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Malaria remains a major health priority in Nigeria. Among children with fever who seek care, less than a quarter gets tested for malaria, leading to inappropriate use of the recommended treatment for malaria; Artemether Combination Therapies (ACT). Here we test an innovative strategy to target ACT subsidies to clients seeking care in Nigeria's private retail health sector who have a confirmed malaria diagnosis. We supported point-of-care malaria testing (mRDTs) in 48 Private Medicine Retailers (PMRs) in the city of Lagos, Nigeria and randomized them to two study arms; a control arm offering subsidized mRDT testing for USD $0.66, and an intervention arm where, in addition to access to subsidized testing as in the control arm, clients who received a positive mRDT at the PMR were eligible for a free (fully subsidized) first-line ACT and PMRs received USD $0.2 for every mRDT performed. Our primary outcome was the proportion of ACTs dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients who were tested at the PMR and adherence to diagnostic test results. Overall, 23% of clients chose to test at the PMR. Test results seemed to inform treatment decisions and resulted in enhanced targeting of ACTs to confirmed malaria cases with only 26% of test-negative clients purchasing an ACT compared to 58% of untested clients. However, the intervention did not offer further improvements, compared to the control arm, in testing rates or dispensing of ACTs to test-positive clients. We found that ACT subsidies were not passed on to clients testing positive in the intervention arm. We conclude that RDTs could reduce ACT overconsumption in Nigeria's private retail health sector, but PMR-oriented incentive structures are difficult to implement and may need to be complemented with interventions targeting clients of PMRs to increase test uptake and adherence. Clinical Trials Registration Number: NCT04428307.

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Introduction: As at 2019, Nigeria was ranked the fourth highest HIV burden in the world. There is varied geographical HIV prevalence in Nigeria. The progress made is inequitable across geographical locations and sub-populations (18). Benue state has the second highest HIV prevalence in Nigeria. In 2018, about 35,623 people living with HIV (PLHIV) were yet to commence antiretroviral treatment (ART) in the state, accounting for an estimated ART coverage gap of 11% out of the combined gap of 320,921 in the country. To close this gap, the Benue ART surge (BAS) was implemented. The aim of this study was to describe the BAS strategic approaches and demonstrate progress in expanding ART access for PLHIV in Benue State, Nigeria. Methods: BAS was implemented in 252 health facilities from May 2019 to September 2021. Data were collected and reported using an Excel-based dashboard and electronic medical records. The trend of HIV case identification, ART initiation, viral load suppression rate, and rate of interruption in treatment during the BAS period was then described and analyzed. Results: Out of 893,462 clients reached, 6.7% (n = 60,297) were diagnosed with HIV and 99.8% (n = 60,236) were initiated on ART. HIV case identification per month increased by 467% from 650 at baseline to a peak of 3685 in August 2020, and then declined by 35% to 2380 in September 2021. All new HIV-infected patients (100%) were linked to ART. Viral load testing coverage and viral load suppression rate increased from 30% (43,185/126,004) and 84% (n = 36,165/43,185) at baseline to 95% (n = 193,890/204,095) and 96% (185,785/193,890), respectively. Conclusion: Implementation of the BAS improved access to comprehensive HIV services in Benue State. The increase in HIV case identification and ART initiation significantly reduced the HIV treatment gap in the state. To fast track the attainment of UNAIDS 95-95-95 goals, lessons learnt from the BAS should be adapted and scaled up in the national HIV program in Nigeria.

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BACKGROUND: Most women in extended post partum period often have desire to use family planning. Disappointedly, majority of such women end up having unplanned or unwanted children. Little is currently known about factors responsible for such unmet family planning need among Nigerian women. OBJECTIVES: To assess the prevalence and determinants of unmet need for post partum family planning (PPFP) among women in Oyo State, south- west, Nigeria. METHODOLOGY: This cross-sectional analytic study was carried out using systematic sampling technique among 444 women attending immunization clinic in Ogbomoso, Nigeria. A pre-tested questionnaire was used for data collection and data analysis. was done using SPSS version 17. Chi-square test and binary logistic regression were used for analysis. RESULT: The mean age of the respondents was 36?9. Majority (65.7%) of the respondents demonstrated poor knowledge on PPFP. More than half (54.0%) of them had unmet need for limiting while 46.0% had unmet need for spacing. Fear of side effects was the commonest reason for lack of PPFP use (17.4%). Unmet need was significantly associated with marital status, educational status and level of awareness about PPFP. Level of awareness was the only significant predictor of unmet need among our study participants (OR; 2.973, 95% C.I; 0.119-0.459). CONCLUSION: Our study shows a high unmet need for PPFP among women in Ogbomoso, thus there is need for a more programmatic focus on women in their extended post partum periods. There is need for more awareness program on PPFP to increase contraceptive uptake in Nigeria.

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The ability of supercritical water (SCW) to decompose heterocyclic compounds (quinoline and isoquinoline) has been explored in this study. The results obtained suggest that water acts as a chemical reagent above its critical point (374 degrees C and 22.1 MPa). Significant proportions of isoquinoline and quinoline were removed during the reaction with SCW. The response of these compounds to pyrolysis was also compared with their reaction with SCW. Both compounds were relatively more reactive in the presence of SCW than during pyrolysis. Because of the different positions of N atom in the two compounds, they reacted with SCW differently. Breaking of C-N bonds during SCW reaction was by hydrogenation and hydrocracking, while pyrolysis was due to thermocracking mainly.

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Blood lead levels were analysed and pulmonary function tests were performed on Nigerian traffic wardens, comprising sixty from Lagos (ages 24-52 years; 27 +/- 6), thirteen from the sparsely populated university town of Ile-Ife (ages 22-40 years; 27 +/- 8) and a control group of twenty-four subjects (age 19-55 years; 31 +/- 8). Perkin-Elmer Zeeman 3030/HGA 600 AAS was used for blood analysis. The mean lead level in Lagos wardens was 18.1 +/- 6.4 micrograms/dl, which was significantly higher than the level of 10.2 +/- 2.7 micrograms/dl in Ife wardens and 12.9 +/- 7.0 micrograms/dl obtained in the controls (P < 0.001). However, there was no significant difference between the levels of blood lead in Ife traffic wardens and normal controls. Significant differences (P < 0.0005) in spirometric measurements--peak flow rate (PEFR), forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC)--were observed between traffic wardens and control subjects. The noise levels measured along traffic roads exceeded the threshold for hearing damage.

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In this pioneering effort on Nigerians, the arithmetic means, ranges, and standard deviations for the concentrations of the 13 elements, Br, Ca, Cl, Cu, Fe, K, Na, P, Pb, Rb, S, Se, and Zn, detected in freeze-dried whole blood, erythrocytes, and plasma of 120 subjects drawn from different geographical regions of Nigeria are reported. Elemental analyses have been carried out largely using instrumental neuron activation analysis (INAA) with both proton-induced X-ray emission (PIXE) and graphite furnace atomic absorption spectrometry (AAS) serving as complementary techniques. Our values, compared with similar data from other parts of the world, show a general good agreement. Values in male and female subjects are compared. Correlations between different elements are also noted.

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