Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study

INTRODUCTION

Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans.

METHODS

A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05.

RESULTS

Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates.

CONCLUSIONS

NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans.

IMPLICATIONS

A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.

Socio-demographic and lifestyle factors associated with hypertension in Nigeria: results from a country-wide survey

With the rising prevalence of hypertension, especially in Africa, understanding the dynamics of socio-demographic and lifestyle factors is key in managing hypertension. To address existing gaps in evidence of these factors, this study was carried out. A cross-sectional survey using a modified WHO STEPS questionnaire was conducted among 3782 adult Nigerians selected from an urban and a rural community in one state in each of the six Nigerian regions. Among participants, 56.3% were women, 65.8% were married, 52.5% resided in rural areas, and 33.9% had tertiary education. Mean ages (SD) were 53.1 ± 13.6 years and 39.2 ± 15.0 years among hypertensive persons and their normotensive counterparts respectively. On lifestyle, 30.7% had low physical activity, 4.1% consumed tobacco currently, and 35.4% consumed alcohol currently. In comparison to unmarried status, being married (OR = 1.88, 95% CI: 1.41-2.50) or widowed (OR = 1.57, 95% CI: 1.05-2.36) was significantly associated with hypertension, compared with never married. Compared with no formal education, primary (OR = 1.44, 95% CI: 1.12-1.85), secondary (OR = 1.37, 95% CI: 1.04-1.81), and tertiary education (OR = 2.02, 95% CI: 1.57-2.60) were associated with hypertension. Low physical activity (OR = 1.23, 95% CI: 1.05-1.42), alcohol consumption, (OR = 1.18, 95% CI: 1.02-1.37), and unemployment status (OR = 1.42; 95% CI: 1.07-1.88) were also associated with hypertension. Our study indicates an association of socio-demographic and lifestyle factors with hypertension, hence, there is a need for counselling, health education and policy formulation and implementation targeting these factors to prevent and control hypertension.

The importance of need-altruism and kin-altruism to blood donor behaviour for black and white people

BACKGROUND

Need-altruism (a preference to help people in need) and kin-altruism (a preference to help kin over non-kin) underlie two hypotheses for voluntary blood donation: (i) Need-altruism underlies motivations for volunteer blood donation and (ii) Black people express a stronger preference for kin-altruism, which is a potential barrier to donation. This paper tests these hypotheses and explores how need- and kin-altruism are associated with wider altruistic motivations, barriers, and strategies to encourage donation.

METHODS

We assessed need- and kin-altruism, other mechanisms-of-altruism (e.g., reluctant-altruism), barriers, strategies to encourage donation, donor status, and willingness-to-donate across four groups based on ethnicity (Black; White), nationality (British; Nigerian), and country-of-residence: (i) Black-British people (n = 395), and Black-Nigerian people (ii) in the UK (n = 97) or (iii) across the rest of the world (n = 101), and (v) White-British people in the UK (n = 452). We also sampled a Black-Nigerian Expert group (n = 60).

RESULTS

Need-altruism was higher in donors and associated with willingness-to-donate in non-donors. Levels of kin-altruism did not differ between Black and White people, but need-altruism was lower in Black-British people. Kin-altruism was associated with a preference for incentives, and need-altruism with a preference for recognition (e.g., a thank you) as well as an increased willingness-to-donate for Black non-donors. Need-altruism underlies a blood-donor-cooperative-phenotype.

CONCLUSION

Need-altruism is central to blood donation, in particular recruitment. Lower need-altruism may be a specific barrier for Black-British people. Kin-altruism is important for Black non-donors. The blood donor cooperative phenotype deserves further consideration. Implications for blood services are discussed.

GBA1 rs3115534 Is Associated with REM Sleep Behavior Disorder in Parkinson's Disease in Nigerians

BACKGROUND

Rapid eye movement (REM) sleep behavior disorder (RBD) is an early feature of Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Damaging coding variants in Glucocerebrosidase (GBA1) are a genetic risk factor for RBD. Recently, a population-specific non-coding risk variant (rs3115534) was found to be associated with PD risk and earlier onset in individuals of African ancestry.

OBJECTIVES

We aimed to investigate whether the GBA1 rs3115534 PD risk variant is associated with RBD in persons with PD.

METHODS

We studied 709 persons with PD and 776 neurologically healthy controls from Nigeria. All DNA samples were genotyped and imputed, and the GBA1 rs3115534 risk variant was extracted. The RBD screening questionnaire (RBDSQ) was used to assess symptoms of possible RBD.

