Background Fungal infections in children infected with human immunodeficiency virus (HIV) are a significant cause of morbidity and mortality. However, there are no reports on this subject in Nigerian children. Objective This study aimed to document the spectrum of fungal infections and their outcomes in Nigerian children infected with HIV. Methodology The case records of all children infected with HIV in three South West Nigerian tertiary hospitals were studied. Data on the identified fungal infection, clinical presentation, and outcomes were obtained and analyzed. Results A total of 175 children infected with HIV, comprising 89 (50.9%) boys and 86 (49.1%) girls, with ages ranging from 2 months to 16 years, were studied. Of the population studied, 83 (47.4%) had dermatophytosis and 24 (13.7%) had invasive fungal infections (IFIs). Tinea capitis, thrush (pityriasis versicolor), and tinea corporis constituted more than 75% of the dermatophytosis. Invasive candidiasis, Pneumocystis pneumonia, cryptococcal disease, and aspergillosis accounted for more than 95% of the IFIs. Among the 175 children, 61 (34.9%) admissions and 12 (6.9%) deaths were recorded. Nine of the 12 deaths were due to IFIs. Infants and children not on Highly Active Anti-Retroviral Therapy had higher rates of IFIs ( p < 0.01). Admission and death rates were higher among those with IFIs ( p < 0.01). Higher rates of IFIs and dermatophytosis were found among those with a low socioeconomic status ( p < 0.05). Appropriate diagnostics were lacking for Pneumocystis pneumonia and cryptococcal disease diagnosis. Fluconazole was the only antifungal available and accessible for cryptococcal meningitis management. Conclusion Fungal infections cause significant morbidity and mortality in children infected with HIV. Appropriate diagnostics and medications must be made accessible to reverse IFI treatment outcomes.
Olusola Adetunji Oyedeji, Joseph Babafunso Ayinde, Odunayo Afolayan et al.
This study investigated the impact of Conditional Cash Transfer (CCT) Programme on vulnerable population in Akwa Ibom State of Nigeria. The study became necessary because of the ongoing problem of poverty, unemployment, and socioeconomic deprivation despite the implementation of the National Social Investment Programme (NSIP), as one of the major strategies in Nigeria's social protection system for poverty reduction. Specifically, the study aimed at assessing how the CCT programme had impact on the human capital development, economic empowerment of the vulnerable groups and the overall well-being of beneficiaries in the study area. The type of research in this study was descriptive survey. Target population were beneficiaries of the Conditional Cash Transfer programme of the selected Local Government Areas of Akwa Ibom State. The respondents were selected using correct sampling procedures in drawing a sample of 380 respondents. The structured questionnaire items that were used to collect primary data were based on four-point Likert scale items. Frequency counts and simple percentages were used in the analyses of the data to answer the research questions and in testing the hypotheses the Chi-square (χ²) statistical technique at 0.05 significance level was used. The results showed that the Conditional Cash Transfer programme failed to significantly increase human capital development of vulnerable populations (χ² = 2.803, p > 0.05) because there was no significant improvement in school enrolment, utilization of healthcare services, child nutrition and awareness of education. The study also indicated that there was a marginal economic empowerment of the beneficiaries with no significant improvement in income of the beneficiaries, food security and financial stability and only marginal improvement in income generating activities (χ² = 2.203, p > 0.05). The study recommended that the Conditional Cash Transfer programme though had achieved some level of improvement in poverty reduction, human capital development, economic empowerment and sustainable livelihood improvement in Akwa Ibom State, it still has limitation as a result of irregularity in cash disbursement, underfunding, low proportion of the poor and vulnerable targeted, limited programme coverage, weak monitoring and evaluation system, poor institutional co-ordination efforts and lack of integration with other complementary livelihood intervention efforts. The study thus suggested that for the effectiveness of the Program as a sustainable social protection and poverty reduction tool, government should ensure regular and timely cash disbursement, improve beneficiary targeting, monitoring and evaluation systems, and link the program to other relevant sectors, including skill and vocational acquisition, entrepreneurship development, agricultural support, financial inclusion, quality education, health care services, and employment generation.
