BackgroundDespite the widespread acceptability of glucometers as a blood glucose self-monitoring and point-of-care device, their usage is confronted with operational, technical, regulatory, and quality control concerns.ObjectiveThis study assessed knowledge, estimated competence, and measured experience of healthcare practitioners using glucometers for patient care in two states of Northern Nigeria.MethodsThis cross-sectional, descriptive study used a total population sampling strategy and self-completed questionnaires. A total of 768 questionnaires were distributed to hospitals in Jigawa and Kogi States, Nigeria, from December 2019 to April 2022. The questionnaire had three sections: collecting details about type of healthcare facility, sociodemographic characteristics and educational qualifications of participants, and assessment of knowledge, competence and practice. Data were analysed and results expressed as frequencies and percentages.ResultsOverall, 570 questionnaires were filled and retrieved, giving a response rate of 74.2%. Most of the participants were male (312; 54.7%); female participants totalled 258 (45.3%). Most participants were aged < 50 years (25–40 years, 215 [37.7%]; 41–50 years, 246 [43.2%]). The majority of participants were Medical Laboratory Scientists (124, 21.8%]), Technicians (151, 26.5%), or Nurses (132, 23.2%). Most participants (284, 49.8%) reported having no formal training prior to first use of glucometers in patient care. Many participants (379, 66.5%) knew about glucometer calibrators; 235 (41.2%) did not know what specific purpose calibrators served.ConclusionThis study found a lack of knowledge, competence and experience among healthcare practitioners, especially for hands-on use of glucometer calibrators and standard operating procedures for blood glucose testing using glucometers.What this study addsThe study brings to fore the need for training and retraining of healthcare practitioners on the theoretical and practical skills required for operating glucometers. Periodic calibration of glucometers and provision of quality control materials should be incorporated into standard operating procedures at point-of-care testing workstations in health facilities.

BackgroundInternet addiction (IA) is prevalent among Nigerian undergraduates. This study seeks to explore the broader mental health consequences of IA among diverse groups of students in Nigerian universities.AimThis study aims to assess the prevalence of IA among undergraduates in Lagos State and examine its relationship with health conditions such as depression, anxiety and stress.SettingThe research was conducted in three public tertiary institutions in Lagos State, involving 830 undergraduates aged 18–24 years.MethodsThis cross-sectional study used a structured questionnaire, incorporating the Internet Addiction Test (IAT) and the Depression, Anxiety and Stress Scale (DASS-21). Chi-square tests determined associations and logistic regression identified predictors of IA. Data analyses were performed using IBM® SPSS 25.0.ResultsThe prevalence of IA was 73.3%. Certain critical predictors of IA emphasised the role of institutional affiliation, living arrangements, purpose and timing of use and duration of daily internet engagement. There were positive correlations between IA and depression (rs = 0.368), anxiety (rs = 0.359) and stress (rs = 0.401).ConclusionThe study found a high prevalence of IA among undergraduates, with significant associations with depression, anxiety and stress.ContributionThe findings underscore the need to raise awareness about IA and also highlight the need for context-sensitive, evidence-based interventions and for universities and policymakers to implement strategies that aim at promoting healthier internet usage, improving mental health services and raising awareness of the risks associated with excessive online activities.

Intermittent physiological monitoring and early warning scores (EWS) are limited in their ability to detect deteriorating patients in a timely manner. Wearable physiological sensors allow continuous remote monitoring and may be more timely and accurate in the identification of those at risk, compared with manual collection. This study aims to determine if wearable physiological sensors can be used for the early detection of postoperative deterioration, while being acceptable to patients and healthcare staff. This is a prospective observational cohort study that will recruit adults undergoing major surgery in Benin, India, Ghana, Guatemala, Mexico, Nigeria, Rwanda and the UK. Participants will wear wearable physiological chest and limb sensors before, during and after surgery for up to 10 days or until discharge. In this 'shadow-mode' study, continuous physiological observations collected using the devices will not be made available to clinical teams. No changes in participant care will result. Standard of care clinical data will be collected contemporaneously. Continuous sensor data will be used to design algorithms to predict deterioration and specific complications in this population. Usability and feasibility testing, through focus groups, interviews and questionnaires, will be undertaken with healthcare professionals and people undergoing surgery. Our stakeholder panel are directly involved in all aspects of this study, which will be conducted in accordance with the principles of the International Conference on Harmonisation Tripartite Guideline for Good Clinical Practice (ICH GCP) in addition to the principles of the ethics committee(s)/Institutional Review Boards (IRBs) who have reviewed and approved this study. Artificial intelligence (AI) prediction models will be reported in accordance with the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis+Artificial Intelligence (TRIPOD+AI) and Developmental and Exploratory Clinical Investigations of DEcision support systems driven by Artificial Intelligence (DECIDE-AI) reporting guidelines frameworks. NCT06565559.