RESULTS

RBD was present in 200 PD (28.2%) and 51 (6.6%) controls. We identified that the non-coding GBA1 rs3115534 risk variant is associated with possible RBD in individuals of Nigerian origin (β, 0.3640; standard error [SE], 0.103, P = 4.093e-04), as well as in all samples after adjusting for PD status (β, 0.2542; SE, 0.108; P = 0.019) suggesting that although non-coding, this variant may have the same downstream consequences as GBA1 coding variants.

CONCLUSIONS

Our results indicate that the non-coding GBA1 rs3115534 risk variant is associated with an increasing number of RBD symptoms in persons with PD of Nigerian origin. Further research is needed to assess if this variant is also associated with polysomnography-defined RBD and with RBD symptoms in DLB. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Prevalence of bifidity of the seventh cervical vertebral spinous process in southwestern Nigeria: a computed tomography based study

Palpation of the seventh cervical vertebra (C7) is an important landmark for counting vertebrae for vertebral spine surgical instrumentation. However, studies have shown that the spinous process of C7 displays an anatomical deviation among individuals, which may mislead a surgeon who is not aware of this, and there have been no such studies among southwest Nigerians. The present study aimed to examine the incidence of bifidity in the C7 spinous process and their variation among 48 subjects with the aid of a three-dimensional (3D) computed tomography. The 48 subjects who had undergone cervical spine computed tomography studies comprised the pooled data of ages between 12 and 55 years of black race in southwest Nigeria from the radiology department of the Trauma and Surgical Centre, Ondo State, Nigeria. A series of multivariate and discriminant statistical tests were performed on the measurement data to determine the occurrence of bifid spinous processes at C7 in southwestern Nigeria. The results show about 10% bifidity in the C-7 vertebra and no bifidity in the first cervical vertebra and the highest rate in the C-6 vertebra in the study population. The incidence in this study is significantly higher than findings in previous works. Thus, there is a need for clinicians to pay more attention to this variation when using C7 as a landmark especially in the studied population.

Is the national health insurance scheme a pathway to sustained access to medicines in Nigeria?

OBJECTIVE

The debate surrounding access to medicines in Nigeria has become increasingly necessary due to the high cost of essential medicine drugs and the prevalence of counterfeit medicines in the country. The Nigerian government has proposed the implementation of the National Health Insurance Scheme (NHIS) to address these issues and guarantee universal access to essential medicines. Access was investigated using the 3 A's (accessibility, affordability, and availability). This paper investigates whether the NHIS is a viable pathway to sustained access to medicines in Nigeria.

DESIGN

This was a cross-sectional study using a mixed-methods design. Both qualitative and quantitative methods were utilized for the study.

SETTING

This study was conducted at NHIS-accredited public and private facilities in Enugu State.

PARTICIPANTS

296 randomly selected enrollees took part in the quantitative component, while, 6 participants were purposively selected for the qualitative component, where in-depth interviews (IDIs) were conducted face-to-face with NHIS desk officers in selected public and private health facilities.

RESULTS

The quantitative findings showed that 94.9% of respondents sought medical help. Our data shows that 78.4% of the respondents indicated that the scheme improved their access to care (accessibility, affordability, and availability). The qualitative results from the NHIS desk officers showed that respondents across all the socio-economic groups reported that the NHIS had marginally improved access to medicine over the years. It was also observed that most of the staff in NHIS-accredited facilities were not adequately trained on the scheme's requirements and that most times, essential drugs were not readily available at the accredited facilities.

CONCLUSION

The study findings revealed that although the NHIS has successfully expanded access to medicines, there remain several challenges to its effective implementation and sustainability. Additionally, the scheme's coverage of essential medicines is could be improved even more, leading to reduced access to needed drugs for many Nigerians. A focus on the 3As for the scheme means that all facility categories (private and public) and their interests (where necessary) must be considered in further planning of the scheme to ensure that things work out well.

Exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) at Nigeria's petrol stations: a review of current status, challenges and future directions

Introduction

In Nigeria, because of increasing population, urbanization, industrialization, and auto-mobilization, petrol is the most everyday non-edible commodity, and it is the leading petroleum product traded at the proliferating Nigeria's petrol stations (NPSs). However, because of inadequate occupational health and safety (OHS) regulatory measures, working at NPSs exposes petrol station workers (PSWs) to a large amount of hazardous benzene, toluene, ethylbenzene, and xylene (BTEX) compounds.

