Divorced women in Nigeria: empowered or disempowered?

This paper is a report of a study that investigates the outcomes of divorce among divorced women in semi-urban and rural communities in Ekiti State, Nigeria to determine whether they were empowered or disempowered being divorced. A total of 52 divorced woman purposively selected were interviewed. The findings revealed that almost half of the divorced women reported that they were empowered in some areas depending on their socio-economic status, educational qualifications and age but overall, the outcome(s) of divorce was more disempowering than empowering for the vast majority of the divorced women. Within this context, understanding reasons for disempowerment of divorced women is a key theme for understanding marriage, divorce and empowerment in Nigeria

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Sero-prevalence of hepatitis C virus amoung patients attending STD clinic in Ibadan, Nigeria

In the tropics, hepatitis C virus (HCV) seroprevalence ranges from < 0.2% in whole Africa. A strong association between HCV and hepatitis B surface antigen (HBsAg)-negative chronic liver disease and hepatocellular carcinoma has been described. Hepatocellular carcinoma (HCC) is one of the most common cancers among Africans, and in Nigeria by 1970 the estimated rate was 6.6 per 100,000 populations per annum. Sexual transmission was regarded as a minor cause of HCV, the degree of which has not been properly evaluated in most environments. Since it has been established that sexual transmission is an important mode of acquisition of the infection, we therefore set out to find the seroprevalence of HCV among 95 patients attending sexually transmitted diseases (STD) clinic in University College Hospital, Ibadan, Nigeria with a view to recommending preventive and control measures of HCV in our community. The sera collected from these respondents were used for screening for syphilis using the VDRL test, and for HCV antibodies using the MONOLISA anti-HCV (Sanofi, Pasteur France). Mid-stream urine was collected from all participants, and urethral swabs from all male participants while endocervical and high vaginal swabs were collected from female participants. Ulcer swabs were collected from those with genital ulcers. The prevalence of HCV infection was found to be 37.9% in patients presenting with STDs. This comprised 38.9% of males and 61.1% females. This prevalence rate is very high compared with the rate in the general population and other “high-risk” groups in previous studies in the same environment. Factors associated with HCV infection in this environment include high heterosexuality, high level of education, and previous instrumentations such as in scarifications and termination of pregnancy. Prevention and control of STDs will definitely reduce HCV infection and hence the attendant consequences, particularly hepatocellular carcinoma, in our environment. Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 53-5

Geographical analysis of airport choice factors among domestic air travelers in Nigeria

An effective airline operation is largely a function of the quality of service provided by the host airports. There are numerous studies outlining different factors on the determinants of airline choice or preference, but there is very limited information in this regard on airport’s choice among domestic air travelers in Nigeria. The rationale for this study is two-fold. Firstly, the study attempts to establish what influences the choice of airport among domestic air travelers. The second rationale is to significantly contribute to the enrichment of the existing literature on airport choice among air travelers. This paper, therefore attempts to identify the determining factors for choice of airport, particularly where airport is found in towns that are separated by few distance. Primary data was adopted for this study using a structured questionnaire focusing on the determinant factors of airport’s choice. A total of 493 domestic air travelers were sampled using the systematic random sampling method. The result of the hypothesis revealed that route availability and airfare were significant factors that influenced the choice of airports among passengers. Furthermore, the stepwise multiple regression analysis results showed that the availability of aircraft for passenger destinations was a strong influence at 91.1% (F = 28875.881, p&lt;0.05). The study, however, identified the factor that determines choice of airport. Also, apart from enriching the literature, this finding is expected to assist policy makers to formulate policies that could further entrench equity in the provision of air service to the people in the nearest future

Academic Domains as Political Battlegrounds: A Global Enquiry by 99 Academics in the Fields of Education and Technology

This article theorizes the functional relationship between the human components (i.e., scholars) and nonhuman components (i.e., structural configurations) of academic domains. It is organized around the following question: in what ways have scholars formed and been formed by the structural configurations of their academic domain? The article uses as a case study the academic domain of education and technology to examine this question. Its authorship approach is innovative, with a worldwide collection of academics (99 authors) collaborating to address the proposed question based on their reflections on daily social and academic practices. This collaboration followed a three-round process of contributions via email. Analysis of these scholars’ reflective accounts was carried out, and a theoretical proposition was established from this analysis. The proposition is of a mutual (yet not necessarily balanced) power (and therefore political) relationship between the human and non-human constituents of an academic realm, with the two shaping one another. One implication of this proposition is that these non-human elements exist as political ‘actors’, just like their human counterparts, having ‘agency’ – which they exercise over humans. This turns academic domains into political (functional or dysfunctional) ‘battlefields’ wherein both humans and non-humans engage in political activities and actions that form the identity of the academic domain

Academic domains as political battlegrounds : A global enquiry by 99 academics in the fields of education and technology

Academic cognition and intelligence are ‘socially distributed’; instead of dwelling inside the single mind of an individual academic or a few academics, they are spread throughout the different minds of all academics. In this article, some mechanisms have been developed that systematically bring together these fragmented pieces of cognition and intelligence. These mechanisms jointly form a new authoring method called ‘crowd-authoring’, enabling an international crowd of academics to co-author a manuscript in an organized way. The article discusses this method, addressing the following question: What are the main mechanisms needed for a large collection of academics to collaborate on the authorship of an article? This question is addressed through a developmental endeavour wherein 101 academics of educational technology from around the world worked together in three rounds by email to compose a short article. Based on this endeavour, four mechanisms have been developed: a) a mechanism for finding a crowd of scholars; b) a mechanism for managing this crowd; c) a mechanism for analyzing the input of this crowd; and d) a scenario for software that helps automate the process of crowd-authoring. The recommendation is that crowd-authoring ought to win the attention of academic communities and funding agencies, because, given the well-connected nature of the contemporary age, the widely and commonly distributed status of academic intelligence and the increasing value of collective and democratic participation, large-scale multi-authored publications are the way forward for academic fields and wider academia in the 21st century.peerReviewe

Academic domains as political battlegrounds:A global enquiry by 99 academics in the fields of education and technology

This article theorizes the functional relationship between the human components (i.e., scholars) and non-human components (i.e., structural configurations) of academic domains. It is organized around the following question: in what ways have scholars formed and been formed by the structural configurations of their academic domain? The article uses as a case study the academic domain of education and technology to examine this question. Its authorship approach is innovative, with a worldwide collection of academics (99 authors) collaborating to address the proposed question based on their reflections on daily social and academic practices. This collaboration followed a three-round process of contributions via email. Analysis of these scholars’ reflective accounts was carried out, and a theoretical proposition was established from this analysis. The proposition is of a mutual (yet not necessarily balanced) power (and therefore political) relationship between the human and non-human constituents of an academic realm, with the two shaping one another. One implication of this proposition is that these non-human elements exist as political ‘actors’, just like their human counterparts, having ‘agency’ – which they exercise over humans. This turns academic domains into political (functional or dysfunctional) ‘battlefields’ wherein both humans and non-humans engage in political activities and actions that form the identity of the academic domain. For more information about the authorship approach, please see Al Lily AEA (2015) A crowd-authoring project on the scholarship of educational technology. Information Development. doi: 10.1177/0266666915622044.</p