Lassa fever (LF) is an acute viral hemorrhagic fever that poses a substantial public health security threat in West Africa. The non-specific clinical presentation of LF, coupled with a lack of reliable point-of-care diagnostics, means delayed diagnosis, leading to severe complications and mortality during epidemics. A systematic review and meta-analyses were performed by conducting an extensive online search using PubMed, Web of Science, Scopus, CINAHL, and Google Scholar (PROSPERO protocol identifier number CRD42024587426). Only peer-reviewed studies written in English were included in publications from 1 September 2014, to 31 August 2024. The analysis and reporting followed PRISMA guidelines. The quality of the included studies was assessed using the critical appraisal tools developed from the Joanna Briggs Institute Systematic Review Checklist for cohort studies. We included 19 studies that contained data from 4177 patients hospitalized with LF of any age. Most included studies employed a retrospective cohort design and were conducted in Nigeria (16/19; 84.2%). The mortality rate was highest in a Sierra Leonean study (63.0%), whereas a group-based analysis of Nigerian studies using a random-effects model identified Owo as having the highest mortality rate of 13% (95% CI: 6–23; I2 = 98%). The pooled mortality rate for severe LF was 19% (95% confidence interval [CI]:10–32). The most common complications of LF are acute kidney injury (AKI) at a pooled proportion of 19% (95% CI; 13–26; I2 = 89%)), followed by abnormal bleeding at a pooled proportion of 17% (95% CI; 9–30; I2 = 98%), and central nervous system (CNS) dysfunction at a pooled proportion of 15% (95% CI; 6–32; I2 = 98%). With one out of every five hospitalized LF patients likely to die in West Africa, accelerating the development of rapid diagnostic tests, licensed vaccines, and novel therapeutics is crucial. Strengthening community engagement and risk communication, developing regional treatment guidelines, decentralizing LF care units, and training healthcare workers using a harmonized curriculum will enhance early diagnosis and effective case management, thereby reducing severe complications and mortality.

Prostate cancer (PCa) is a primary global health concern and the leading cause of cancer-related deaths in men. Genetic variation in androgen pathways is essential in PCa development and progression. Cytochrome P450 17A1 (CYP17A1) gene encodes a critical metabolic enzyme involved in testosterone (TT) synthesis, as it converts cholesterol into androstenedione. Similarly, the 3β-hydroxysteroid dehydrogenase type 1 (HSD3B1) gene encodes an enzyme that catalyses the conversion of dehydroepiandrosterone (DHEA) to androstenedione, a critical precursor for TT production. The case-control study was conducted on 40 PCa patients and 40 healthy males with matching ages. Detection of CYP17A1 and HSD3B1 polymorphisms was done using the TaqMan genotyping assay, and estimation of TT levels in serum was done using the enzyme-linked immunosorbent assay technique. Detected genotypes were AA, AG, and GG for CYP17A1, and AA and CA for HSD3B1; the adrenal-permissive CC genotype of HSD3B1 was absent. The TT levels were significantly lower in PCa patients (p = 0.00148). No significant associations were found between polymorphisms in CYP17A1, HSD3B1 and TT levels. The HSD3B1 CA genotype showed a non-significant trend toward increased PCa risk (OR = 2.39, p = 0.183) that requires validation in larger studies before any clinical relevance can be established.

