Geopolitical Zones Research Articles

Exploring the emigration intentions of Nigerian medical and nursing students: factors driving migration and implications for Nigeria’s healthcare system

BackgroundThe emigration of healthcare professionals significantly contributes to brain drain within Nigeria’s healthcare sector, exacerbating existing workforce shortages. This study investigates the emigration intentions of Nigerian medical and nursing students, focusing on preferred destinations, key motivating factors, and the potential long-term consequences for the nation’s healthcare system.MethodsA cross-sectional study was conducted among undergraduate medical and nursing students from six universities, purposefully selected to represent Nigeria’s geopolitical zones. A total of 2,152 students (Medicine and Surgery = 1254; Nursing = 898) participated in the study. Data were collected using a structured, self-administered online questionnaire and analysed with IBM SPSS version 27. Descriptive statistics, chi-square tests, and binary logistic regression were applied, with statistical significance set at p < 0.05.Results72.9% of students expressed intentions to practice abroad, primarily seeking specialist training within the first five years post-graduation (97.7%). Alarmingly, 32.7% had no intention of ever returning to Nigeria, while only 11.7% of those intending to stay intend to leave after completing specialist training. The top three emigration destinations were the United States (28.5%), the United Kingdom (24.6%), and Canada (23.1%). The main drivers of emigration included better training opportunities (75.2%), access to advanced equipment (61.1%), and improved career prospects (56.7%). Respondents predicted negative impacts on Nigeria’s healthcare system, including increased mortality rates and potential system collapse.ConclusionThe findings reveal a high propensity for emigration among Nigerian medical and nursing students, with significant implications for the country’s healthcare system. The study underscores the urgent need for policy interventions that address systemic challenges such as inadequate resources, poor working conditions, remuneration and career development opportunities. Strengthening local training conditions and offering competitive incentives may help mitigate the brain drain and ensure a sustainable healthcare workforce in Nigeria.

Relationship between perceived material living conditions and subjective health and wellbeing as moderated by personal attributes in a representative sample of Nigerians

BackgroundPrevious research has linked material living conditions to subjective health and wellbeing. However, moderators are mainly unknown. Thus, the current study examined whether gender, age, and education moderate Nigerians’ subjective health and wellbeing, considering their material living conditions.MethodsThe 2023 Afrobarometer survey in Nigeria’s six geopolitical zones included 1,600 adults aged 18–97 (Mean age = 34.93 years, standard deviation = 13.12, female = 51.9%). IBM SPSS Amos 23 performed SEM and multi-group analyses.ResultsThe study found that insufficient material living conditions harm subjective health and wellbeing. It revealed that such conditions harmed subjective health and wellbeing, regardless of age or gender. Surprisingly, education affected the relationship between material living conditions and subjective health and wellbeing, particularly among highly educated individuals.ConclusionThe study concluded that poor living conditions harm health and wellbeing, whereas education moderates the relationship between material living conditions and subjective health and wellbeing. These findings highlight the need for psychological interventions and policies to improve Africans’ health and wellbeing.

The Impact of University Theoretical Frameworks on Graduates' Preparedness for the 21st-Century Global Workforce and the Sustainability of Educational Systems

This study employed a descriptive survey research design to investigate the impact of university theoretical frameworks on graduates' preparedness for the 21st-century global workforce and the sustainability of educational systems. The study population consisted of one thousand five hundred (1500) respondents who were employers of labour from the South-South Geopolitical Zone of Nigeria, selected through an accidental sampling technique. Data were collected using a validated questionnaire titled "Impact of University Theoretical Frameworks on Graduates' Preparedness for the 21st-Century Global Workforce and the Sustainability of Educational Systems" (IUTFGPGWSES), which demonstrated a high reliability coefficient of 0.88 and 0.85 as established by the Cronbach Alpha statistic. The data analysis involved calculating mean scores, standard deviations, and conducting independent t-tests to assess significant differences between groups. The findings indicate that the identified theoretical frameworks are crucial for enhancing graduates' preparedness for the modern workforce and ensuring educational sustainability. Additionally, the study identified essential strategies for improving these frameworks, emphasizing the need for universities to incorporate competency-based education (CBE), digital literacy, and interdisciplinary approaches into their curricula. Recommendations include regular reviews of educational programs to align with industry needs and foster adaptability mong university graduates in preparation for the complexities of the 21st-century job market. Received: 30 September 2024 / Accepted: 4 April 2025 / Published: 08 May 2025

