment was 96.5%, with Pakistan, Comoros and Afghanistan having comparatively less prevalence: 86.0%, 90.3% and 90.9%, respectively. Conclusions Overuse of medical injection and potentially unsafe injection practices remain a considerable challenge in LMICs. To stem the tides of these challenges, national governments of LMICs need to initiate appropriate interventions, including education of stakeholders, and equity in access to quality healthcare services. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence and determine the factors associated with the use of antibiotics in the management of non-bloody diarrhoea in children under 5 years of age in sub-Saharan Africa (SSA).Methods: We conducted a meta-analysis of demographic and health survey data sets from 30 countries in SSA. Pooled prevalence estimates were calculated using random effects model. Χ2 tests were employed to determine the factors associated with the antibiotic use.Results: The pooled prevalence of antibiotic use among cases of non-bloody diarrhoea in children under 5 years of age was 23.1% (95% CI 19.5 to 26.7). The use of antibiotics in children with non-bloody diarrhoea in SSA was associated with (p<0.05) the source of care, place of residence, wealth index, maternal education and breastfeeding status.Conclusion: We found an unacceptably high use of antibiotics to treat episodes of non-bloody diarrhoea in children under the age of 5 in SSA. [ABSTRACT FROM AUTHOR]

Objectives: To quantify the epidemiology of bladder cancer in Africa to guide a targeted public health response and support research initiatives. Methods: We systematically searched publicly available sources for population‐based registry studies reporting the incidence of bladder cancer in Africa between January 1980 and June 2017. Crude incidence rates of bladder cancer were extracted. A Bayesian network meta‐analysis model was used to estimate incidence rates. Results: The search returned 1328 studies. A total of 22 studies carried out across 15 African countries met our pre‐defined selection criteria. Heterogeneity across studies was high (I2 = 98.9%, P < 0.001). The pooled incidence of bladder cancer in Africa was 7.0 (95% credible interval 5.8–8.3) per 100 000 population in men and 1.8 (95% credible interval 1.2–2.6) per 100 000 in women. The incidence of bladder cancer was consistently higher in North Africa in both sexes. Among men, we estimated a pooled incidence of 10.1 (95% credible interval 7.9–11.9) per 100 000 in North Africa and 5.0 (95% credible interval 3.8–6.6) per 100 000 in sub‐Saharan Africa. In women, the pooled incidence was 2.0 (95% credible interval 1.0–3.0) per 100 000 and 1.5 (95% credible interval 0.9–2.0) per 100 000 in North Africa and sub‐Saharan Africa, respectively. Incidence rates increased significantly among men from 5.6 (95% credible interval 4.2–7.2) in the 1990s to 8.5 (95% credible interval 6.9–10.1) per 100 000 in 2010. Conclusions: The present study suggests a growing incidence of bladder cancer in Africa in recent years, particularly among men and in North Africa. This study also highlights the lack of quality data sources and collection of essential clinical and epidemiological data in several African countries, and this hinders public health planning. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study was carried out to: (1) explore the views of pharmacists in Nigeria on the extension of prescribing authority to them and determine their willingness to be prescribers and (2) identify the potential facilitators and barriers to introducing pharmacist prescribing in Nigeria. Method: An online cross‐sectional survey was conducted from August to October 2014 among 775 pharmacists recruited from the Facebook group of the Pharmaceutical Society of Nigeria using a simple random technique. The questionnaire used for the survey was developed based on the review of the literature and previous qualitative studies conducted in Nigeria. The instrument was evaluated for content validity by two external pharmacy practice researchers and the reliability of items assessed using internal consistency tests. Data obtained from the survey were entered into SPSS v.22, and descriptive statistics were generated. Relationships between variables were evaluated using the chi‐square test, and P < 0.05 was considered statistically significant. Key findings: The response rate was 40.6% (315/775). Three hundred and six (97.1%) respondents agreed that pharmacists should be given prescribing authority. Of these 306, 295 (96.4%) were willing to be prescribers, and just over half of them (148/295; 50.2%) would prefer to prescribe in collaboration with medical doctors. Of those willing to be prescribers, 285 (96.6%) reported that they would need additional training. The most perceived areas of training needed were in the principles of differential diagnosis (81.4%), pathophysiology of diseases (74.0%) and interpretation of laboratory results (68.1%). Respondents identified increasing patients’ access to care (308/315; 97.8%) and better utilisation of pharmacists’ skills (307/315; 97.5%) as the most likely facilitators to pharmacist prescribing in Nigeria. On the other hand, resistance from the medical doctors (299/315; 94.9%) and pharmacists’ inadequate skills in diagnosis (255/315; 81.0%) were perceived as the most likely barriers. Conclusion: Pharmacist prescribing represents an opportunity to promote patients’ access to care and the utilisation of pharmacists’ skills in Nigeria. The majority of pharmacists showed a positive attitude towards pharmacist prescribing and were willing to be prescribers. The findings of this study could potentially contribute to future medicine prescribing policy and pharmacy practice in Nigeria. [ABSTRACT FROM AUTHOR]

Background: This study investigates and compares the rates and factors associated with early initiation of breastfeeding (EIBF) within one hour of birth in rural and urban Nigeria. Methods: Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were analyzed. The rates of EIBF were reported using frequency tabulation. Associated factors were examined using Chi-Square test and further assessed on multivariable logistic regression analysis. Results: The rates of EIBF were 30.8% (95% confidence interval [CI] 29.0, 32.6) and 41.9% (95% CI 39.6, 44.3) in rural and urban residences, respectively (p < 0.001). The North-Central region had the highest EIBF rates both in rural (43.5%) and urban (63.5%) residences. Greater odds of EIBF in rural residence were significantly associated with higher birth order (Adjusted Odds Ratio [AOR] 1.29, 95% CI 1.10, 1.60), large birth size (AOR 1.33, 95% CI 1.10, 1.60), and health facility delivery (AOR 1.46, 95% CI 1.23, 1.72). Rural mothers in the rich wealth index, not working and whose husbands obtained at least a secondary school education had significantly higher odds of early initiation of breastfeeding. Regardless of residence, greater odds of EIBF were significantly associated with non-cesarean delivery (Rural AOR 3.50, 95% CI 1.84, 6.62; Urban AOR 2.48, 95% CI 1.60, 3.80) and living in North-Central (Rural AOR 1.84, 95% CI 1.34, 2.52; Urban AOR 4.40, 95% CI 3.15, 6.15) region. Also, higher odds of EIBF were significantly associated with living in North-East (Rural AOR 1.48, 95% CI 1.05, 2.08; Urban AOR 3.50, 95% CI 2.55, 4.83), South-South (Rural AOR 1.51, 95% CI 1.11, 2.10; Urban AOR 2.84, 95% CI 2.03, 3.97) and North-West (Urban residence only AOR 2.08, 95% CI 1.54, 2.80) regions. Conclusions: Rural-urban differences in the rates and factors associated with EIBF exist in Nigeria with rural residence having significantly lower rates. Intervention efforts which address the risk factors identified in this study may contribute to improved EIBF rates. Efforts need to prioritize rural mothers generally, (particularly, those in rural North-West region) as well as mothers in urban South-West region of Nigeria. [ABSTRACT FROM AUTHOR]