Ethical considerations in determining standard of prevention packages for HIV prevention trials: Examining PrEP

The successful demonstration that antiretroviral (ARV) drugs can be used in diverse ways to reduce HIV acquisition or transmission risks – either taken as pre-exposure prophylaxis (PrEP) by those who are uninfected or as early treatment for prevention (T4P) by those living with HIV – expands the armamentarium of existing HIV prevention tools. These findings have implications for the design of future HIV prevention research trials. With the advent of multiple effective HIV prevention tools, discussions about the ethics and the feasibility of future HIV prevention trial designs have intensified. This article outlines arguments concerning the inclusion of newly established ARV-based HIV prevention interventions as standard of prevention in HIV prevention trials from multiple perspectives. Ultimately, there is a clear need to incorporate stakeholders in a robust discussion to determine the appropriate trial design for each study population

Mechanical Description of a Hyper-Redundant Robot Joint Mechanism Used for a Design of a Biomimetic Robotic Fish

A biologically inspired robot in the form of fish (mackerel) model using rubber (as the biomimetic material) for its hyper-redundant joint is presented in this paper. Computerized simulation of the most critical part of the model (the peduncle) shows that the rubber joints will be able to take up the stress that will be created. Furthermore, the frequency-induced softening of the rubber used was found to be critical if the joints are going to oscillate at frequency above 25 Hz. The robotic fish was able to attain a speed of 0.985 m/s while the tail beats at a maximum of 1.7 Hz when tested inside water. Furthermore, a minimum turning radius of 0.8 m (approximately 2 times the fish body length) was achieved

Barriers of West African women scientists in their research and academic careers: A qualitative research

Objective This study aims to identify barriers to the professional advancement of women researchers in West Africa. Methods This was a descriptive, observational, cross-sectional qualitative study conducted between June and September 2020 in five West African countries (Ghana, Senegal, Burkina Faso, Niger and Mali). Interviews were conducted with 21 female and 9 male health researchers by video call. After transcription, the data was thematically analysed using an inductive process. Results Four themes associated with barriers to women’s careers development were identified. First. was family- and environmental-related barriers. Gender norms that assign domestic tasks and responsibilities to women reduced the time they were able to dedicate to research. Second was gender insensitive organisational culture and institutional policies that deepened gender disparities and made it more difficult for women to attain leadership positions. Third was the need for women in research to undergo emancipation programs to strengthen their resilience and ability to make critical decisions as strategic approaches to address the challenges faced by women in the academia were a lot more focused on addressing their relationship with their spouse. Forth, was the individual intermediate perception of professional and personal success which for many women, they perceive themselves as competent as their male counterparts and should not be subject to the gender discrimination they experience. Conclusion The web created between work-life and home-life for West African women researchers mainly as a result of the gender inequalities in the social structure will require more medium- and long-term strategic planning by institutional authorities to reduce gender disparities in research and academia. This work has highlighted the influence of family and social life on the professional lives of West African women researchers. The study could help contribute to the development of gender equality interventions for the career development of women researchers in West Africa

Risk indicators for oral ulcers among people living with HIV during the first wave of the pandemic: A cross-sectional study

Background: Little is currently known about HIV-related parameters that may increase the risk for oral ulcers during the COVID-19 pandemic. This study aimed to overcome this gap in research by assessing the associations between HIV viral load, antiretroviral adherence profile, co-morbidity status, SARS-CoV-2 infection and oral ulcers among people living with HIV (PLHIV). Methods: This was a secondary analysis of data generated from 21,206 to 18 years and above, recruited from 152 countries through an online survey between July and December 2020. Data were extracted for 874 people who reported living with HIV. The dependent variable was reporting having oral ulcer. The independent variables were the viral load, adherence to antiretroviral treatment and a history of SARS-CoV-2 infection. The confounding variables were age at last birthday and sex at birth. A multivariable logistic regression analysis was conducted to determine the associations between the dependent and independent variables after adjusting for the confounding variables. Results: Of the 874 participants, 99 (11.3%) reported having oral ulcers during the first wave of the COVID-19 pandemic. The odds of PLHIV having oral ulcers during the first wave of the COVID-19 pandemic was significantly higher for people who did not know their viral load than those who had undetectable viral load (AOR: 2.036; 95% CI: 1.204–3.443; p = 0.008); and people who did not adhere to the use of antiretroviral treatment than those who adhered (AOR: 4.113; 95% CI: 2.567–6.589; p < 0.001). Also, PLHIV who had SARS-CoV-2 infection had significantly higher odds of having oral ulcers than those who did not have the infection (AOR: 14.556; 95% CI: 4.500-47.078; p < 0.001). PLHIV who had co-morbidities had non-significantly higher odds of having oral ulcers than those without co-morbidities (AOR: 1.170; 95% CI: 0.656–2.085; p = 0.595). Conclusion: Oral ulcers may be an indicator of poor adherence to antiretroviral therapy and unsuppressed viral load among PLHIV. It may also be an indicator of SARS-CoV-2 infection and a signal to take prompt and critical care of affected individuals because of the risk for severe COVID-19 for these individuals.publishedVersio