Nurses’ knowledge and willingness to recommend malaria vaccination to caregivers of under-5 in Nigeria: a nationwide survey

BackgroundMalaria is a major public health problem in Nigeria. This study set out to ascertain Nigerian nurses' knowledge and willingness to recommend malaria vaccination to caregivers of under-5 children.MethodsThis was a cross-sectional study carried out among nurses from all six geopolitical zones of Nigeria. A pretested semi-structured questionnaire was used to collect data on participants' demographics, their knowledge of the RTS S/AS01 and R21 Matrix M malaria vaccines, how they obtain malaria vaccine-related information, and the factors that the nurses consider when recommending any malaria vaccine. Univariate association between each of the demographics characteristics and the key research variables: knowledge of the vaccine and willingness to recommend was used. This was examined using the Chi-Square test and multiple logistic regression.ResultsThe study found that nearly two out of every three nurses had poor knowledge and perception of the vaccines (p < 0.05). Awareness of the malaria vaccine was the only factor that was found to be associated with their knowledge (p <0.05). The odds of willingness to promote the vaccine were about 21 times higher among nurses with high perceptions of efficacy than their counterparts who have low perceptions.ConclusionsThe findings highlight major gaps in Nigerian nursing's knowledge and awareness of malaria vaccinations, as well as their willingness to recommend the vaccine to parents. Addressing these gaps will enable nurses to play a critical role in the successful implementation of malaria immunization campaigns, lowering the illness burden among vulnerable populations.

Geopolitical sacrifice zones in US strategic thought: erasure, the frontier and the Blue Pacific

Bridging the critical concepts of the spatial frontier and sacrifice zones with strategic thought, this article argues that Washington’s recent geopolitical ‘rediscovery’ of the Pacific primarily represents an imagining of the Blue Pacific as a new frontier for geopolitical competition; a site toward which its military strategy can redirect adversary violence. Unconsciously erasing actually existing social and political structures across the region is a condition of possibility for exclusionary strategies based on a prejudicial rationality that, ironically, risks heightening regional and US insecurity. This insight corrects a common category error claiming that the US goal in the Pacific is ‘strategic denial’ when it is more precisely described as control in the name of strategic denial. The risk that entire Pacific nations become zones for extraction or wartime sacrifice increases when policymakers imagine it as a blank canvas for a ‘great game’.

African leadership in brain diplomacy: The Yaoundé declaration advances the global brain economy playbook for better brain Health.

African leadership in brain diplomacy: The Yaoundé declaration advances the global brain economy playbook for better brain Health.

For girls and women (4GW) HPV RCT protocol: a crowdsourced, pragmatic stepped-wedge cluster randomized trial to improve uptake of HPV vaccination and screening among mother-daughter dyads in Nigeria