Idaisin Israel Akpan, Chijioke Basil Onuoha, Itoro Bassey Ebong
Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical cancer; however, achieving high vaccination coverage among eligible girls depends largely on parental decision-making. This study assessed parental perceptions and intention to vaccinate female children aged 9–14 years against HPV in Ile-Ife, Nigeria, using the Theory of Planned Behaviour (TPB). A cross-sectional study was conducted between August and September 2024 among 163 parents of female children aged 9–14 years attending selected secondary schools in Ile-Ife, Nigeria, using a multistage sampling technique. Data were collected using a pretested questionnaire developed from previously validated instruments and analysed using IBM SPSS Statistics version 27. Chi-square tests and multivariable logistic regression were performed to identify factors associated with parental intention to vaccinate at a significance level of p < 0.05. Of the 163 questionnaires distributed, 160 (98.2%) were completed and analysed (response rate: 98.2%). Overall, 59.4% of parents had a positive perception of HPV vaccination, while 60.6% expressed an intention to vaccinate their female children. Higher education level (adjusted odds ratio [AOR] = 6.06; 95% confidence interval [CI] 2.11–17.38) and perceived behavioural control (AOR = 11.97; 95% CI 4.69–30.56) were associated with parental intention to vaccinate. In conclusion, both positive perception of HPV vaccination and parental intention to vaccinate female children were suboptimal. Perceived behavioural control and parental educational level were significant predictors of parental intention to vaccinate. Interventions aimed at strengthening parental intention should therefore give attention to these factors.
Background: Children with sickle cell anaemia (SCA) are at increased risk of invasive pneumococcal disease, making pneumococcal vaccination an important preventive measure. However, vaccine hesitancy may reduce uptake, particularly in resource-limited settings where access to vaccines and reliable information may be constrained. Aim: This study examined factors contributing to pneumococcal vaccination hesitancy among caregivers of children with SCA and their implications for vaccine coverage. Study Design: The work was a hospital-based cross-sectional study conducted among caregivers of children with SCA. Place and Duration of Study: The study was conducted at the sickle cell clinic of the Yobe State Specialist Hospital, Potiskum, from April to June 2026. Methodology: Data were collected using a structured, interviewer-administered questionnaire addressing sociodemographic characteristics, vaccination status, and reported reasons for hesitancy. Descriptive statistics were used to summarise the reported barriers. Results: Of the 126 participating caregivers, 108 (85.7%) vaccinated their children, while 18 (14.3%) did not or were unsure of their vaccination status. The most frequently reported reasons for hesitancy were fear of side effects and vaccine unavailability (27.8% each), followed by lack of trust (16.7%), lack of awareness (11.1%), and high cost (11.1%). The majority (83.3%) of the hesitant caregivers indicated that encouragement from healthcare workers would motivate them to vaccinate their children. Conclusion: Pneumococcal vaccine hesitancy is influenced by both caregiver-related concerns and health-system barriers. Strengthening vaccine counselling services, addressing safety concerns, and ensuring that vaccines are available, affordable, and accessible may enhance pneumococcal conjugate vaccine (PCV) uptake among children with SCA.
Maternal healthcare-seeking behaviour (MHSB) is a key determinant of childhood vaccination rates. In rural Nigeria, MHSB remains low and has been associated with poor maternal and child health outcomes. However, empirical evidence linking MHSB to timely childhood immunisation, particularly among agricultural households in rural Nigeria, is limited. This study therefore examined the effect of maternal healthcare-seeking behaviour on timely childhood vaccination among agricultural households in rural Nigeria. The study utilised secondary data from the 2018 Nigeria Demographic and Health Survey (NDHS). Information on vaccines received by children, prenatal care, timing of first antenatal visit, number of antenatal visits, skilled birth attendance, and postnatal care was extracted for 2,751 rural women with under-five children in agricultural households. Data was analysed using descriptive statistics, multiple correspondence analysis (MCA) to generate the MHSB index, and an extended ordered probit model. The findings show that women in agricultural households in rural Nigeria moderately utilise maternal healthcare services, with a mean MHSB index of 0.54, while 55.83% of children were unimmunised. Maternal healthcare-seeking behaviour and husband’s education significantly improved partial vaccination status, while husband’s education and mother’s full-time employment in agriculture were associated with improved full vaccination status in children. Maternal healthcare-seeking behaviour positively influences child immunisation status among agricultural households in rural Nigeria. Strengthening policies that promote maternal healthcare utilisation and expanding access to antenatal and vaccination services particularly through community and market-based health centres and male involvement are essential to improving vaccination coverage in rural Nigeria.
Mobolaji Victoria Adejoorin, Kabir Kayode Salman, Mutiat Bukola Salawu et al.
Background Nigeria ranks second globally in the burden of stunted children, with 40% of children under five affected and poor infant and young child feeding (IYCF) practices as a primary contributor. This study assessed mothers' knowledge, attitudes, and feeding practices related to IYCF in Plateau State, Nigeria, comparing beneficiaries and non-beneficiaries of the Accelerating Nutrition Results in Nigeria (ANRiN) project, and identifying sociodemographic predictors associated with these outcomes. Methods A mixed-methods cross-sectional design was employed. A total of 503 mothers of children aged 6–23 months completed structured questionnaires for quantitative analysis, while 8 focus group discussions and 12 key informant interviews provided qualitative data. Knowledge, attitude, and practice scores were computed with categorization (adequate/inadequate, positive/negative, good/poor). Data were analyzed using chi-square tests, independent t -tests, and multivariable logistic regression stratified by beneficiary status. Results The overall prevalence of adequate knowledge was 21.1%, positive attitudes 91.4%, and good feeding practices 55.7%. Beneficiaries demonstrated significantly better practice scores than non-beneficiaries (mean 6.95 ± 1.42 vs. 6.34 ± 1.57, p < 0.001), while non-beneficiaries showed slightly higher attitude scores (3.68 ± 0.64 vs. 3.52 ± 0.77, p = 0.012). No significant difference in knowledge scores was observed. Maternal tertiary education was significantly associated with adequate knowledge in both groups ( p < 0.01), while healthcare provider information was the strongest predictor of knowledge and attitudes among beneficiaries ( p < 0.001 and p = 0.019, respectively). Qualitative findings identified poverty, food insecurity, and cultural norms as barriers to applying knowledge, while hands-on food demonstrations improved practical skills. Conclusion The study highlights a persistent knowledge-practice gap and demonstrates that ANRiN participation is associated with improved feeding practices. The distinct predictors between beneficiaries and non-beneficiaries suggest that tailored interventions accounting for these differential factors could strengthen IYCF program effectiveness in Nigeria.
Demilade Osoteku, Abdulateef Salisu, Muyi Aina et al.
Abstract Parenting in urban informal settlements is shaped by intersecting economic, environmental, and institutional constraints. However, less is known about how young mothers experience and make sense of everyday caregiving under these conditions. This study explored the lived experiences of 20 young mothers aged 18–35 years raising children in Old Fadama and African Eleven, two informal settlements in Accra, Ghana. Guided by Jack’s framework of ecological influences on parenting and using an interpretative phenomenological analysis, the study examined experiences of child health care, housing, and education. Participants described recurrent childhood illness, limited access to formal health services, overcrowded and flood-prone living environments, and financial barriers to children’s schooling. Their accounts suggested that caregiving decisions were shaped by restricted material and institutional options, while mothers continued to negotiate available resources and sustain educational aspirations for their children. Although the two settlements differed as a “slum of hope” and a “slum of despair,” settlement type shaped the intensity of these hardships more than their fundamental characteristics. The study contributes an experience-centered account of parenting under structural constraint and highlights the importance of integrated, context-responsive interventions addressing health care, housing, education and the socioeconomic conditions of young mothers and improve child well-being in marginalized communities.
Portia Nana Ama Brempong, Kingsley Saa‐Touh Mort, Eunice Abbey et al.
Observed impacts of the COVID-19 pandemic in countries in the global north include increasing rates of maternal anxiety and depression. However, little research has been done in sub-Saharan Africa assessing the impact of the pandemic on maternal psychosocial stress. This study aimed to examine the association between COVID-related stressors and psychosocial health among Ghanaian women who were pregnant during the pandemic. This was a sequential explanatory mixed-methods study. An online survey was administered to conveniently sampled Ghanaian mothers with children 0–15 months old from June 2021 to January 2022. Demographic and health information, health literacy (HL) information measured by the All Aspects of Health Literacy scale (AAHL), and COVID-19 health and well-being were collected. Using the Coronavirus Anxiety Scale (CAS) and the Obsession with Coronavirus Scale (OCS), mothers were asked to recall their levels of anxiety and worry while they were pregnant during the pandemic. Generalized linear models were used to assess the association between COVID-related stressors and maternal CAS and OCS scores. In-depth interviews were conducted to gather information from participants about their experiences of pregnancy and childbirth during the COVID-19 pandemic, and thematic analyses were performed using the social support networks in health framework. A total of 221 mother-child dyads were analyzed. Eleven women participated in the in-depth interviews. We observed a rate of 11% for probable dysfunctional coronavirus-related anxiety and 33% for probable dysfunctional thinking about COVID-19. In adjusted models for baseline characteristics, we observed that higher HL scores corresponded with reduced CAS scores (β=-0.43, 95% CI [-0.80, -0.05] for every point increase in AAHLS scores). For COVID-related health and well-being, loss of jobs and wages predicted higher CAS scores when adjusted for HL as a main covariate (β = 1.30, 95% CI [0.07, 2.53]). Participants who reported exercising during COVID had higher OCS scores compared to those who reported not exercising, when adjusting for HL (β = 1.08, 95% CI [-0.01, 2.16], p = 0.05). Themes emerging were categorized into three domains: COVID-19 Pandemic Impacts, COVID-19 Adaptations, and Social Support Networks. This study assessing the association between COVID-19 pandemic stressors and maternal health and well-being provides valuable insights into the pandemic’s short- and medium-term effects. Given the complexity of the pandemic’s stress response, including potential intersections between psychosocial health, social support, and health literacy, public health policies must incorporate these needs into future pandemic responses. This includes leveraging telehealth and mHealth platforms for maternal mental health screening as well as providing community-based health literacy resources. Further studies examining the longer-term effects of the pandemic are also warranted.