Modelling the impact and cost-effectiveness of combination prevention amongst HIV serodiscordant couples in Nigeria.

OBJECTIVE: To estimate the impact and cost-effectiveness of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and condom promotion for serodiscordant couples in Nigeria. DESIGN: Mathematical and cost modelling. METHODS: A deterministic model of HIV-1 transmission within a cohort of serodiscordant couples and to/from external partners was parameterized using data from Nigeria and other African settings. The impact and cost-effectiveness were estimated for condom promotion, PrEP and/or TasP, compared with a baseline where antiretroviral therapy (ART) was offered according to 2010 national guidelines (CD4 <350 cells/μl) to all HIV-positive partners. The impact was additionally compared with a baseline of current ART coverage (35% of those with CD4 <350 cells/μl). Full costs (in US $2012) of programme introduction and implementation were estimated from a provider perspective. RESULTS: Substantial benefits came from scaling up ART to all HIV-positive partners according to 2010 national guidelines, with additional smaller benefits of providing TasP, PrEP or condom promotion. Compared with a baseline of offering ART to all HIV-positive partners at the 2010 national guidelines, condom promotion was the most cost-effective strategy [US$1206/disability-adjusted-life-year (DALY)], the next most cost-effective intervention was to additionally give TasP to HIV-positive partners (incremental cost-effectiveness ratio US $1607/DALY), followed by additionally giving PrEP to HIV-negative partners until their HIV-positive partners initiate ART (US$7870/DALY). When impact was measured in terms of infections averted, PrEP with condom promotion prevented double the number of infections as condom promotion alone. CONCLUSIONS: The first priority intervention for serodiscordant couples in Nigeria should be scaled up ART access for HIV-positive partners. Subsequent incremental benefits are greatest with condom promotion and TasP, followed by PrEP

The Use of Ict‐Rooted Communication Codes and Slangs among Nigerian Students

Scholars categorize slang as a language of the deviatory type that ranks below a formal speech and contains words that are used in special ways. Since its advent in the 18th century with its negative connotation and use by persons of low and disreputable character, including thieves, it has since been undergoing a dramatic transformation over time. Lately, slangs have found their ways into formal language codes in Nigeria especially among the youth. This study is an exploratory investigation of the patterns and meanings of slangs used by students of tertiary institutions in the country. This is a step toward the codification of these language deviances so that they can be better understood as communication tools and be an example to be imitated by other climes. The study found that many of the slangs and other coded words being used by the respondents were ICT‐inspired. The research presents analysis of meanings, usage patterns and nature of such slangs

Association between early childhood caries and poverty in low and middle income countries

Background: The aim of this study was to assess the relationship between early childhood caries (ECC) in 3–5-year-old children, seven indicators of poverty and the indicator of monetary poverty in low- and middle-income countries (LICs, MICs). Methods: This ecologic study utilized 2007 to 2017 country-level data for LICs and MICs. Explanatory variables were seven indicators of poverty namely food, water, sanitation, health, shelter, access to information, education; and monetary poverty. The outcome variable was the percentage of 3–5-year-old children with ECC. A series of univariate general linear regression models were used to assess the relationship between the percentage of 3–5 year-old children with ECC and each of the seven indicators of poverty, and monetary poverty. This was followed by multivariable regression models to determined the combined effect of the seven indicators of poverty, as well as the combined effect of the seven indicators of poverty and monetary poverty. Adjusted R2 measured models’ ability to explain the variation among LICs and MICs in the percentage of 3–5-year-old children with ECC. Results: Significantly more people had food, sanitation, shelter, access to information, education and monetary poverty in LICs than in MICs. There was no difference in the prevalence of ECC in 3–5-year-old children between LICs and MICs. The combination of the seven indicators of poverty explained 15% of the variation in the percentage of 3–5-year-old children with ECC compared to 1% explained by monetary poverty. When the seven indicators of poverty and the indicator for monetary poverty were combined, the amount of variation explained by them was 10%. Only two of the poverty indicators had a direct relationship with the percentage of children with ECC; there was a higher percentage of ECC in countries with higher percentage of population living in slums (B = 0.35) and in those countries with higher percentage of the population living below poverty lines (B = 0.19). The other indicators had an inverse relationship. Conclusion: The use of multiple indicators to measures of poverty explained greater amount of variation in the percentage of 3–5-year-olds with ECC in LICs and MICs than using only the indicator for monetary poverty.publishedVersio

Governance, maternal well-being and early childhood caries in 3-5-year-old children

BACKGROUND: This study assessed the direct, indirect and total effect of distal - political - risk indicators (affecting populations), and proximal risk indicators (affecting women) on the global prevalence of early childhood caries (ECC) in 3-5 year old children. METHODS: Data on global ECC prevalence were obtained from a prior study. Data for distal risk indicators (voice and accountability; political stability/absence of terrorism; control of corruption) were obtained from the World Bank Governance indicators, 2016. Data for proximal risk indicators (women's opportunity for leadership; percentage of female legislators, top officials and managers; basic employability status of women; ability of women to afford time off work to care for newborns; gross national income (GNI) per capita for females) were derived from the Human Development Index, 2016. Associations between variables were assessed with path analysis. RESULTS: Voice and accountability (β = - 0.60) and GNI per capita for females (β = - 0.33) were directly associated with a lower ECC prevalence. Political stability/absence of terrorism (β =0.40) and higher percentage of female legislators, senior officials and managers (β = 0.18) were directly associated with a higher ECC prevalence. Control of corruption (β = - 0.23) was indirectly associated with a lower ECC prevalence. Voice and accountability (β = 0.12) was indirectly associated with a higher ECC prevalence. Overall, voice and accountability (β = - 0.49), political stability/absence of terrorism (β = 0.34) and higher female GNI (β = - 0.33) had the greatest effects on ECC prevalence. CONCLUSION: Distal risk indicators may have a stronger impact on ECC prevalence than do proximal risk indicators.. Approaches to control ECC may need to include political reforms

Differences in COVID-19 Preventive Behavior and Food Insecurity by HIV Status in Nigeria

The aim of the study was to assess if there were signifcant diferences in the adoption of COVID-19 risk preventive behaviors and experience of food insecurity by people living with and without HIV in Nigeria. This was a cross-sectional study that recruited a convenience sample of 4471 (20.5% HIV positive) adults in Nigeria. Binary logistic regression analysis was conducted to test the associations between the explanatory variable (HIV positive and non-positive status) and the outcome variables—COVID-19 related behavior changes (physical distancing, isolation/quarantine, working remotely) and food insecurity (hungry but did not eat, cut the size of meals/skip meals) controlling for age, sex at birth, COVID-19 status, and medical status of respondents. Signifcantly fewer people living with HIV (PLWH) reported a positive COVID-19 test result; and had lower odds of practicing COVID-19 risk preventive behaviors. In comparison with those living without HIV, PLWH had higher odds of cutting meal sizes as a food security measure (AOR: 3.18; 95% CI 2.60–3.88) and lower odds of being hungry and not eating (AOR: 0.24; 95% CI 0.20–0.30). In conclusion, associations between HIV status, COVID-19 preventive behaviors and food security are highly complex and warrant further in-depth to unravel the incongruities identifed