HIV associated high-risk HPV infection among Nigerian women

Background: In developed countries, the incidence of cervical cancer has remained stable in HIV+ women but the prevalence and multiplicity of high-risk HPV (hrHPV) infection, a necessary cause of cervical cancer, appears different comparing HIV+ to HIV- women. Little is known about HIV and HPV co-infection in Africa. Methods: We enrolled women presenting at our cervical cancer screening program in Abuja, Nigeria between April and August 2012, and collected information on demographic characteristics, risk factors of HPV infection and samples of exfoliated cervical cells. We used Roche Linear Array HPV Genotyping Test® to characterize prevalent HPV and logistic regression models to estimate the association between HIV and the risk of hrHPV infection. Results: There were 278 participants, 54% (151) were HIV+, 40% (111) were HIV-, and 6% (16) had unknown HIV status. Of these, data from 149 HIV+ and 108 HIV- women were available for analysis. The mean ages (±SD) were 37.6 (±7.7) years for HIV+ and 36.6 (±7.9) years for HIV- women (p-value = 0.34). Among the HIV+ women, HPV35 (8.7%) and HPV56 (7.4%) were the most prevalent hrHPV, while HPV52 and HPV68 (2.8%, each) were the most prevalent hrHPV types among HIV- women. The multivariate prevalence ratio for any hrHPV and multiple hrHPV infections were 4.18 (95% CI 2.05 – 8.49, p-value <0.0001) and 6.6 (95% CI 1.49 – 29.64, p-value 0.01) respectively, comparing HIV + to HIV- women, adjusted for age, and educational level. Conclusions: HIV infection was associated with increased risk of any HPV, hrHPV and multiple HPV infections. Oncogenic HPV types 35, 52, 56 and 68 may be more important risk factors for cervical pre-cancer and cancer among women in Africa. Polyvalent hrHPV vaccines meant for African populations should protect against other hrHPV types, in addition to 16 and 18

Access to maternal-child health and HIV services for women in North-Central Nigeria: A qualitative exploration of the male partner perspective.

BackgroundIn much of sub-Saharan Africa, male partners play influential roles in women's access to maternal-child healthcare, including prevention of mother-to-child transmission of HIV services. We explored male partner perspectives on women's access to maternal-child healthcare in North-Central Nigeria.MethodsThree focus groups were conducted with 30 men, purposefully-selected on the basis of being married, and rural or urban residence. Major themes explored were men's maternal-child health knowledge, gender power dynamics in women's access to healthcare, and peer support for pregnant and postpartum women. Data were manually analyzed using Grounded Theory, which involves constructing theories out of data collected, rather than applying pre-formed theories.ResultsMean participant age was 48.3 years, with 36.7% aged ConclusionsStrategic engagement of community leaders, including traditional and religious leaders, is needed to address harmful norms and practices underlying gender inequity in health decision-making. Gender mainstreaming, where the needs and concerns of both men and women are considered, should be applied in maternal-child healthcare education and delivery. Clinic fee reductions or elimination can facilitate service access. Finally, professional organizations can do more to reinforce respectful maternity care among healthcare workers

Assessing the acceptability of village health workers' roles in improving maternal health care in Gombe State, Nigeria a qualitative exploration from women beneficiaries.

IntroductionMaternal, and under-five mortality rates in Gombe State are disproportionately high. The Society for Family Health (a Non-Governmental Organization) in collaboration with Gombe State Primary Health Care Development Agency implemented the Village Health Worker (VHW) Program in Gombe to address the low uptakes of maternal neonatal and child health (MNCH) services and reduced the impact of healthcare worker insufficiency. VHWs are lay indigenous women trained to educate and encourage women to use MNCH services, provide simple community-based maternal and new-born care through home visits, and facilitate facility linkage. We assessed the acceptability of VHW services among women beneficiaries of the Program.MethodsQualitative data were obtained through six focus group discussions with 58 women beneficiaries of the VHW program who delivered within the last 12 months preceding study period (October-November 2018). Themes explored were roles and acceptability of VHWs, and the influence of VHWs on the uptake of MNCH services. We analyzed data with NVivo 12, using Grounded Theory.ResultsParticipants' mean age was 25.1 (± 5.3) years old. Most participants 39 (67%), had been in contact with a VHW for at least 10 months. VHWs visited pregnant women at home and registered them for antenatal care, provided them basic maternal healthcare, health education, and facilitated facility linkage. Participants generally accepted the VHW Program because it was community-based, VHWs were indigenous community members, delivered clear messages, and influenced husbands and mothers-in-law to support women's' use of MNCH services. VHWs' interventions were perceived to have improved health literacy and the uptake of MNCH services. Participants generally admired the VHW occupation and recommended VHW program scale-up, and for VHWs to be offered basic obstetric training and employment by health facilities or the government.ConclusionThe general acceptance and positive views of VHWs from beneficiaries of the program demonstrates the feasibility of the program to improve the uptake of MNCH services

Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria

Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facilitybased services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment

Evaluation of enzymatic and non-enzymatic antioxidant potential of sprouted indigenous legumes from Pakistan

