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Background: Breast and cervical cancers are in the top 10 most common cancers in women globally and the most common cancers in Nigerian women. The incidences have been rising steadily over the years. Involvement of men as key players in reproductive health issues has been receiving global attention especially in low and middle-income countries., Aim: To assess male involvement in their female partners' screening for breast and cervical cancers in Southwest, Nigeria., Method: This was a community-based, cross-sectional study that employed a multi-stage sampling method to select 254 men who were married or in steady relationships in Lagos State, Southwest Nigeria. Data were collected from June to October 2018 using a semi-structured interviewer-administered questionnaire, analyzed using Epi Info version 3.5.1 and summarized with mean and standard deviation. Chi-square test was used for bivariate statistics, and the p-value of ≤0.05 was considered statistically significant. Multivariable logistic regression was used for predictor variables of male involvement in screening., Results: 29.5% of the respondents had good knowledge of breast and cervical cancers and screening and majority (85.5%) had a positive attitude towards screening. Only few, 19.3% and 15.7% had provided money for breast and cervical cancer screening respectively. Most men, 75% and 87.4% respectively had not accompanied their wife/female partner for breast and cervical cancer screening, while almost half (49.2%) and one-third (33.5%) respectively, had encouraged their female partners to screen for breast and cervical cancers. Overall, only about half, 138 (54.3%) of the men were considered 'involved' in their female partners' screening for breast and cervical cancers. Male involvement was significantly associated with screening for female cancers (χ2 = 77.62, p = 0.001). Older age group (AOR = 2.64, 95% CI: 1.3-4.9), higher educational attainment (AOR = 3.51, 95% CI: 1.14-10.73), and positive attitude (AOR = 2.48, 95% CI:1.16-5.33) were found to be the predictors of male involvement., Conclusion: Community-based programs for males, especially the younger and less educated, should be implemented to increase their involvement. It is also suggested that mass media messages be spread and online platforms be explored in order to increase men's awareness and participation in female cancer screening., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Okafor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Context: Tuberculosis (TB) treatment support is one of the recommended strategies to enhance treatment adherence and outcomes. Treatment supporters are at risk of contracting TB and adequate knowledge of TB and good preventive practices are required for their protection., Aims: This study aimed at assessing the knowledge and preventive practices of TB treatment supporters at Directly Observed Treatment Short-course (DOTS) centers in Lagos Mainland Local Government Area of Lagos state, Nigeria., Settings and Design: This cross-sectional study was conducted among 196 TB treatment supporters selected from five DOTS centers in Lagos., Methods: Data were obtained using an adapted pretested questionnaire., Statistical Analysis Used: Bivariate and multivariate analyses were performed to determine the factors associated with self-protection practices. A P < 0.05 was considered statistically significant., Results: The mean age of the participants was 37.3 ± 12.1 years. More than half of the respondents were females (59.2%) and immediate family members (61.3%). Overall, 22.5% had good knowledge of TB, while 53.0% had positive attitudes toward TB. Only 26.0% adequately protected themselves from infection. The caregiver's level of education (P = 0.001) and their relationship to the patient (P = 0.001) were significantly associated with good preventive practices in bivariate analysis. Not being related to the patient was a predictor of adequate TB prevention practices (adjusted odds ratio = 2.852; P = 0.006; 95% confidence interval = 1.360-5.984)., Conclusions: This study revealed low levels of TB knowledge and fair preventive practices, especially among caregivers who are relatives. There is, therefore, a need to improve population literacy about TB and its prevention and a more focused orientation of relatives who volunteer as treatment supporters, through health education, with periodic monitoring during clinic visits, of how they prevent TB., Competing Interests: None

Background: Electronic cigarette (e-cigarette) use is becoming popular among undergraduate students in Nigeria with a tendency for escalation because of the coronavirus disease 2019 (COVID-19) pandemic., Aim: The aim of this study was to assess electronic cigarette use in COVID-19 era among undergraduate students of a tertiary institution in Lagos state, Southwestern Nigeria., Setting: A tertiary institution in Southwestern Nigeria., Methods: The study design was a descriptive cross-sectional study with a pretested, structured, close- and open-ended self-administered questionnaire used for collection of data on knowledge, attitude and use of e-cigarettes., Results: Data from 183 respondents were analysed. The mean age of respondents was 24.8 ± 3.38 years, most (63%) of whom were males. The prevalence of ever-use of e-cigarettes was 15.3% of which 60.7% reported increased use of e-cigarettes since the COVID-19 pandemic. Age, education, tribe and religion (p 0.001) were significantly associated with higher odds of use of e-cigarettes., Conclusion: This study found an increase in the quantity of e-cigarettes used and online purchase of the same by respondents since the COVID-19 pandemic. Paying attention to the rate of use and having control measures in place for online purchase of e-cigarettes by youths in Nigeria may be necessary in the years to come.Contribution: This study addresses a gap in the availability of knowledge of use of e-cigarettes among a growing population of youths in Nigeria.

