90 research outputs found
SYNERGIC RELATIONSHIP BETWEEN EFFECTIVE INFORMATION AND INTELLIGENCE NEEDS ANALYSIS, UTILIZATION AND SECURITY IN NIGERIA
The general objective of the paper examines critically the synergic relationship between effective information and intelligence needs gathering, analysis and utilization in relation to security situation in Nigeria. Effective pursuit and execution of security needs in every nation depend critically on the conscious security information drive, intelligence gathering, the existence of the necessary security gadgets and apparatus, the zeal of the citizenry to be security conscious and to provide information needed, the will power of the government in place and security institutions to analyze and utilize the available information and intelligence gathered. The challenging problems of study indicate that budgetary funds are made available to security agencies and institutions yet insecurity prevails in Nigeria, lives and properties are destroyed on daily basis, foreign investors relocate out of Nigeria for fear of insecurity, inability of security agencies to pro-actively respond to security demands, seemingly government complicity in curtailing the incessant insecurity, etc. These point to the lack of information and intelligence needs gathering and analysis, lack of relevant modern ICT security equipment and personnel, sharing intelligence information and collaborative efforts among these agencies. The paper is discursive and analytical in methodology. While the paper examined the challenges faced by these agencies and reasons for their ineffectiveness, it avers that, in order to buttress security and grow the economy, the government of Nigeria should, among others, ensure that there are collaborative and effective information and intelligence drive, analysis, sharing and utilization in relation to security pursuit; high technological military hardware for surveillance should be in use; sentiments, individualism, exclusionism, ethnicity and parochialism should not be above national interest; economy should be boosted through job creation, employment, empowerment, entrepreneurship, industrialization and manufacture to mitigate the burden on the agencies and create opportunity for individuals and institutions to explore their potentials and the economy to blossom. Article visualizations
Comparison of Mycobacterium tuberculosis drug susceptibility using solid and liquid culture in Nigeria.
BACKGROUND: This study compares Mycobacterium tuberculosis culture isolation and drug sensitivity testing (DST) using solid (LJ) and liquid (BACTEC-MGIT-960) media in Nigeria. METHODS: This was a cross sectional survey of adults attending reference centres in Abuja, Ibadan and Nnewi with a new diagnosis of pulmonary tuberculosis (TB) or having failed the first-line TB treatment. Patients were requested to provide three sputum specimens for smear-microscopy and culture on LJ and BACTEC-MGIT-960. Positive cultures underwent DST for streptomycin, isoniazid, rifampicin and ethambutol. RESULTS: 527 specimens were cultured. 428 (81%) were positive with BACTEC-MGIT-960, 59 (11%) negative, 36 (7%) contaminated and 4 (1%) had non-tuberculosis mycobacteria (NTM). 411 (78%) LJ cultures were positive, 89 (17%) negative, 22 (4%) contaminated and 5 (1%) had NTM. The mean (SD) detection time was 11 (6) and 30 (11) days for BACTEC-MGIT-960 and LJ. DST patterns were compared in the 389 concordant positive BACTEC-MGIT-960 and LJ cultures. Rifampicin and isoniazid DST patterns were similar. Streptomycin resistance was detected more frequently with LJ than BACTEC-MGIT-960 and ethambutol resistance was detected more frequently with BACTEC-MGIT-960 than LJ, but differences were not statistically significant. MDR-TB was detected in 27 cases by LJ and 25 by BACTEC-MGIT-960 and using both methods detected 29 cases. CONCLUSIONS: There was a substantial degree of agreement between the two methods. However using the two in tandem increased the number of culture-positive patients and those with MDR-TB. The choice of culture method should depend on local availability, cost and test performance characteristics
Religious Vehicle Stickers in Nigeria: a discourse of identity, faith and social vision
This study focuses on analysing the ways in which vehicle
stickers construct individual and group identities, people’s religious faith and social vision in the context of religious assumptions and practices in Nigeria. Data comprise 73 vehicle stickers collected in Lagos and Ota, between 2006 and 2007 and are analysed within the framework of the post-structuralist model of discourse analysis which views discourse as a product of a complex system of social and institutional practices that sustain its continuous
existence (Derrida, 1982; Fairclough, 1989, 1992, 1995; Foucault, 1972, 1981). Results show that through stickers people define their individual and group identities within religious institutional practices. And as a means of group identification, they guarantee social security and privileges. In constructing social vision the stickers help mould the individual aspiration about a future which transcends the present. Significantly, stickers in the data
also reveal the tension between Islam and Christianity and the struggle to propagate one above the other.
KEY WORDS: assumption, discourse, discursive, practices, religion, stickers
Impact of alcohol use disorder severity on human immunodeficiency virus (HIV) viral suppression and CD4 count in three international cohorts of people with HIV.
Alcohol use has been linked to worse human immunodeficiency virus (HIV) immunologic/virologic outcomes, yet few studies have explored the effects of alcohol use disorder (AUD). This study assessed whether AUD severity is associated with HIV viral suppression and CD4 count in the three cohorts of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium.
People with HIV (PWH) in Uganda (n = 301), Russia (n = 400), and Boston (n = 251), selected in-part based on their alcohol use, were included in analyses. Logistic and linear regressions were used to assess the cross-sectional associations between AUD severity (number of DSM-5 diagnostic criteria) and (1) HIV viral suppression, and (2) CD4 count (cells/mm <sup>3</sup> ) adjusting for covariates. Analyses were conducted separately by site.
The proportion of females was 51% (Uganda), 34% (Russia), and 33% (Boston); mean age (SD) was 40.7 (9.6), 38.6 (6.3), and 52.1 (10.5), respectively. All participants in Uganda and all but 27% in Russia and 5% in Boston were on antiretroviral therapy. In Uganda, 32% met criteria for AUD, 92% in Russia, and 43% in Boston. The mean (SD) number of AUD criteria was 1.6 (2.4) in Uganda, 5.6 (3.3) in Russia, and 2.4 (3.1) in Boston. Most participants had HIV viral suppression (Uganda 92%, Russia 57%, Boston 87%); median (IQR) CD4 count was 673 (506, 866), 351 (201, 542), and 591 (387, 881), respectively. In adjusted models, there were no associations between AUD severity and HIV viral suppression: adjusted odds ratios (AOR) (95%CI) per 1 additional AUD criterion in Uganda was 1.08 (0.87, 1.33); Russia 0.98 (0.92, 1.04); and Boston 0.95 (0.84, 1.08) or CD4 count: mean difference (95%CI) per 1 additional criterion: 5.78 (-7.47, 19.03), -3.23 (-10.91, 4.44), and -8.18 (-24.72, 8.35), respectively.
