Awareness of hypertension and its risk factors in Maiduguri, north eastern Nigeria

Objectives: To determine the level of awareness of hypertension and its risk factors in Gwange community of Maiduguri North-eastern Nigeria. Method: A community based cross sectional study in Gwange community of Maiduguri, a major city in North-eastern Nigeria. Participants were selected through a stratified randomize sample method. Demographic data including age, gender, marital status, highest educational qualification and occupation were recorded. Information on awareness of hypertension and level of awareness of risk factors for hypertension were also obtained. Blood pressure was taken once on the left arm using a standard mercury sphygmomanometer. Results: In all, 485(175 females) were included. The study showed a statistically significant higher level of awareness among young individuals with declining trend with aged (p=0.01). The study also recorded a statistically significant difference in the level of awareness of hypertension among individuals with different educational levels attained, with secondary and tertiary levels of education having higher awareness (p=0.00) and also a statistically significant difference in the awareness of hypertension among different occupational groups, with higher awareness among artisans and professionals. (p=0.00). The study found 13 (6.5%) hypertensives among 199 individuals who are not aware of the risk factors for hypertension, 38 (21.6%) hypertensives among 176 individuals who are aware of one risk factor for hypertension, 12 (23.5%) hypertensives among 51 individuals who are aware of two risk factors for hypertension, and 11 (26.8%) hypertensives among 41 individuals who are aware of three or more risk factors for hypertension. Conclusion: Awareness of hypertension among hypertensives is higher than in normotensives with statistically significant higher awareness of its risk factors. Awareness is also found to be higher among people of young age group, secondary and tertiary levels of education and also among artisans and professional. Special attention should be given to those leaving in remote villages and those least aware or treated in view of the consequences of hypertension on multiple organs and regular blood pressure check should be recommended to all individuals at risk

Limited emergence of resistance to integrase strand transfer inhibitors (INSTIs) in ART-experienced participants failing dolutegravir-based antiretroviral therapy: a cross-sectional analysis of a Northeast Nigerian cohort

Background Due to the high prevalence of resistance to NNRTI-based ART since 2018, consolidated recommendations from the WHO have indicated dolutegravir as the preferred drug of choice for HIV treatment globally. There is a paucity of resistance outcome data from HIV-1 non-B subtypes circulating across West Africa. Aims We characterized the mutational profiles of persons living with HIV from a cross-sectional cohort in North-East Nigeria failing a dolutegravir-based ART regimen. Methods WGS of plasma samples collected from 61 HIV-1-infected participants following virological failure of dolutegravir-based ART were sequenced using the Illumina platform. Sequencing was successfully completed for samples from 55 participants. Following quality control, 33 full genomes were analysed from participants with a median age of 40 years and median time on ART of 9 years. HIV-1 subtyping was performed using SNAPPy. Results Most participants had mutational profiles reflective of exposure to previous first- and second-line ART regimens comprised NRTIs and NNRTIs. More than half of participants had one or more drug resistance-associated mutations (DRMs) affecting susceptibility to NRTIs (17/33; 52%) and NNRTIs (24/33; 73%). Almost a quarter of participants (8/33; 24.4%) had one or more DRMs affecting tenofovir susceptibility. Only one participant, infected with HIV-1 subtype G, had evidence of DRMs affecting dolutegravir susceptibility—this was characterized by the T66A, G118R, E138K and R263K mutations. Conclusions This study found a low prevalence of resistance to dolutegravir; the data are therefore supportive of the continual rollout of dolutegravir as the primary first-line regimen for ART-naive participants and the preferred switch to second-line ART across the region. However, population-level, longer-term data collection on dolutegravir outcomes are required to further guide implementation and policy action across the region

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates