Lessons learnt from assessing and improving accuracy and positive predictive value of the national HIV testing algorithm in Nigeria.

Background: HIV testing remains an entry point into HIV care and treatment services. In 2007, Nigeria adopted and implemented a two-test rapid HIV testing algorithm of three HIV rapid test kits, following the sequence: Alere Determine (first test), Unigold (second test), and STAT-PAK as the tie-breaker. Sub-analysis of the 2018 Nigeria HIV/AIDS Indicator and Impact Survey data showed significant discordance between the first and second tests, necessitating an evaluation of the algorithm.

Longitudinal viral load outcomes of adults with HIV after detectable viremia on tenofovir, lamivudine, and dolutegravir.

Background: To inform optimal management of HIV viremia on tenofovir, lamivudine, and dolutegravir (TLD), we examined viral load (VL) outcomes of a large cohort of adult PWH on TLD in Nigeria.

Methods: We conducted a retrospective study of adult PWH who had ≥1 VL after initiating TLD during January 2017-February 2023. VLs were categorized as undetectable (≤50 copies/ml), low low-level viremia (LLV, 51-199 copies/ml), high LLV (200-999 copies/ml), virologic nonsuppression (VLNS, ≥1000 copies/ml), and virologic failure (VF, ≥2 consecutive VLNS results).

Effect of Test and Treat on clinical outcomes in Nigeria: A national retrospective study.

Background: In Nigeria, results from the pilot of the Test and Treat strategy showed higher loss to follow up (LTFU) among people living with HIV compared to before its implementation. The aim of this evaluation was to assess the effects of antiretroviral therapy (ART) initiation within 14 days on LTFU at 12 months and viral suppression.

Methods: We conducted a retrospective cohort study using routinely collected de-identified patient-level data hosted on the Nigeria National Data Repository from 1,007 facilities.

Estimation of HIV prevalence and burden in Nigeria: a Bayesian predictive modelling study.

Background: The cost of population-based surveys is high and obtaining funding for a national population-based survey may take several years, with follow-up surveys taking up to five years. Survey-based prevalence estimates are prone to bias owing to survey non-participation, as not all individuals eligible to participate in a survey may be reached, and some of those who are contacted do not consent to HIV testing. This study describes how Bayesian statistical modeling may be used to estimate HIV prevalence at the state level in a reliable and timely manner.

From Paper Files to Web-Based Application for Data-Driven Monitoring of HIV Programs: Nigeria's Journey to a National Data Repository for Decision-Making and Patient Care.

Background: Timely and reliable data are crucial for clinical, epidemiologic, and program management decision making. Electronic health information systems provide platforms for managing large longitudinal patient records. Nigeria implemented the National Data Repository (NDR) to create a central data warehouse of all people living with human immunodeficiency virus (PLHIV) while providing useful functionalities to aid decision making at different levels of program implementation.

An analysis of the uptake of anti-retroviral treatment among pregnant women in Nigeria from 2015 to 2020.

The percentage of Human Immunodeficiency Virus (HIV) positive pregnant women that receive anti-retroviral treatment in Nigeria is low and has been declining. Consequently, 14% of all new infections among children in 2020 occurred in Nigeria. A detailed analysis of available data was undertaken to generate evidence to inform remedial actions.

Individual and household factors associated with non-disclosure of positive HIV status in a population-based HIV serosurvey.

Objectives: Non-disclosure of positive HIV status in population-based surveys causes underestimation of national HIV diagnosis and biases inferences about engagement in the care continuum. This study investigated individual and household factors associated with HIV non-disclosure to survey interviewers in Nigeria.

Design: Secondary analysis of a cross sectional population-based household HIV survey.

Predictors of adherence to option B+ approach for the prevention of mother to child transmission of human immunodeficiency virus in Abuja, 2017.

Introduction: option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja.

Serological markers and risk factors associated with Hepatitis B virus infection among Federal Capital Territory prison inmates, Nigeria: Should we be concerned?

Introduction: Hepatitis B virus (HBV) infection is hyper-endemic in Nigeria. Prisons are high-risk environments for the spread of infectious diseases. Worldwide, seroprevalence of HBV infection is substantially higher among individuals in correctional facilities when compared to general population.

10-year risk for cardiovascular diseases using WHO prediction chart: findings from the civil servants in South-western Nigeria.

Background: Globally, cardiovascular diseases (CVDs) have continued to ravage the human existence through the premature deaths of its workforce. Despite this burden, many studies in Nigeria have focused on determining the prevalence of risk factors which alone are insufficient to assess the risk of future cardiovascular events. Therefore, we determined the pattern and predictors of 10-year risk for CVDs in South-western Nigeria.

Epidemiology of Lassa Fever and Factors Associated with Deaths, Bauchi State, Nigeria, 2015-2018.

We report the epidemiology of Lassa fever in Bauchi State, a disease-endemic region, in Nigeria. Since 2015, major increases in Lassa fever attack rate and in the case-fatality rate have occurred in this state. A delay in seeking care by a case-patient for >7 days after symptom onset was the major predictor of death.

Demographic factors associated with HIV infection between low and high prevalence areas in Nigeria, 2015.

Introduction: Sub-Saharan Africa accounts for 66% of 36.7 million individuals living with HIV in 2015 with Nigeria having the second highest prevalence in Africa. The study aimed to find the prevalence and socio-demographic factors associated with HIV infection and compare these findings between high and low prevalence areas.

A cholera outbreak in a rural north central Nigerian community: an unmatched case-control study.

Background: Cholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in suspected cholera cases in Gomani, Kwali Local Government Area. NFELTP residents were deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and instituting appropriate control measures to control the outbreak.

Mortality Among Confirmed Lassa Fever Cases During the 2015-2016 Outbreak in Nigeria.

Objectives: To determine factors associated with mortality among confirmed Lassa fever cases.

Methods: We reviewed line lists and clinical records of laboratory-confirmed cases of Lassa fever during the 2016 outbreak in Nigeria to determine factors associated with mortality. We activated an incident command system to coordinate response.

High rates of loss to follow-up during the first year of pre-antiretroviral therapy for HIV patients at sites providing pre-ART care in Nigeria, 2004-2012.

Background: With about 3.4 million HIV-infected persons, Nigeria has the second highest number of people living with HIV (PLHIV) in the world. However, antiretroviral treatment (ART) coverage in Nigeria remains low with only 748,846 (22%) of PLHIV on ART by the end of 2014.

Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment - 10 Countries, 2004-2015.

Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/μL) among persons starting antiretroviral therapy (ART) is important to understand ART program outcomes, inform HIV prevention strategy, and forecast need for adjunctive therapies.

Incidence and predictors of tuberculosis among HIV-infected adults after initiation of antiretroviral therapy in Nigeria, 2004-2012.

Background: Nigeria had the most AIDS-related deaths worldwide in 2014 (170,000), and 46% were associated with tuberculosis (TB). Although treatment of people living with HIV (PLHIV) with antiretroviral therapy (ART) reduces TB-associated morbidity and mortality, incident TB can occur while on ART. We estimated incidence and characterized factors associated with TB after ART initiation in Nigeria.

A Decade of Monitoring HIV Epidemics in Nigeria: Positioning for Post-2015 Agenda.

Background: Nigeria accounts for 9% of the global HIV burden and is a signatory to Millennium Development Goals as well as the post-2015 Sustainable Development Goals. This paper reviews maturation of her HIV M&E system and preparedness for monitoring of the post-2015 agenda.

Methods: Using the UNAIDS criteria for assessing a functional M&E system, a mixed-methods approach of desk review and expert consultations, was employed.

Controlling malaria in pregnancy: how far from the Abuja targets?

Background: The Roll Back Malaria (RBM) initiative recommended that all pregnant women receive Inter mittent Preventive Treatment (IPTp) and that by 2010 at least 80% of people at risk of malaria (including pregnant women) use insecticide-treated bednets (ITN) in areas with stable transmission. We evaluated ITN/IPTp coverage, explored its associated factors, and estimated the number of pregnancies protected from malaria.

Materials And Methods: This analysis was based on data from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus).

Lower Levels of Antiretroviral Therapy Enrollment Among Men with HIV Compared with Women - 12 Countries, 2002-2013.

Equitable access to antiretroviral therapy (ART) for men and women with human immunodeficiency virus (HIV) infection is a principle endorsed by most countries and funding bodies, including the U.S. President's Emergency Plan for AIDS (acquired immunodeficiency syndrome) Relief (PEPFAR) (1).

The Nigeria wealth distribution and health seeking behaviour: evidence from the 2012 national HIV/AIDS and reproductive health survey.

Background: Recently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior.

Setting research priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop.

In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.

A description of HIV prevalence trends in Nigeria from 2001 to 2010: what is the progress, where is the problem?

Introduction: Nigeria's population of 160 million and estimated HIV prevalence of 3.34% (2011) makes Nigeria the second highest HIV burden worldwide, with 3.2 million people living with HIV (PLHIV).

Comparison of audio computer assisted self-interview and face-to-face interview methods in eliciting HIV-related risks among men who have sex with men and men who inject drugs in Nigeria.

Introduction: Face-to-face (FTF) interviews are the most frequently used means of obtaining information on sexual and drug injecting behaviours from men who have sex with men (MSM) and men who inject drugs (MWID). However, accurate information on these behaviours may be difficult to elicit because of sociocultural hostility towards these populations and the criminalization associated with these behaviours. Audio computer assisted self-interview (ACASI) is an interviewing technique that may mitigate social desirability bias in this context.