BackgroundExpanding human papillomavirus (HPV) vaccination for girls and HPV self-collection for women can reduce the global burden of cervical cancer. However, HPV vaccination and self-collection services are rarely implemented simultaneously in mother-daughter dyads, leaving a critical gap in cervical cancer prevention. From 2023 to 2024, a community-engaged model for combined HPV vaccination and screening was co-designed using crowdsourcing open calls and designathons with mother-daughter teams and pilot-tested by trained research facilitators. This study explores the impact of this crowdsourced, community-engaged mother-daughter campaign and implementation strategy bundle on HPV vaccination among girls and HPV screening among their mothers in Nigeria over 6 months in 18 Nigerian local government areas (LGAs).MethodsA hybrid effectiveness-implementation type II pragmatic stepped-wedge cluster randomized control trial has been employed to the effectiveness of an implementation strategy bundle; a crowdsourced, tailored, community-engaged, mother-daughter HPV campaign on increasing uptake of HPV vaccination among girls aged 9–14 and HPV screening uptake among women aged 30–49 in Nigeria. The mother-daughter campaign will be tailored to local sites and conducted among 612 mother-daughter dyads (1,224 participants) recruited from 18 LGAs in six geopolitical zones of Nigeria. Trained community health workers will collect baseline data and implement a mother-daughter campaign that will provide education on cervical cancer control and access to onsite services for HPV vaccination and screening in a private area while engaging mothers and daughters simultaneously to increase uptake of the services. A mixed-methods evaluative and iterative assessment will be conducted using Proctor’s Implementation Outcomes Framework and the PEN- 3 cultural model. The primary outcomes are the uptake of HPV preventive measures—HPV vaccination (one dose) among girls (ascertained by onsite clinical records of vaccine uptake) and HPV self-collection completion among mothers (ascertained by laboratory receipt of self-collected specimens) within six months of trial enrollment. Pre-post effectiveness and cost of study components are embedded in the implementation and sustainment phases, compared to pre-implementation data assessed for each LGA.DiscussionThis study is a unique dyadic intervention focused on both girls and their mothers or female caregivers to drive cervical cancer control in Africa. Findings have the potential to inform local and global policies aimed at reducing the cervical cancer burden in African countries like Nigeria, eliminating missed opportunities by closing the research-to-translation gap. The protocol was registered with clinicaltrials.gov under registration NCT06728085.

Digital Instructions and Self-Directed Learning as Determinants of Academic Performance Amongst Higher Education Institutions’ Students (Heis)

The rapid digitalization of education has transformed instructional methodologies in higher education institutions (HEIs). This paper explores the role of digital instruction and self-directed learning (SDL) as key determinants of academic performance. While digital instruction offers flexibility and accessibility, SDL empowers students to take ownership of their learning. The interplay between these factors significantly influences academic success. The population of study covered all the students of the government owned tertiary institutions in the six geopolitical zones used for the study. The study adopted the correlational survey design and utilized purposive sampling technique to select 185 students from the institutions. The instruments used for the study was developed by the researchers, titled Digital Instructions and Self-directed Learning as determinants of academic performance amongst Higher Education Institutions’ Students (HEIs) Questionnaire (DIaSLdAHEIsQ). The instrument was validated by experts in measurement and evaluation department to ensure content validity. The reliability of 0.88 at Cronbach alpha using test-retest method, there after Pearson Product Moment Correlation (PPMC) was used. Two (2) research questions were raised to guide this study and they were answered using the PPMC. The findings of the study revealed that digital instructions significantly correlate with academic performance of students in HEI (r = .244**, N= 185, P &lt; .05), and also that digital instructions positively correlate with self – directed learning amongst students in HEI (r = .337***, N= 185, P &lt; .05) at 0.05 level of significance. Based on the findings the following recommendations were made, that articulate use of digital resources ought to be underpinned by deployment of meaningful instructional materials and digital tools and activities. Teachers’ professional competence on the use of digital resources.

Exploring the role of open and distance education in empowering women technological skills in Nigeria

The pursuit of gender equality and women's empowerment is a crucial driver of societal and economic growth in any nation. Despite the expansion of educational opportunities, women in Nigeria still encounter major obstacles to pursuing higher education and developing their technological skills, particularly in rural areas. The study focuses on exploring how Open and Distance Education (ODE) can empower women's technological skills in Nigeria. The study used a descriptive survey design to examine 200 females (56% students and 44% staff) who were purposively selected from study centres of the National Open University of Nigeria (NOUN) in the six geo-political zones. Findings reveal that ODE greatly impacted women's access to quality education in Nigeria's rural regions. It also reveals financial constraints, limited access to information technology (IT) resources, and weak support mechanisms as major obstacles women face while accessing ODE. Finally, the findings suggest that ODE can play a transformative role by equipping women with skills relevant to the 4th industrial revolution, thereby enhancing their employment prospects, fostering entrepreneurial initiatives, and ultimately contributing to Nigeria’s broader socio-economic growth. Policy recommendations include investing in ODE infrastructure, increasing community awareness, and developing women-focused curricula to support an inclusive digital future for Nigerian women.