Methods

Studies on BTEX exposures among Nigerian PSWs are scarce. Thus, constraints in quantifying the health risks of BTEX limit stakeholders' ability to design practical risk assessment and risk control strategies. This paper reviews studies on the OHS of Nigerian PSWs at the NPSs.

Results

Although knowledge, attitude, and practices on OHS in NPSs vary from one Nigeria's study setting to another, generally, safety practices, awareness about hazards and personal protective equipment (PPE), and the use of PPE among PSWs fell below expectations. Additionally, air quality at NPSs was poor, with a high content of BTEX and levels of carbon monoxide, hydrogen sulfide, particulate matter, and formaldehyde higher than the World Health Organization guideline limits.

Discussion

Currently, regulatory bodies' effectiveness and accountability in safeguarding OHS at NPSs leave much to be desired. Understanding the OHS of NPSs would inform future initiatives, policies, and regulations that would promote the health and safety of workers at NPSs. However, further studies need to be conducted to describe the vulnerability of PSWs and other Nigerians who are occupationally exposed to BTEX pollution. More importantly, controlling air pollution from hazardous air pollutants like BTEX is an essential component of OHS and integral to attaining the Sustainable Development Goals (SDG) 3, 7, and 11.

Untargeted metabolomic profiling reveals molecular signatures associated with type 2 diabetes in Nigerians

BACKGROUND

Type 2 diabetes (T2D) has reached epidemic proportions globally, including in Africa. However, molecular studies to understand the pathophysiology of T2D remain scarce outside Europe and North America. The aims of this study are to use an untargeted metabolomics approach to identify: (a) metabolites that are differentially expressed between individuals with and without T2D and (b) a metabolic signature associated with T2D in a population of Sub-Saharan Africa (SSA).

METHODS

A total of 580 adult Nigerians from the Africa America Diabetes Mellitus (AADM) study were studied. The discovery study included 310 individuals (210 without T2D, 100 with T2D). Metabolites in plasma were assessed by reverse phase, ultra-performance liquid chromatography and mass spectrometry (RP)/UPLC-MS/MS methods on the Metabolon Platform. Welch's two-sample t-test was used to identify differentially expressed metabolites (DEMs), followed by the construction of a biomarker panel using a random forest (RF) algorithm. The biomarker panel was evaluated in a replication sample of 270 individuals (110 without T2D and 160 with T2D) from the same study.

RESULTS

Untargeted metabolomic analyses revealed 280 DEMs between individuals with and without T2D. The DEMs predominantly belonged to the lipid (51%, 142/280), amino acid (21%, 59/280), xenobiotics (13%, 35/280), carbohydrate (4%, 10/280) and nucleotide (4%, 10/280) super pathways. At the sub-pathway level, glycolysis, free fatty acid, bile metabolism, and branched chain amino acid catabolism were altered in T2D individuals. A 10-metabolite biomarker panel including glucose, gluconate, mannose, mannonate, 1,5-anhydroglucitol, fructose, fructosyl-lysine, 1-carboxylethylleucine, metformin, and methyl-glucopyranoside predicted T2D with an area under the curve (AUC) of 0.924 (95% CI: 0.845-0.966) and a predicted accuracy of 89.3%. The panel was validated with a similar AUC (0.935, 95% CI 0.906-0.958) in the replication cohort. The 10 metabolites in the biomarker panel correlated significantly with several T2D-related glycemic indices, including Hba1C, insulin resistance (HOMA-IR), and diabetes duration.

CONCLUSIONS

We demonstrate that metabolomic dysregulation associated with T2D in Nigerians affects multiple processes, including glycolysis, free fatty acid and bile metabolism, and branched chain amino acid catabolism. Our study replicated previous findings in other populations and identified a metabolic signature that could be used as a biomarker panel of T2D risk and glycemic control thus enhancing our knowledge of molecular pathophysiologic changes in T2D. The metabolomics dataset generated in this study represents an invaluable addition to publicly available multi-omics data on understudied African ancestry populations.

Nonalcoholic Fatty Liver Disease and Associated Risk Factors in Obese Nigerians: A Cross-Sectional Study

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is now adjudged the most common liver disease in the world, contributing to the rising incidence of hepatocellular carcinoma worldwide. However, the true prevalence of nonalcoholic fatty liver disease among obese individuals and its contribution to the burden of liver disease in Nigeria is unknown.

AIM

To determine the prevalence of nonalcoholic fatty liver disease and associated risk factors in obese subjects.