In three cohorts of PWH, AUD severity was not associated with HIV viral suppression or CD4 count. PWH with AUD in the current era of antiretroviral therapy can achieve virologic control
Qualitative Study of Changes in Alcohol Use Among HIV-Infected Adults Entering Care and Treatment for HIV/AIDS in Rural Southwest Uganda
Alcohol has a substantial negative impact on the HIV epidemic in sub-Saharan Africa, particularly in Uganda, where heavy alcohol consumption is common. Using a content analytic approach, this qualitative study characterizes changes in alcohol use among 59 HIV-infected Ugandan adults (>18 years old), who reported any alcohol use in the previous year as they entered HIV care. Most participants reported attempting to cease or reduce alcohol intake over the study period. Reasons for decreased use included advice from clinicians, interference with social obligations, threats to financial security, and negative impact on social standing. Participants reported difficulty abstaining from alcohol, with incentives to continue drinking including desire for social inclusion, stress relief, and enjoyment of alcohol. These contrasting incentives created a moral quandary for some participants, who felt ‘pulled’ between ‘good’ and ‘bad’ influences. Results suggest brief interventions addressing self-identified obstacles to change may facilitate long-term reductions in drinking in this population
Retention in Care and Connection to Care among HIV-Infected Patients on Antiretroviral Therapy in Africa: Estimation via a Sampling-Based Approach
Current estimates of retention among HIV-infected patients on antiretroviral therapy (ART) in Africa consider patients who are lost to follow-up (LTF) as well as those who die shortly after their last clinic visit to be no longer in care and to represent limitations in access to care. Yet many lost patients may have "silently" transferred and deaths shortly after the last clinic visit more likely represent limitations in clinical care rather than access to care after initial linkage.We evaluated HIV-infected adults initiating ART from 1/1/2004 to 9/30/2007 at a clinic in rural Uganda. A representative sample of lost patients was tracked in the community to obtain updated information about care at other ART sites. Updated outcomes were incorporated with probability weights to obtain "corrected" estimates of retention for the entire clinic population. We used the competing risks approach to estimate "connection to care"--the percentage of patients accessing care over time (including those who died while in care).Among 3,628 patients, 829 became lost, 128 were tracked and in 111, updated information was obtained. Of 111, 79 (71%) were alive and 35/48 (73%) of patients interviewed in person were in care and on ART. Patient retention for the clinic population assuming lost patients were not in care was 82.3%, 68.9%, and 60.1% at 1, 2 and 3 years. Incorporating updated care information from the sample of lost patients increased estimates of patient retention to 85.8% to 90.9%, 78.9% to 86.2% and 75.8% to 84.7% at the same time points.Accounting for "silent transfers" and early deaths increased estimates of patient retention and connection to care substantially. Deaths soon after the last clinic visit (potentially reflecting limitations in clinical effectiveness) and disconnection from care among patient who were alive each accounted for approximately half of failures of retention
A Molecular Epidemiological and Genetic Diversity Study of Tuberculosis in Ibadan, Nnewi and Abuja, Nigeria
Background
Nigeria has the tenth highest burden of tuberculosis (TB) among the 22 TB high-burden countries in the world. This study describes the biodiversity and epidemiology of drug-susceptible and drug-resistant TB in Ibadan, Nnewi and Abuja, using 409 DNAs extracted from culture positive TB isolates.
Methodology/Principal Findings
DNAs extracted from clinical isolates of Mycobacterium tuberculosis complex were studied by spoligotyping and 24 VNTR typing. The Cameroon clade (CAM) was predominant followed by the M. africanum (West African 1) and T (mainly T2) clades. By using a smooth definition of clusters, 32 likely epi-linked clusters related to the Cameroon genotype family and 15 likely epi-linked clusters related to other “modern” genotypes were detected. Eight clusters concerned M. africanum West African 1. The recent transmission rate of TB was 38%. This large study shows that the recent transmission of TB in Nigeria is high, without major regional differences, with MDR-TB clusters. Improvement in the TB control programme is imperative to address the TB control problem in Nigeria
Resourcing resilience: Social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa
Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern
Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key
drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural
and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence
that social protection has the potential to reduce the risk of HIV infection among children and adolescents.
This research combined expert consultations with a rigorous review of academic and policy literature on the
effectiveness of social protection for HIV prevention among children and adolescents, including prevention for
those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social
protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes
that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in
Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and
responsive social protection mechanisms. Results confirmed that HIV-inclusive child- and adolescent-sensitive
social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular,
empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection
particularly cash/in-kind components combined with “care” and “capability” among children and adolescents.
Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and
context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake.
Effective HIV prevention also requires integrated social protection policies, developed through strong national
government ownership and leadership. Future research should explore which combinations of social protection
work for sub-groups of children and adolescents, particularly those living with HIV
Transportation Costs Impede Sustained Adherence and Access to HAART in a Clinic Population in Southwestern Uganda: A Qualitative Study
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