Background: In sub-Saharan Africa, women are bearing a heavier burden than men in terms of rate of infection and socio-economic impact of HIV/AIDS. This study was aimed at assessing gender disparities in the socio-economic burden of HIV/AIDS., Methods: This descriptive cross-sectional study was conducted among 422 HIV-positive adult patients attending an HIV clinic in Lagos, Nigeria, selected by multi-stage sampling and interviewed using a pretested, semi-structured questionnaire. Bivariate analysis was used to assess how the socioeconomic constructs differed by gender., Results: This study revealed that females suffered more of the socio-economic consequences of having HIV/AIDS than males; cruelty and isolation were significantly higher among the females (p<0.0001), more females (50.0%) were discriminated against at the workplace compared to males (32.1%) (p=0.005), physical abuse (p=0.002) and extortion (p=0.029) were experienced by more of the females than the males. Also, the cost of care outside of antiretroviral therapy was significantly higher among the females (p= 0.002)., Conclusion: Quantifying the social and economic disparities between HIV-infected men and women has shown that the burden is by far higher among women than men. Focused interventions are therefore needed to control the spread of the disease and improve the quality of life of HIV-infected women., (© 2022 Charles-Eromosele TO et al.)

Background: Healthcare professionals (HCPs) working to save lives during the coronavirus disease 2019 (COVID-19) pandemic are under tremendous physical and psychological pressure, therefore facing the risk of developing challenges with mental health., Aim: This study aimed primarily to determine the prevalence and factors associated with depression, anxiety and stress among HCPs in a tertiary hospital in Lagos State during the COVID-19 pandemic., Setting: Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria., Methods: This was a descriptive cross-sectional study conducted between June and July 2021 among 1452 doctors and nurses in LASUTH, Ikeja, Lagos, Nigeria, selected by the multistage sampling method. Depression, anxiety and stress were assessed using the Patient Health Questionnaire, Generalised Anxiety Disorder and Perceived Stress Scale, respectively., Results: The majority of respondents were female (72.5%), with two-thirds being nurses. The prevalence of depression, anxiety and stress was 9.8%, 5.0% and 62.4%, respectively. Nurses showed a higher prevalence of these mental health conditions as compared with doctors. Younger HCPs, nurses, those that lost a colleague to COVID-19, and those whose family members were infected with COVID-19 were more likely to be depressed. Nurses and those afraid of being infected were more likely to experience anxiety. Younger HCPs, nurses, history of anxiety and/or depression and previous COVID-19 infection were identified as factors associated with stress., Conclusion: Stress was the most prevalent mental health condition with nurses being the most affected of the HCPs and at a greater risk of developing challenges with mental health. Psychosocial interventions and stress management techniques are recommended to minimise the risks., Contribution: This study adds to the few studies on the mental health of HCPs during COVID-19 and calls for in-depth surveys to understand psychosocial challenges among HCPs in Nigeria., Competing Interests: The authors have declared that no competing interest exists., (© 2022. The Authors.)

Background: Cervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings., Objectives: This qualitative study was done prior to the introduction of a cervical cancer screening program in two slum areas in Lagos Nigeria and explored women's knowledge about cervical cancer, and their perceived barriers and recommendations for the program., Method: Four focus group discussions(FGD) were conducted among 35 women between the ages of 21-65 years residing in two urban slums in Lagos, Nigeria from February to April 2019. Each FGD was limited to 8-10 participants of women of similar ages. Voice recordings were transcribed verbatim and thematic analysis was done., Results: Most of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby primary health center, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women's poorly perceived susceptibility to cervical cancer., Conclusion: Interventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge of cervical cancer and address barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered., (© 2022. The Author(s).)

