Elias Chikee Aniwada

Introduction Prevention of Mother-to-Child Transmission of HIV (PMTCT) is a critical component of HIV control and if well implemented drastically reduces transmission to a child. However, Mother-to-Child Transmission of HIV (MTCT) remains a huge burden. Health facility-based antenatal care is still the main vehicle used for PMTCT services in Nigeria, when less than 40% patronize them. In view of shortages of qualified health personnel globally, engaging TBAs will improve the coverage of PMTCT services as it has the potential of bridging the gap. The aim of this study is to provide evidence to inform engagement of TBAs for PMTCT service delivery scale-up in Nigeria. Methods A cross-sectional survey was conducted among TBAs using questionnaires. Total study was done involving 409 TBAs. Data collected was analyzed using IBM SPSS version 25. Chi-square test was used for association of characteristics of TBAs with knowledge and practice on HIV as well as factors influencing willingness to collaborate in the PMTCT programme at < 0.05. Predictors were ascertained using Binary Logistic regression. Ethical Consideration were duly observed. Results In all, 241(58.9%) had overall good knowledge on HIV. The main source of knowledge was Healthcare workers 336 (82.2%). Majority correctly identified ways of HIV transmission and how transmission from infected mother to child can be prevented (>75%). The overall practice on HIV was poor 264 (64.5%) even though the majority 341 (83.4%) refer their HIV clients to health facility. Practices on personal protection was good (>70%). About 378 (92.4%) agree that they have a role in PMTCT for their clients and babies, however only 99 (24.2%) were willing to collaborate in the PMTCT programme. Identified predictors for good practice were; aged ≤ 45 years (AOR 2.66; 95% CI 1.08– 18.46), had primary education and below (AOR 0.68; 95% CI 0.05 – 0.75) and good knowledge (AOR 12.62; 95% CI 8.33 – 44.17). Identified predictors for agreeing to collaborate in the PMTCT programme were good knowledge (AOR 6.34; 95% CI 3.55 – 41.27) and good practice (AOR 3.15; 95% CI 1.74 – 13.35). Conclusions The attainment of PMTCT treatment targets for Nigeria is crucial to that of the world. TBAs are an important but currently underused resource for PMTCT scale-up. There is need to involve TBAs in PMTCT service delivery in Nigeria as if effectively engaged could bridge the gap in HIV control in Nigeria.

Child marriage represents a fundamental violation of human rights, nonetheless, several societies accept and practice this. This practice is life in Becheve, in Obanliku Local Government, Cross River State despite its implications to people involved, their communities and the world at large. It has received less attention from policymakers and health researchers. This study is to assess the betrothing of young girls into marriage in this area. Methods A descriptive cross-sectional study design was adopted among adults using questionnaires. Data was analysed using IBM SPSS version 23.0. Chi square test was used to ascertain the association between socio-demographic characteristics and agreement to betrothed/child marriage at significance level of p < 0.05. Binary Logistic Regression was used for predictors for variable with p value of ≤ 0.2 Result: High proportion of the respondents 222(53.9%) were currently in betrothed/child marriage, 184 (44.7%) had female children and 319(77.4%) have relatives or know anyone in such marriage. Only 82(19.9%) were happy and agree with such marriage. Key perceived reasons for such marriage were poverty 412(100%), tradition 412(100%), lack of education 410(99.5%), gender inequality 404(98.1%) and rural/urban area residence 402(97.6%). Psychological effects include; personality problems 410 (99.5%) and worries 402 (97.6%). Socioeconomic effects include; large family size 410 (99.5%), low education 409 (99.3%) and lack of decision making 408 (99.0%). Medical effects include; malnutrition 410 (99.5%), poor health seeking behavior 408 (99.0%), increased maternal and child mortality 400 (97.1%) and increased risk of STD 396 (96.1%). Identified predictors were age 35 - 50 years (AOR 6.34; 95% CI 3.55 – 75.23), ≥ 51 years (AOR 12.37; 95% CI 8.86 – 138.88), Widowed/Divorced/Separated (AOR 4.06; 95% CI 1.23 – 18.35), Islam religion (AOR 40.36; 95% CI 4.54 – 358.84), secondary education (AOR 0.23; 95% CI 0.15 – 0.45), tertiary education (AOR 0.060; 95% CI 0.014 – 0.495) and farming (AOR 24.12; 95% CI 15.41 – 37.56). Conclusion: This practice is still common in the study area. Lack of education, tradition, religion, lack of family support and insecurity fuel this practice. The consequences are manifold, overlapping and the impact trans-generational. There is need for concerted effort by all to end this menace

Background: Substance use is an increasing trend and has become one of the most disturbing public health problems. More attention has been drawn recently to substance use and driving because of road traffic accidents causally related to substance use. The study aims to assess substance use and its effect among tricycle drivers in Federal Capital Territory, Abuja. Methods: A cross sectional study using semi-structured pre-tested Questionnaires among 360 tricycle drivers in FCT, Abuja was done. They were selected for the study using Time location sampling and simple random sampling. Chi square test was employed and tested at a significance level of 95%. Results: The study revealed that the prevalence of substance use among tricycle riders in FCT, Abuja was high 291(80.8%). The most used substance was alcoholic beverages 291 (100%) followed by tobacco products 260 (89.3%) and bitter cola, kolanut, 256 (88.0%), etc. Only 35(9.7%) of the substance was prescribed by a medical personnel while one-third 13(37.1%) were prescribed by mostly non-certified doctors. The knowledge of the effects of substance use among the tricycle drivers was high 291 (80.9%). The effects of substance use on the physical health of the tricycle riders in FCT include liver damage 261(72.5%), hand tremors 251(69.7%), high blood pressure 214(59.4%), etc. There was a significant association between the age, educational status, marital status, ethnic origin, religion and income level of the tricycle riders and their abuse of substance (P-value <0.001 in all cases). Conclusion: The prevalence of substance use among tricycle riders in FCT, Abuja was high and there was significant association of characteristic with substance use. There is need for intervention to reduce the health burden associated with substance abuse among through health education on the dangers of substance use at all levels