METHODS

This was a cross-sectional analytical study of 280 obese subjects and 280 nonobese age and sex-matched controls seen at our health facility. Data collection was done using an interviewer-administered questionnaire and anthropometric parameters were obtained. Fasting blood samples were collected for blood glucose, lipid profile, and liver biochemistry. Abdominal ultrasound was used to screen for NAFLD. The results were subjected to relevant statistical analysis using SPSS version 20.

RESULTS

A higher prevalence of NAFLD was found in obese subjects, compared with nonobese controls (36.4% versus 0.4% P < 0.001). The degree of obesity, transaminases, total cholesterol, diastolic hypertension, fasting blood glucose, and waist circumference was significantly associated with a higher prevalence of NAFLD. However, using multivariate logistic regression analysis, diabetes mellitus and hypertension were significant associations for NAFLD. Individuals with NAFLD had a significantly higher prevalence of metabolic syndrome 65.9%, compared with 34.1% in obese individuals without NAFLD (P < 0.001).

CONCLUSION

The prevalence of NAFLD in obese subjects was significant. NAFLD in obese subjects was associated with degree of obesity, hyperlipidemia, hypertension, and diabetes mellitus.

Knowledge, Accessibility and Utilization of the National Health Insurance Scheme (NHIS) Among Registered Employees of Federal Government Institutions in Ebonyi State: Lessons for Medical Social Workers

Like most low-and-middle-income countries, Nigeria has been finding it difficult to meet the basic needs of her populace including their health needs. Nigerians are dying of preventable diseases because of poverty and the lack of a functional healthcare system. As a result, the Nigerian government introduced the National Health Insurance Scheme (NHIS) to cater to the health needs of its population. This study assessed the knowledge, accessibility and utilization of the NHIS among registered employees of federal government institutions in Ebonyi state. The study used Focus Group Discussions (FGDs) and in-depth interviews (IDIs) to collect data from 43 participants. The collected data was analyzed using thematic analysis. Findings revealed that most of the participants have accessed and utilized the scheme and saw it as a good healthcare system. They also reported a lack of most of the prescribed drugs and inadequate personnel at the NHIS clinics which is impacting the effectiveness of the scheme. The paper recommends that NHIS should create more awareness about the scheme, and cover more dependents, drugs, tests, and treatment bills to make it more effective in healthcare delivery.

Mining from the pipeline: Artisanal oil refining as a consequence of failed CSR policies in the Niger Delta

Oil production in the Niger Delta first attained global prominence after the 1995 hangings of Ken Saro-Wiwa and eight other Ogonis. In the face of horrible publicity and credible allegations that international oil companies were complicit in systematic human rights violations against local host communities, corporate social responsibility (CSR) was embraced. CSR in the Nigerian oil industry has evolved from non-existent to limited community development programs to today's Global Memorandum of Understanding model. Yet, concomitant with CSR's growth has been a devastating increase in artisanal oil refining or "bunkering." In this article, we do not focus on industrial scale bunkering, which clearly requires high-level political support. Instead, we focus on the growth of small-scale artisanal refining in the rural Niger Delta. We situate this sector's growth in failed government and CSR policies, highlight its devastating environmental impacts, and advocate a shift away from flawed and limited CSR to legal and regulated modular refineries that, with fewer negative developmental and environmental externalities, could serve as a vital source of job creation and wealth generation.

Immunological insights into COVID-19 in Southern Nigeria

Introduction

One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic.

Methods

We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses.

Result

Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic.

Discussion

These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.

Coronavirus Disease 2019 Vaccination Coverage and Seropositivity amongst Nigerians 18 Years Old and Above

BACKGROUND

This was a cross-sectional community-based survey to study the prevalence of serum antibodies against the severe acute respiratory syndrome coronavirus 1 (SARS-COV-1) and determine possible source of antibodies as to whether from vaccination or from natural infection as well as attempt to compare antibody levels in response to the different four types of vaccines administered in Nigeria.

METHODS

A cross-sectional community-based study of the prevalence of serum antibodies against all four vaccine types used in Nigeria amongst a representative sample of people aged 18 years and above in the six geopolitical zones of the country using a multistage sampling technique covering 12 states of the country with two states being randomly selected from each geopolitical zone. High-throughput Roche electrochemiluminescence immunoassay system (Elecsys Anti-SARS-COV-1 Cobas) was used for qualitative and quantitative detection of antibodies to SARS-COV-1 in human plasma.