This study investigates the dynamic interaction between career aspirations and family planning decisions among women in Lagos State, Nigeria. It explores how societal norms, personal ambitions and practical considerations influence these choices, using the Work-Family Conflict Theory as a guiding framework. Employing a qualitative research approach, a diverse group of 30 women in their reproductive years were selected from Lagos Island Maternity Hospital (LIMH) and Lagos University Teaching Hospital (LUTH) using a combination of purposive and snowball sampling techniques. Thematic content analysis was used to analyse their perspectives. The findings reveal that women with ambitious career goals often delayed childbearing to avoid career interruptions, reflecting a shift towards viewing career success as compatible with family life. However, health considerations sometimes supersede career ambitions, indicating a complex interplay between work, health and family planning. Contextual factors such as societal norms and workplace support systems also play a role in shaping family planning decisions. Women in self-employment experience greater flexibility in managing both careers and families, whereas those in traditional employment face more rigid constraints. Supportive workplace policies, particularly maternity leave provisions, emerge as critical in facilitating family planning decisions. Self-employed women emphasise the autonomy they gain in managing family planning, while those in structured employment often navigate stricter timelines. There is a need to align family planning policies with women's career goals, and future research should explore these dynamics in diverse settings.

Abstract Background: Artificial Intelligence (AI) is rapidly transforming healthcare delivery worldwide. However, its adoption, patterns of use, and associated factors among healthcare professionals in Nigeria remain underexplored. This study assessed the prevalence, patterns, and determinants of AI use among healthcare professionals in Lagos State, Nigeria. Methods: A descriptive cross-sectional study was conducted between May and August 2024 among 415 healthcare professionals, selected using stratified random sampling from tertiary, secondary, and primary government-owned health facilities. Data were collected usingself-administered, structured questionnaires and analysed using SPSS. Descriptive statistics, chi-square tests, and logistic regression were employed. Results: Despite only 19.8% receiving formal AI training, 86.5% of respondents reported using AI, with 51.3% applying it to professional duties - mainly for diagnostic support. AI use in professional duties was significantly associated with educational level (p = 0.042) and showed a borderline association with facility type (p = 0.055). Those with postgraduate degrees were twice as likely to use AI compared to those with a bachelor’s degree or lower (OR = 2.07, p = 0.014), while professionals at secondary facilities were approximately1.5 times more likely to use AI than those at primary facilities (OR = 1.55, p = 0.056). The main motivators included convenience and efficiency, and the barriers included data privacy concerns and distrust in AI. Conclusion: AI use is widespread among healthcare professionals in Lagos, Nigeria,despite limited formal training, with education level and facility type influencing professional application. Targeted training, improved digital infrastructure, and clear data protection policies are recommended to foster equitable AI integration at all levels of care.

Pulmonary tuberculosis (PTB) and chronic respiratory diseases (CRDs) are intricately linked. People with PTB and CRDs experience similar symptoms, including breathlessness, cough and chest pain. They may have similar risk factors for disease, including smoking and occupational exposures. PTB is also a direct cause of lung damage in the form of post-TB lung disease. However, despite the overlap in risk factors, symptoms and sequelae, public health and clinical care pathways for TB and CRDs remain almost entirely separate in many low- and middle-income countries (LMICs). Those with respiratory symptoms are directed to TB services as a first point of contact where they are known as 'people with presumptive TB', and pathways to respiratory diagnosis and care remain largely inadequate. In this opinion piece we describe opportunities for the integration of tuberculosis (TB) and respiratory care, as a means of improving patient outcomes in LMICs. Strategies may include upstream public health interventions to address shared risk factors, the use of shared diagnostic pathways, the provision of decentralised access to both TB and CRD care, and coordinated information provision about the risk factors and symptoms of both conditions. Health-related benefits may include more timely diagnosis of CRDs, improved CRD treatment and care, and reduced inappropriate empirical TB treatment or retreatment. We highlight the need for pilot models of integrated care, with robust design and evaluation, and we note that an integrated approach may be particularly timely given the increasing scarcity of global health donor funding.