Association between lifestyle trends and obesity among adults in Imo state

Background: Obesity is a rising global public health concern that has complex causes. The aim of study was to ascertain the association between lifestyle trend and obesity among adults in Imo State and to ascertain the awareness of obesity and its lifestyle modification among the participants. Methods: This study used a cross-sectional, community-based methodology and focused on some communities in each of the three geopolitical zones of Imo State, South East, Nigeria. Using multistage proportionate stratified random cluster sampling technique, study areas were chosen. Participants' information were obtained using a standardised, validated questionnaire that was designed to have both open-ended and closed-ended questions. After the questionnaire have been administered, anthropometric measures were taken. Multiple linear regression was used to determine associations. Results: Awareness of obesity was low, with only 21.6% of obese participants recognising their condition. Multiple linear regression to test for association between regression lifestyle trends and obesity was insignificant (R2=0.793, F=2.09, P=0.189). Conclusions: This study highlights a low awareness of obesity status among obese participants pointing to a critical gap in health literacy in the area. Lifestyle trends did not independently predict obesity, suggesting the complexity of obesity determinants in this population.

Integrating Traditional Medicine into Nigeria’s National Healthcare System: A Literature Review

United Nations Sustainable Develop Goal (SDG) number 3 is to “Ensure healthy lives and promote the well-being for all at all ages”. To achieve the SDGs by 2030, the United Nations expects all countries and stakeholders to act in a collaborative partnership to implement the action plan forward in 2015. However, the attitude, and actions of Nigerian policymakers and the decision makers in the healthcare sector, which contribute to poor state of the health sector and the continuous migration of Nigerian healthcare professionals, tend to show that this goal is not likely to be achieved in 2030 or the nearest future. Nigeria’s healthcare system has been ailing for many decades and has consistently failed to adequately meet the healthcare needs of most Nigerians. The political leaders have failed to come up with effective policies to address the situation due largely to their non or low patronage of Nigerian hospitals for treatment. The World Health Organization (WHO) has provided Member States with general guidelines for methodologies on research and evaluation of traditional medicine and strategies for integrating it with orthodox medicine, and different countries have identified the important contributions of traditional medicine to the health and well-being of their citizens. The objective of this paper is to explore the influence and contributions of traditional medicine to the health and wellness of Nigerians and recommend how policymakers in Nigeria can develop policies and strategies to standardize and integrate traditional medicine into the healthcare system in Nigeria as part of the process of addressing healthcare problems and move towards the attainment of the SDGs. A scoping search method of Google Scholar and other websites for studies and reports on Nigeria’s traditional medicine, orthodox medicine, healthcare system, healthcare infrastructure, integration of traditional and orthodox medicines, health policies, and global traditional medicine practices was conducted. A total of seventy-seven studies and reports that focused on these key search words were included, reviewed and analyzed. On traditional medicine usage, majority of participants in the thirteen studies that covered one or more of each of the six geopolitical zones in Nigeria showed that majority of Nigerians use traditional medicines. However, the results of studies on the development, standardization and integration of traditional medicine into Nigeria’s healthcare system showed that the design and implementation of appropriate policies for research, evaluation of the safety and efficacy of traditional medicines, and its integration with orthodox medicine in Nigeria remains incoherent.

Organisational Process Assets Management and Sustainable Growth of Manufacturing Companies in the South-South Geo-Political Zone of Nigeria.