RESULTS

There was no statistically significant difference between the proportions with seropositivity for both the vaccinated and the unvaccinated (P = 0.95). The nucleocapsid antibody (anti-Nc) titres were similar in both the vaccinated and the unvaccinated, whereas the Spike protein antibody (anti-S) titres were significantly higher amongst the vaccinated than amongst the unvaccinated. Antibody levels in subjects who received different vaccines were compared to provide information for policy.

CONCLUSION

While only 45.9% of the subjects were reported to have been vaccinated, 98.7% of the subjects had had contact with the SARS-COV-1 as evidenced by the presence of nucleocapsid (NC) antibodies in their plasma. The 1.3% who had not been exposed to the virus, had spike protein antibodies which most likely resulted from vaccination in the absence of NC antibodies. Successive vaccination and booster doses either through heterogeneous or homologous vaccines increased antibody titres, and this stimulation of immune memory may offer greater protection against coronavirus disease 2019.

Association between Alanine Aminotransferase, Hypertension and Obesity in Nigerians

BACKGROUND

Cardiovascular diseases (CVDs) are the leading causes of morbidity and mortality worldwide. Alanine aminotransferase (ALT) is associated with hypertension and obesity.

OBJECTIVES

To determine the association between ALT within the reference range with hypertension and obesity.

METHODS

This study utilized the data of a cross-sectional health survey involving 558 adult participants. Anthropometry, blood pressure, and plasma glucose were determined with standard protocols. Quartiles of log-transformed ALT were generated and the association with obesity/hypertension was determined with ANOVA and regression analysis.

RESULTS

There were 205 (36.7%) men. The mean fasting plasma glucose (FPG) of all participants was 4.7 (1.6) mmol/L. In men, there was a positive correlation between ALT and body mass index (BMI) (r=0.148; p=0.038), waist circumference (WC) (r=0.166; p=0.020), and waist-to-height-ratio (WHtR) (r=0.163; p=0.021). No correlation was observed between ALT and anthropometric indices in women, or with blood pressure indices in both genders. In men, only WHtR (p for trend, 0.045) was significantly associated with ALT quartiles, whereas in women, only WC (p for trend, 0.028) was significantly associated with ALT quartiles. In men, compared to 1st quartile, the OR for general obesity of the 4th quartile of Log ALT was 2.662 (95% CI 1.219 - 5.816; p=0.014). In women, the OR for hypertension of the 3rd quartile of Log ALT versus the 1st quartile was 1.955 (95% CI 0.694 - 2.416; p=0.041). Log ALT did not predict hypertension and obesity in men and women, respectively.

CONCLUSIONS

The risks of obesity and hypertension increase as the ALT level increases within the normal ALT range. People with normal levels of ALT in the upper limits need to be evaluated for metabolic disorders.

Language-to-music transfer effects depend on the tone language: Akan vs. East Asian tone languages

Recent research suggests that speaking a tone language confers benefits in processing pitch in nonlinguistic contexts such as music. This research largely compares speakers of nontone European languages (English, French) with speakers of tone languages in East Asia (Mandarin, Cantonese, Vietnamese, Thai). However, tone languages exist on multiple continents-notably, languages indigenous to Africa and the Americas. With one exception (Bradley, Psychomusicology, 26(4), 337-345, 2016), no research has assessed whether these tone languages also confer pitch processing advantages. Two studies presented a melody change detection task, using quasirandom note sequences drawn from Western major scale tone probabilities. Listeners were speakers of Akan, a tone language of Ghana, plus speakers from previously tested populations (nontone language speakers and East Asian tone language speakers). In both cases, East Asian tone language speakers showed the strongest musical pitch processing, but Akan speakers did not exceed nontone speakers, despite comparable or better instrument change detection. Results suggest more nuanced effects of tone languages on pitch processing. Greater numbers of tones, presence of contour tones in a language's tone inventory, or possibly greater functional load of tone may be more likely to confer pitch processing benefits than mere presence of tone contrasts.