Background:  Sickle cell disease (SCD), a common hereditary disease, can be prevented by preparing young people ahead of the conception of an affected foetus., Aim:  To assess the knowledge and attitude regarding SCD amongst senior secondary school students in Surulere Local Government Area (LGA), Lagos, Nigeria., Setting:  Senior secondary schools in Surulere LGA., Methods:  This was a descriptive cross-sectional study amongst 300 senior secondary school students. Data were collected using a self-administered questionnaire and analysed using Stata16. The Chi-square and Fisher's exact tests were used to determine the association between categorical variables. The level of significance was predetermined at p  0.05., Results:  The mean age of the respondents was 15.2 (±1.3) years, with a male-to-female ratio of about 1:2. The majority (90.0%) of the respondents were aware of SCD, 63.0% had good knowledge, although less than half of them (46.3%) knew SCD to be a blood disorder, whilst about two-thirds (53.1%) knew that it was an inherited condition. About one fifth (24.4%) of them knew about prevention by genetic counselling. The majority (97.0%) of them had a positive attitude towards SCD. Over two-thirds (72.6%) were aware of their genotype. The prevalence of SCD was 2.0%, whilst 18.9% of them were carriers of the sickle cell trait. Knowing their SCD status but not necessarily their genotype was significantly associated with their attitude towards the disease (p = 0.014)., Conclusion:  The prevention of SCD was not known to the majority, and better attitudes were more likely when the SCD status was known. Therefore, routine screening and counselling could potentially aid SCD control.

Background: Four decades after its discovery, HIV continues to be a major global public health issue, even with antiretroviral therapy (ART). Strict adherence to ART remains a challenge, with attendant implications for treatment success. This study aimed at comparing ART adherence between north-east and south-west Nigeria., Methods: A comparative cross-sectional study was conducted in two regions in Nigeria among 400 HIV/AIDS patients on ART. Data were collected using a pre-tested, semi-structured interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of ART adherence in the regions. The level of significance was set at 0.05., Results: The majority of respondents from both the north-east (87.5%) and south-west (92.5%) of Nigeria had good knowledge about ART. The self-reported adherence level was 90.0% in the north-east and 87.5% in the south-west. Predictors of ART adherence in the north-east were knowledge about ART (AOR 9.949; 95% CI 2.009-49.284) and transport costs to the clinic (AOR 0.177; 95% CI 0.047-0.661). In the south-west, education (AOR 0.198; 95% CI 0.047-0.832) and knowledge of ART (AOR 8.945; 95% CI 1.749-45.751) were identified as predictors of ART adherence., Conclusion: In both regions, knowledge about ART was appreciable, but adherence was sub-optimal. Strategies to support adherence should be tailored to specific predictors in each region.

Context: Tuberculosis (TB), though preventable and curable, remains a global health problem, ranked one of the top causes of death worldwide, despite the World Health Organization's strategies. This may be due to the stigma surrounding the disease., Aim: This study assesses TB stigma in light of knowledge, attitudes, and preventive practices among individuals in an urban community., Settings and Design: This was a descriptive, cross-sectional study among 317 residents of Surulere, Lagos, Nigeria, selected by multi-stage sampling., Subjects and Methods: Data were collected using a pretested, semi-structured, interviewer-administered questionnaire and analyzed using Epi InfoTM version 7.2.2.6 2018 (Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA)., Statistical Analysis Used: Descriptive variables were summarized as frequencies, and the Chi-square test was used to test the associations. The level of significance was predetermined at P ≤0.05., Results: Most participants were between the age group of 21 and 40 years. Approximately 9 out of every 10 respondents (91.8%) were aware of TB. Overall, only 2.4% of respondents had good knowledge of TB, more than half (59.1%) had positive attitudes toward TB, about one-third (37.1%) had good preventive practices and 22.7% of respondents expressed TB stigma, 63.6% would show no compassion or desire to help people with TB while 64.3% would rather people with TB were never employed. However, good knowledge translated into less stigma (P <0.001)., Conclusions: Most participants were aware of TB, although knowledge, attitude, and practice levels were poor. Knowledge was found to reduce TB stigma, reinforcing the need for improved community literacy regrading TB. This has the potential to influence health-seeking behavior and promote better TB prevention, detection, and treatment outcomes., Competing Interests: None