Purpose: This study examined organisational process assets management and sustainable growth of manufacturing companies in the South-South Geopolitical Zone of Nigeria. The study focused on the relationship between defect management process, financial management process, organisational policy, and sustainable growth of manufacturing companies. Methodology: The study adopted a descriptive survey with a sample size of 395 SME owners. A questionnaire was used as the instrument. The Pearson Product Moment Correlation (PPMC) was used to test the hypotheses. Findings: The findings revealed that there is a positive significant relationship between defect management processes and sustainable growth of manufacturing companies (r=0.132, p=0.000); there is a positive significant relationship between financial management processes and sustainable growth of manufacturing firms (r=0.110, p=0.000); and there is a positive significant relationship between organisational policy and sustainable growth of manufacturing firms (r=0.110, p=0.000). Unique Contribution to Theory, Practice, and Policy: It was recommended, among others, that manufacturing firms should incorporate defect management processes, financial management processes, and organisational policy into their strategic management processes.

Spatial and temporal modeling of conflict related fatality and public health implications in Nigeria

Fatality resulting from violent conflicts poses a critical public health challenge in Nigeria, straining healthcare systems, disrupting resource allocation, and necessitating targeted interventions to curb the prevalence and strengthen community resilience. According to the Global Organized Crime and Terrorism Indices, Nigeria is ranked among the top countries most impacted by terrorism in 2020. Despite numerous studies on crimes in Nigeria, adequate attention has not been given to quantifying the patterns of fatalities due to conflict events. This work aims to unveil the subtle spatio-temporal pattern of fatality resulting from violent events in Nigeria over a quarter-century. A spatio-temporal mixed model within a Bayesian framework was adopted, and data was sourced from the Armed Conflict Location and Event Data Project. The study found existing temperate seasonality in the pattern of fatalities, with a high fatality impact in Autumn and Winter. Among all the events, sexual violence was the leading cause of fatality in the country. Findings identified spatial and temporal disparities in fatality, with the North-East geopolitical zone being the most exposed region over the years, and uneducated members of poorest households are relatively more at risk of these events. The identified factors and patterns could be relevant for designing sustainable intervention programs or response policies to mitigate violent events in Nigeria.

The 4 youth by youth (4YBY) crowdsourced HIV prevention intervention: A stepped-wedge longitudinal trial on HIV self-testing uptake among adolescents and young people in Nigeria.

The 4 youth by youth (4YBY) crowdsourced HIV prevention intervention: A stepped-wedge longitudinal trial on HIV self-testing uptake among adolescents and young people in Nigeria.

Communicating health information at the community level in Nigeria: examining common practices and challenges

ABSTRACT Background Communicating health information at the community level is a vital strategy in managing community health issues in Africa. This study examines the different practices of communicating health information towards improving community health in Nigeria, and how effective they have been. The social cognitive theory (SCT) provides the conceptual framework for the study. Methodology A qualitative study was carried out in three states from three out of the six geopolitical zones of Nigeria. The states were Akwa Ibom State (South-south), Anambra State (South-east) and Kano State(North-west). The primary data for the study were collected from a diverse group of stakeholders cutting across community leaders, policy-makers, and informal and formal health providers, using ninety in-depth interviews and twelve Focus Group Discussions (FGDs). Thematic analysis was used to explore the data. Result Different practices of communicating health information in Nigeria include organizing meetings among community members, training community health workers, data/records management, community collaboration for health, use of educational institutions, and community advocacy. The study identified inadequate finance, shortage of manpower, lack of motivation and cultural beliefs as barriers to effective practices of communicating health information at the community level. Conclusion There are unsystematic and sub-optimal communications of health information at the community level, which can militate against such information and hinder the effective delivery of health programmes to communities. Hence, health communication and promotional interventions should align with the needs of the communities, encompassing their structural, cultural, social, religious and economic systems. Abbreviations LGAs: Local Governments Areas; CDC: Centre for Disease Control; FMOH: Federal Ministry of Health; IDIs: In-depth Interviews; CSOs: Civil Societies Organisations; FGDs: Focus Group Discussions; UNTH: University of Nigeria Teaching Hospital; CGW: Community Group for Women; R: Respondent; OIC: official-in-charge; WDC: Ward Development Chairman; TBAs: Traditional Birth Attendants; IHP: Informal Health Provider; HMIS: Health Management Information System; PMV: Patent Medicine Vendor; HIV: Human Immune Virus; NGOs: Non-governmental Organisation; CL: Community Leader; HRH: Human Resources for Health; PHC: Primary Health Care; USAID: United States Agency for International Development; WHO: World Health Organization; OO: Obinna Onwujekwe; EE: Enyi Etiaba; AJA: kogwu James Abah; HPRG: Health Policy Research Group

The determinants of female genital mutilation among daughters in Nigeria.

Female Genital Mutilation/Circumcision (FGM/C) refers to the complete or incomplete removal of the female external genital or other injuries for non-medical or cultural reasons. It is a culturally harmful practice without health benefits with long-term complications to women's psychological, physical, and sexual health and well-being that violates the victims' rights because it is done without their consent. Despite International efforts to eradicate this harmful practice, it persists, therefore, this study examined the sociodemographic factors of mothers of reproductive age that affected the likelihood of their daughters undergoing female genital mutilation or circumcision. The 2021 Multiple Indicator Cluster Survey (MICS) female genital mutilation response weighted data of women of reproductive age 15-49 years was used for this study. Bivariate and multivariable logistic regression analyses were done to predict the determinants of female genital mutilation among daughters, and those with a p-value of ≤.05 were considered statistically significant determinants. Results showed a statistically significant difference between educational level, ethnicity of household head, household wealth index, geopolitical zone, ever circumcised, and daughter circumcised at Alpha =.05 in the multivariable regression analysis. Place of Residence and Marital Status were not statistically significant in the multivariable regression analysis at Alpha =.05. Considering that Nigeria has a population of over 200 million people, a figure of 14.2% of daughters circumcised is high and, therefore, requires concerted interventions by all stakeholders to address this harmful practice.

"Institutional Quality and Export Intensity of Nigerian SMEs: An Institutional-Based View using Logistic Regression Analysis"

In many developing nations, weak institutional quality presents significant hurdles for SMEs, hindering their ability to thrive in international markets due to issues like corruption, Bureaucratic red-tapeism, and unpredictable regulations. As a result, there is a widespread acknowledgement that the quality of institutions profoundly shapes the landscape in which SMEs operate, impacting their survival and export capabilities. This study sets out to explore the intricate relationship between institutional quality and export intensity within Nigeria's diverse geopolitical zones. To achieve this, data was collected from all six geopolitical zones in Nigeria and analyzed it using logistic regression techniques. The study reveals a positive relationship between institutional quality and export intensity in Nigeria, but this relationship varies across different geopolitical zones. This study also highlights the crucial role of institutional quality in driving export-led growth and economic development, shedding light on the complexities inherent in navigating diverse institutional environments. By uncovering these dynamics, the study provides valuable insights for policymakers, businesses, and stakeholders seeking to enhance export performance and foster sustainable economic development.

Concordance of Cervical Cancer Screening Methods in a Low-Resource Setting

Background: Cervical cancer poses a major public health challenge, especially in low-resource settings where advanced screening is scarce. Visual Inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) serve as alternatives to HPV testing. This study evaluates their concordance with HPV testing for cervical cancer screening in Imo State, Nigeria. Materials and Methods: A cross-sectional study was conducted from February to June 2023 across three geopolitical zones of Imo State. A total of 257 women underwent VIA, VILI, and HPV DNA testing. Sensitivity, specificity, Cohen’s kappa value, and Youden’s Index were used to assess concordance. Results: HPV positivity was 43.6%, while VIA and VILI positivity rates were 11.3% and 28.8%, respectively. VIA had a sensitivity of 18.8%, specificity of 94.5%, positive predictive value (PPV) of 72.4%, and negative predictive value (NPV) of 60.1%. VILI showed higher sensitivity (42.0%) but lower specificity (81.4%), with a PPV of 63.5% and NPV of 64.5%. Cohen’s kappa values for VIA and VILI were 0.142 and 0.243, respectively, indicating slight to fair agreement with HPV testing. Youden’s Index values were 0.133 for VIA and 0.234 for VILI, reflecting low diagnostic performance. Conclusion: VIA and VILI demonstrated limited sensitivity and low concordance with HPV testing. VILI performed slightly better, but both methods exhibited poor agreement, highlighting the need for improved screening strategies. Combining visual inspection with more sensitive techniques may enhance diagnostic accuracy. Further research is needed to refine and integrate screening methods in low-resource settings.