ABSTRACTGermination of seeds is a complex process linked to various molecular and biochemical changes that increase the nutritional value. This research has studied the impact of germination on the enzymatic and non-enzymatic antioxidant activities of five domestic staple legumes from Pakistan: chickpea, mung bean, soybean, lentil, and peanut. The maximum moisture content was recorded for chickpea, i.e., 11.7 ± 0.05 g 100 g−1 followed by lentil, soybean, peanut, and mung bean as 9.65 ± 0.02, 8.07 ± 0.01, 7.6 ± 0.01, and 7.31 ± 0.01 g 100 g−1, respectively. The overall augmentation in catalase activity during germination (days 1 to 4) was maximum for lentils, i.e., 76.22%, and ascorbate peroxidase activity for peanuts, i.e., 62.09%. The soybean showed a clear difference from the 1st to 4th days of germination for peroxide activity among all selected legumes with a 37.29% increase. A maximum change in superoxide dismutase was noticed in mung bean. The mung bean also had the highest variation in total flavonoid contents, while total phenolic contents were higher in the chickpea. The radical scavenging activity varied higher in peanuts, while the ascorbic acid content was maximum for soybeans. Among all selected legumes, non-germinated chickpeas showed a lower DPPH value, i.e., 1.15 ± 0.03%, whereas the highest DPPH value was observed in lentils (69.84 ± 0.05%). Thus, the incorporation of ready-to-eat (RTE) germinated legumes with high antioxidant activity would be a contemporary addition to the everyday meal

Anticancer perspectives of genistein: a comprehensive review

ABSTRACTThere is a significant load of degenerative and chronic illnesses, especially cancer, which is one of the main reasons for morbidity and death globally. Polyphenolic phytochemicals found in many plant diets have been shown in epidemiologic and preclinical studies to have chemopreventive activities against numerous cancer types. As a result, there is growing interest in possible cancer chemopreventive medicines derived from natural compounds, such as polyphenols, which may provide a novel, cost-effective way to reduce the global cancer burden. Various epidemiologic researchers have found a link between a soy-rich diet and tumor avoidance, which has been linked to the existence of genistein, a phenolic component found in soy-based diets. Genistein controlled strong anti-inflammatory actions through the blocking of different signaling pathways such as (PGs) Prostaglandins, pro-inflammatory (ROS) reactive oxygen species and cytokines, (iNOS) inducible nitric oxide synthase and (NF-κB) nuclear factor kappa-B. Furthermore, therapeutic effects of genistein have been conveyed in various pathological situations through modifying intracellular paths such as Akt, mTOR, PI3K, PPARγ, NF-κB, Nrf2 and AMPK. Genistein works as a chemotherapeutic drug against several cancers, primarily through modifying the cell cycle, apoptosis, and angiogenesis, as well as limiting metastasis. Genistein also exhibits a synergistic attitude with renowned anticancer medicines including adriamycin, tamoxifen and docetaxel indicating a possible role in grouping treatment. The study presents the recent data available on genistein’s beneficial effects against various forms of cancers

MASI, a Smartphone App to Improve Treatment Adherence Among South African Adolescents and Young Adults With HIV: Protocol for a Pilot Randomized Controlled Trial

BackgroundAdolescents and young adults with HIV repeatedly demonstrate low rates of antiretroviral therapy (ART) adherence as well as low rates of viral suppression. Digital health interventions are a promising way to engage adolescents and young adults with HIV to support ART adherence. However, few digital health interventions have been developed and tested with adolescents and young adults in countries like South Africa, where the HIV burden among adolescents and young adults is greatest. Masakhane Siphucule Impilo Yethu (MASI; Xhosa for “Let's empower each other and improve our health”) is a comprehensive ART adherence-supporting app for South African adolescents and young adults with HIV. It was culturally adapted using the HealthMpowerment platform. ObjectiveThe aim of this paper is to describe the protocol for a pilot randomized controlled trial examining the feasibility, acceptability, and preliminary efficacy of MASI on self-reported ART adherence and social support. MethodsWe will enroll 50 adolescents and young adults with HIV ages 15-21 years. Participants will be recruited from public ART clinics linked to a large government-funded teaching hospital in Cape Town, South Africa. Participants will be randomized 1:1 into either the intervention arm receiving a full version of MASI or the control arm receiving an information-only version of the app (n=25 per arm). Participants will be asked to engage with MASI daily for 6 months. All participants will complete baseline and follow-up assessments at 3 and 6 months. ResultsStudy screening began in May 2022 and the first participant was enrolled on June 21, 2022. As of June 12, 2023, 81 participants have completed screeners, and 36 eligible participants have been enrolled in the pilot randomized controlled trial. Recruitment is anticipated to last through August 31, 2023, with study activities anticipated through February 29, 2024. ConclusionsThere is an urgent need for innovative interventions to improve ART adherence among adolescents and young adults in settings like South Africa. If found to be feasible and acceptable, MASI could be implemented with adolescents and young adults with HIV in other parts of the country. Trial RegistrationClinicalTrials.gov NCT04661878; https://clinicaltrials.gov/ct2/show/study/NCT04661878 International Registered Report Identifier (IRRID)DERR1-10.2196/4713