Ruthfirst E. A. Ayande, Gloria Ethel Otoo, Jessica Pearlman et al.
ABSTRACT Increasing health issues and rising poverty rates in Nigeria have adversely impacted child health care utilization. This study X‐rays the wealth access and regional variations nexus in child healthcare utilization. The generalized linear model (GLM) approach and the concentration index were adopted, employing data elicited from the Nigeria demographic and health survey (NDHS) conducted in 2008 and 2018. The study identified a substantial variation in child healthcare utilization among households with varying wealth access levels, implying that as households' access to wealth increases, inequality in healthcare utilization reduces among children. Regional analysis shows that the northeast and northwest geopolitical zones exhibited a higher prevalence in child healthcare utilization inequality, due to distinct socioeconomic status, cultural, and religious practices. The study therefore recommends that to support and maintain the initiatives for health system reform, a communication plan and an efficient regionally based health management information system must be created. Again, to increase child healthcare accessibility and utilization, such programmes should include a thorough health promotion strategy that raises awareness and provides relevant education to low‐income households.
Anthony Orji, Celine Onyinyechi Obochi, Onyinye Imelda Anthony-Orji et al.
ABSTRACT Background Rapidly urbanising complex ecosystems present several challenges to the organisation, availability, and accessibility of healthcare services. This study describes the availability and distribution of health facilities offering services, with a focus on maternal and newborn health services in the seven health districts of Grand Conakry, Methods This study using primary data from a census of health facilities (June 2025). Finally, healthcare landscape was drawn up using the GPS coordinates collected, based on the boundaries of the seven including health districts. The census started with an existing list of 459 facilities and snowball sampling was used to identify facilities that were not initially on the list. We collected information on basic facility characteristics and GPS coordinates. Results A total of 795 health facilities exist in Grand Conakry, with 564 facilities which were not on the initial lists, 104 were either closed, out of service, or refused to participate. The questionnaire was completed by 691 health facilities. The private sector dominated the landscape and was mainly concentrated in the Ratoma and Matoto health districts; with most facilities (63%) not reporting to the national health information system, in contrast to those in public sector (85.7%). 332/691 facilities reported providing childbirth care, and 132 of them (40%) offered caesarean section, while 87 (26%) offered blood transfusions. Conclusion Despite the high number of facilities, geographic imbalances in distribution exist. Equitable access to healthcare in rapidly urbanising Grand Conakry requires strengthening urban health planning and public-private collaboration regarding ongoing rapid urbanisation in Grand Conakry. Key messages What is already known on this topic? The rapid urbanisation of Grand Conakry is accompanied by an expansion in healthcare provision, but information on the geographical distribution and characteristics of healthcare facilities, particularly for maternal and neonatal care is limited and incomplete. What this study adds? A significant number of healthcare facilities operating in Grand Conakry are missing from existing health authority lists. Healthcare provision is largely dominated by the private sector. The availability of comprehensive emergency obstetric and neonatal care services remains limited, and only 4% of facilities offer childbirth care that is completely free of charge (all public). How this study might affect research, practice or policy? The comprehensive facility list generated by this census strengthens healthcare system planning for maternal and neonatal care provision, including improving referral networks in Grand Conakry.
Nafissatou Dioubate, Aline T. Semaan, Rehema Ouko et al.