Conflict Entrepreneurs, Insurgency and Underdevelopment in the North-East Geopolitical Zone of Nigeria

Insurgency and other violent conflicts in the Northeastern part of Nigeria remain a recurring challenge to Nigeria's security and national development. This is largely due to the activities of conflict entrepreneurs whose business interest is directed to stimulate and prolong conflicts through various means. The menace led to the destruction of lives and properties and the displacement of residents. Several interventions by the government have been put in place to curb the menace, yet insecurity heightens. This paper examined how conflict entrepreneurs promote insurgency and under-development in the North-East geopolitical zone of Nigeria. The paper adopted the Queer Ladder Theory (QLT) and the Greed and Grievance theory as a guide. The qualitative approach that relied on secondary data sources was employed. The study revealed that conflict entrepreneurs in the northeast region of Nigeria sustain insurgencies and underdevelopment through economic incentives, political manipulation, and ideological extremism. Weak governance, corruption, and poor security responses enable these actors, to lead to declining infrastructure, mass displacement, food insecurity, and human capital erosion. It is recommended that the government should focus on dismantling economic networks supporting conflict entrepreneurs, strengthening border security, disrupting illicit trade, and enforcing stricter financial regulations. Alternative economic opportunities should be provided to vulnerable populations. Strong governance and accountability measures, anti-corruption initiatives, and community engagement strategies should be implemented to curb political actors' influence and promote social cohesion.

Seroprevalence, seroconversion, and mother-to-child transmission of dual and triplex infections of HIV, HBV, and HCV among Nigerian obstetric population: A national multicentre prospective cohort study.

ObjectivesTo determine seroprevalence, seroconversion, and mother-to-child transmission (MTCT) rates for dual and triplex infections of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among pregnant women.MethodsA multicentre prospective cohort study was conducted in six randomly selected tertiary hospitals from six geopolitical zones of Nigeria. Consenting participants were tested at recruitment for triplex infections and followed-up till delivery. Retests were performed at delivery for those who tested negative for all three infections/positive for only one. Polymerase chain reaction was used for validation while rapid test kits were employed for initial screening.ResultsOf the 2775 participants recruited, 13 (0.47%; 95% CI: 0.25%-0.80%) and 4 (0.14%; 95% CI: 0.04%-0.37%) were seropositive for dual and triplex infections, respectively. Dual infections revealed seroprevalences of 0.22% for HIV-HBV (6/2775; 95% CI: 0.08%-0.47%), 0.14% for HIV-HCV (4/2775; 95% CI: 0.04%-0.37%), and 0.11% for HBV-HCV (3/2775; 95% CI: 0.02%-0.32%). Multivariable analysis highlighted significant associations between HIV/HBV co-infection and religion (adjusted odds ratio (aOR): 0.068, 95% CI: 0.006-0.757) and house ownership (aOR): 1.65 × 10-9, 95% CI: 1.60 × 10-9-1.70 × 10-9). Continuing our follow-up until delivery for 2403 initial participants, 2386 did not have dual or triplex infections at the start. Upon retesting at delivery, three of these women were seropositive for a dual infection of HIV and HBV, giving a seroconversion rate of 0.12% (95% CI: 0.03% to 0.37%). MTCT rate stood at 0% at 6-week post-delivery.ConclusionWe observed a relatively low seroprevalence and seroconversion rates for dual and triplex infections of HIV, HBV, and HCV among pregnant women in Nigeria and no MTCT.