Background: Globally, postpartum depression is one of the most common but often unrecognized complications of childbirth, yearly affecting about 10-15% of postnatal women. This study aimed to determine the prevalence of postpartum depression and its predictors among postnatal women in Lagos., Methods: A descriptive cross-sectional study was conducted among 250 mothers in Eti-Osa Local Government Area of Lagos State, Nigeria, attending six Primary Health Care centers for infant immunization at six weeks post-delivery. Data was collected using a pretested semi-structured interviewer administered questionnaire which included the Edinburgh Postnatal Depression Scale. Analysis was carried out using SPSS version 23TM. Chi-square and logistic regression analyses were used to determine associations and predictive relationships between various factors and the presence of postpartum depression. The level of significance was set at <0.05., Results: The prevalence of postpartum depression was 35.6%. Multiparity, delivery by cesarean section, mother being unwell after delivery, and not exclusively breastfeeding the baby were the factors linked with postpartum depression. Following multiple logistic regression, having postpartum blues (p=0.000; OR=32.77; 95%CI=7.23-148.58)., not getting help with caring for the baby (p=0.008; OR=2.64; 95%CI=1.29-5.42), experiencing intimate partner violence (p=0.000; OR=5.2; 95%CI=2.23-11.91) and having an unsupportive partner (p=0.018; OR=2.6; 95%CI=1.17-5.78) were identified as predictors of postpartum depression., Conclusion: This study revealed a high prevalence of postpartum depression, identifying both the obstetric and psychosocial predictors. Social support for women both in the pre- and postnatal periods and routine screening of women for postpartum depression should be encouraged for early detection and immediate intervention., (© 2020 Adeyemo EO et al.)

Introduction: cervical cancer, which is vaccine preventable, is the commonest gynaecological cancer worldwide. This study aimed to assess parental willingness to vaccinate adolescent girls against human papillomavirus (HPV) for cervical cancer prevention., Methods: this was a descriptive cross-sectional study among 301 parents of adolescent girls who reside in Surulere Local Government Area in Lagos, Nigeria. A pretested, semi-structured interviewer-administered questionnaire was used to collect data and analysis was done using Epi-info™ version 7. The chi-square (or Fisher's exact) test and the t-test were used to test for associations between categorical and continuous variables respectively. The level of significance was set at 0.05., Results: over half (53.5%) of the respondents had heard of cervical cancer. Of these, two thirds (62.1%) were aware that it could be prevented, 19.0% had good knowledge of cervical cancer prevention, only 4% had their daughters vaccinated though 79.2% were willing to vaccinate. The poor vaccine uptake was mostly due to lack of awareness of vaccination centres and the high cost of the vaccine. Willingness was significantly associated with level of education (p = 0.047) and knowledge of HPV vaccination (p < 0.001), however once aware, most parents were willing to get their daughters vaccinated., Conclusion: awareness about cervical cancer prevention was high though uptake was low. A high level of education and good knowledge of cervical cancer prevention were facilitators of willingness to vaccinate, though once aware parents were willing. Creating awareness and educating parents about cervical cancer prevention is essential in improving the uptake of the vaccine., Competing Interests: The authors declare no competing interests., (© Haleemat Wuraola Akinleye et al.)

Background: Knowledge of HIV/AIDS and use of HIV Testing Services in Nigeria is still far from optimal. Good HIV/AIDS-related knowledge and attitudes are important in prevention. The aim of this study was to assess and compare HIV/AIDS knowledge, attitudes and the uptake of HIV Testing Services between male and female senior secondary school students in Lagos, Nigeria., Methods: Using multistage sampling, 543 (50.3% male, 49.7 % female) participants were selected in a comparative cross-sectional study carried out in six senior secondary schools in Alimosho LGA, Lagos. Data was collected using a pre-tested, self-administered questionnaire and analyzed using SPSS- 20, p<0.05 was considered significant., Results: Participants' level of knowledge of HIV/AIDS was good (86.4% male, 86.3% female), the difference was not statistically significant. The main source of HIV/AIDS information was their teachers (male - 53.6%, female - 49.3%). Attitudes were positive (99.3% males, 98.1% females). However, the uptake of HIV testing was low (27.8% male, 24.1% female). Only 41.8% of males and 34.1% of females knew where HIV Testing Services were offered. The uptake of HIV testing showed a significant association, for the males, with family structure (p=0.034), confiding in their fathers (p=0.039) and religion (p=0.044), and for the females, mothers' level of education (p=0.036), number of siblings (p=0.044) and alcohol use (p=0.006)., Conclusion: In both groups, knowledge and attitude were optimal, however. the uptake of HIV testing was low due to poor access. Teaching about HIV/AIDS in schools should be sustained, but to improve the use of HIV Testing Services, stronger families are encouraged, though providing more HIV testing centers, especially Youth Friendly Centers should be considered.