Assessing HLA imputation accuracy in a West African population

The Human Leukocyte Antigen (HLA) region plays an important role in autoimmune and infectious diseases. HLA is a highly polymorphic region and thus difficult to impute. We, therefore, sought to evaluate HLA imputation accuracy, specifically in a West African population, since they are understudied and are known to harbor high genetic diversity. The study sets were selected from 315 Gambian individuals within the Gambian Genome Variation Project (GGVP) Whole Genome Sequence datasets. Two different arrays, Illumina Omni 2.5 and Human Hereditary and Health in Africa (H3Africa), were assessed for the appropriateness of their markers, and these were used to test several imputation panels and tools. The reference panels were chosen from the 1000 Genomes (1kg-All), 1000 Genomes African (1kg-Afr), 1000 Genomes Gambian (1kg-Gwd), H3Africa, and the HLA Multi-ethnic datasets. HLA-A, HLA-B, and HLA-C alleles were imputed using HIBAG, SNP2HLA, CookHLA, and Minimac4, and concordance rate was used as an assessment metric. The best performing tool was found to be HIBAG, with a concordance rate of 0.84, while the best performing reference panel was the H3Africa panel, with a concordance rate of 0.62. Minimac4 (0.75) was shown to increase HLA-B allele imputation accuracy compared to HIBAG (0.71), SNP2HLA (0.51) and CookHLA (0.17). The H3Africa and Illumina Omni 2.5 array performances were comparable, showing that genotyping arrays have less influence on HLA imputation in West African populations. The findings show that using a larger population-specific reference panel and the HIBAG tool improves the accuracy of HLA imputation in a West African population.

Bibliometric structured review of tuberculosis in Nigeria

Background: The tuberculosis burden is growing in Nigeria along with its population. For example, Nigeria has the sixth highest TB burden globally, with an estimated 4.3 per cent multi-drug resistance in new cases. This study builds on the existing study that examined academic involvement in tuberculosis research. The study in question focused on global medical literature related to tuberculosis, but the non-visibility of some low and middle-income countries in the bigger global picture motivated this present study. Every year, over 245,000 Nigerians succumb to tuberculosis (TB), with approximately 590,000 new cases reported (of these, around 140,000 are also HIV-positive). This study carried out an academic publication evaluation with the VOS viewer tool to map bibliometric data for scholarly articles published between 1991 and 2021 on tuberculosis research and used the Biblioshiny app for analytics and plots of authors, sources, and documents to explore the descriptive statistics of tuberculosis literature. The present study delineates that England has the highest collaborating country with Nigeria in the study of tuberculosis over the years and according to the report, the University of Nigeria, the University of Ibadan, and Nnamdi Azikwe University are Nigerian institutions with extensive collaborations. This study concludes with managerial implications for future actions.

Human growth hormone, a marker for HIV infection among adult Igbo Nigerians: relationship between human growth hormone and CD4+ count with viral load

Routine viral load and CD4+ testing is key to monitoring the extent of danger caused by HIV and response to antiretroviral therapy (ART) for HIV individuals, but its availability has been limited in low and middle-income countries. The study sort to ascertain relationship between serum Human Growth Hormone (HGH) gold standard with CD4 cells and viral load in HIV-infected patients. CD4+ T-cells, HIV viral load, and HGH were assayed in HIV- infected patients from May to December 2020. 460 subjects were engaged and separated into two groups: the HIV-infected untreated (Pre-ART) and the control groups. An interventional study was conducted for the Pre-Art group after six months. Serum HGH was assayed by the ELISA method, CD4 cell count was examined by BD-FACScan flow cytometer, and HIV viral load was assessed using RT-PCR. The CD4 count and serum HGH of Pre-ART HIV-infected subjects were significantly low (p<0.05), while the viral load was significantly high compared to those treated with ART for 6months (p<0.05). CD4 count and serum HGH were significantly higher (p<0.05) in females than in males. It also reveals that CD4 count correlates positively with HGH level (r= 0.191**). Serum HGH could serve as a surrogate marker and valuable index in monitoring HIV patients.

Experiences of female clients in the assisted reproductive technology process in Nigeria

Background

Though assisted reproductive technology (ART) has been a source of hope for many infertile couples, it is known to be associated with physical, social, psychological, and ethical challenges in different settings.

Objective

The study objective was to explore the experiences of female clients who accessed services in ART clinics in Nigeria.

Methods

An exploratory qualitative design, using snowballing technique was employed. It involved in-depth interviews of eight women who had gone through the assisted conception process, using an interview guide. Data collection was from November 2019 to January 2020. Results: The age range of the participants was 30 - 52 years with a mean of 41.88 years. Majority of the clients presented at advanced age to their ART providers because of lack of funds and ignorance. Other challenges were suboptimal risk disclosure, high cost of services, feelings of shame and stigmatization during and after the process.

Conclusion

Cost of ART remain unaffordable to most Nigerians hence the need for government subsidization and in-corporation of ART services into the National Health Insurance Scheme. Additionally, lack of adequate information disclosure, shared decision-making and gendered suffering are areas of great concern among the study participants. A national regulatory guideline will ensure uniform international standard of care.