Background: Despite women's adequate knowledge and the obvious unmet need for family planning (FP), contraceptive prevalence in Nigeria is low. A greater understanding of the barriers to FP that informs service utilisation and preferences is needed to improve service delivery., Aim: This study was aimed at assessing the use and preferences of FP services among women., Subjects and Methods: A community-based, descriptive, cross-sectional survey was carried out among 367 women (15-49 years of age) residing in Ikosi-Isheri, Kosofe local government area, who were selected by multistage sampling method. Data were collected using a pre-tested, semi-structured, interviewer-administered questionnaire and were analysed using SPSS software version 20. Frequency distributions and cross tabulations were generated. The Chi-square and Fisher's exact tests were used to determine associations, and the level of significance was set at P ≤ 0.05., Results: Although 64.0% were aware of FP, only 26.4% had ever used FP services. The contraceptive prevalence was 17.9%. Traditional or religious restrictions were given as the reasons for not using FP (40.9%). The preferred FP services were those offered at primary healthcare centres (45.2%) and teaching hospitals (33.9%) because of proximity (38.7%), privacy (14.5%) and health workers being female (22.6%). Age, level of education and marital status were associated with the utilisation of FP services (P < 0.001, P = 0.020 and P < 0.001, respectively)., Conclusion: Although awareness was high, uptake was low. Government health facilities were preferred. Primary healthcare should be strengthened, and FP services should be scaled up to make FP more accessible. Services should be closer to where people live while providing the privacy they desire., Competing Interests: None

Background: Out of pocket payment for health services in the midst of financial hardship is a major contributor to poor access to healthcare in Nigeria with the resultant poor health indices. Towards the goal of Universal Health Coverage, Community Based Health Insurance (CBHI) was introduced in addition to the National Health Insurance Scheme but with minimal impact and utilization., Objective: The objective of this study was to assess health insurance-related knowledge and attitudes and to examine the uptake of CBHI., Methods: This was a descriptive cross-sectional study. A multi-stage sampling method was used to select 419 respondents from the Ajeromi-Ifelodun community. A semi-structured interviewer-administered questionnaire was used to collect data for the study. Data analysis was done using Microsoft Excel and Epi-Info 7.1., Results: Most of the respondents (80.2%) had not heard of Community-Based Health Insurance and only about 9% of respondents had good knowledge about it. However, most (62.5%) of the respondents had a positive attitude towards health insurance generally. Only 4.5% of the respondents were enrolled in the CBHI scheme and had paid their premium up to date. There was a significant association between the respondents' knowledge and their uptake of the scheme (<0.001), and also between their attitudes and uptake (p = 0.002)., Conclusion: This study suggests that for CBHI to be successful, certain strategies must be implemented towards increasing awareness and knowledge about CBHI. This will in turn increase the uptake of the scheme, a necessary requirement for achieving the goal of Universal Health Coverage.

Background: The world population is rapidly ageing and people aged 60 years and above are growing faster than any other age group. In Africa, the most rapid growth of older persons is expected in Western and Northern Africa., Study Design: This was a comparative cross-sectional study of a total of 360 respondents. A multi-stage sampling method was used in selecting 240 respondents in the non-institutional group while all the respondents (120) in the institutional group were included in the study. The data was collected using a pre-tested, semi-structured, interviewer administered quality of life questionnaire (SF-36). Data analysis was done using SPSS version 17., Results: The respondents in the institutional group were older with a mean age of 78.7±8.8 years as compared to 70.1±8.2 years in the non-institutional group. The mean Health-Related Quality of Life (HRQOL) score was higher (64.5±15.6) in the non-institutional group than in the institutional group (52.6±15.7) and this was statistically significant (p<0.001). After controlling for the effect of other variables, the respondents who belonged to the non-institutional group (OR=2.37, p=0.018); who were female (OR=2.00, p=0.019); engaged in work (OR=4.93, p=0.009) and had no co-morbid condition (OR=7.58, p<0.001) were significantly more likely to have good HRQOL., Conclusion: The non-institutional group had better HRQOL than the institutional group in all the domains except in the body pain domain. It is recommended that programs are tailored to the needs of the elderly in institutions and should be targeted towards improving their quality of life and well-being.