World Health Organization - Nigeria

The introduction of significantly shorter, all-oral regimens has significantly shifted the management of drug-resistant tuberculosis (DR-TB) towards a more tolerable and patient-centred therapeutic approach that aims to enhance treatment adherence, clinical outcomes, and quality of life among patients. Nigeria has gradually adopted this all-oral, shorter regimen, but the impact of this regimen in programmatic settings has not yet been studied. In 2022, a longitudinal, two-armed cohort study was conducted to explore the effectiveness, safety, and feasibility of the all-oral shorter regimen in the programmatic management of RR/MDR-TB in Nigeria. Consenting and eligible RR/MDR-TB patients receiving the all-oral regimen (intervention group) in four states were consecutively enrolled and compared to those receiving the standard of care (SOC). Treatment effectiveness, proportion, and 95% confidence intervals of favourable and unfavourable outcomes were measured at the end of treatment and during follow-up (six and 12 months post-treatment). In total 383 Participants were followed monthly throughout the 9-12-month treatment phase and then reassessed at 6 and 12 months after treatment completion, giving a total possible observation period of up to 24 months (185 received the intervention and 198 the standard of care). At the end of follow-up, there was a higher but non-significant proportion of favourable outcomes among the intervention vs. SOC group (80% vs. 69.7%); a higher proportion of favourable outcomes was also noted at the end of treatment among intervention participants (81.1 vs. 76.8%). Around one third of patients reported at least one serious adverse event (SAE), with no significant differences between arms, and none were deemed related to the use of medication. Intervention participants reported greater improvements in health-related quality of life between baseline and four months compared to those receiving the SOC. These findings support the programmatic use of all-oral shorter treatment for RR/MDR-TB as a regimen that is effective, tolerable, safe, and associated with enhanced health-related quality of life for patients in Nigeria.

Hypertension remains a leading contributor to cardiovascular morbidity and premature mortality worldwide, with increasing prevalence observed among younger populations. Although avoidable lifestyle factors account for a substantial proportion of hypertension risk, prevention efforts depend heavily on adequate awareness and understanding of these factors. This study examines the level of knowledge of avoidable risk factors of hypertension among university students in England and evaluates the relationship between these factors and hypertension status. A cross-sectional quantitative design was employed using a structured questionnaire administered to students at a large English university. Descriptive statistics, chi-square analysis, and multinomial logistic regression were used to analyse the data. Findings indicate a high level of knowledge of avoidable risk factors, including alcohol consumption, obesity, high salt intake, and junk food consumption. Despite this, significant associations were observed between several avoidable risk factors and hypertension status, particularly alcohol use, body mass index, salt intake, and frequent consumption of junk food. The results highlight a clear disjunction between knowledge and health behaviour, suggesting that awareness alone is insufficient to reduce hypertension risk among university students. The study underscores the need for prevention strategies that extend beyond information provision to address behavioural, social, and environmental drivers of risk.

Background: Gastric and gastro-oesophageal junction cancers encompass a heterogeneous group of malignancies with distinct histological and biological characteristics. Histological classification remains central to diagnosis, prognostication, and therapeutic decision-making, particularly in settings where molecular profiling is not routinely available. Objective: This study examined the histological spectrum and classification patterns of gastric and gastro-oesophageal junction cancers diagnosed over a ten-year period in Anambra State, South-East Nigeria. Methods: A retrospective review was conducted of gastric and gastro-oesophageal junction cancer cases diagnosed between January 2011 and December 2020 across four major histopathology laboratories in Anambra State. Archived haematoxylin and eosin–stained slides and paraffin blocks were reviewed. Tumours were classified according to the 2019 World Health Organization classification of gastric tumours, with carcinomas further categorised using the Lauren classification system. Descriptive statistics and chi-square testing were applied, with statistical significance set at p < 0.05. Results: Ninety-three cases met inclusion criteria. Carcinomas constituted the majority of tumours, followed by mesenchymal tumours, lymphomas, and neuroendocrine tumours. Tubular adenocarcinoma was the most frequent carcinoma subtype, while intestinal-type carcinoma predominated under the Lauren classification. Most graded carcinomas were well differentiated. No statistically significant associations were identified between histological subtype and patient age or sex. Conclusion: Gastric and gastro-oesophageal junction cancers in this setting are dominated by epithelial malignancies, particularly tubular and intestinal-type adenocarcinomas. The observed histological profile aligns with patterns reported across Nigeria and other low- and middle-income settings, underscoring the continuing relevance of morphology-based classification in regional cancer practice.

Mobility modelling plays a pivotal role in evaluating the performance of Mobile Ad Hoc Networks (MANETs), as the movement patterns of nodes strongly influence routing efficiency, connectivity, and network stability. Existing mobility models, particularly entity and group-based frameworks, have proven useful in simulating various MANET applications but remain limited in capturing the complex movement behaviour characteristic of Search-and-Rescue (SAR) operations in disaster scenarios. This study proposes a realistic hybrid mobility model that integrates the essential features of both entity and group mobility paradigms to better represent the coordinated yet flexible dynamics of SAR teams. Three sets of simulations were performed using the Network Simulator 2 (NS2). The first and second simulations focused on generating and combining existing entity and group mobility patterns using the BonnMotion tool, resulting in two composite models (Real1 and Real2). The third simulation compared these models using AODV and DSDV routing protocols under varying node mobility levels and traffic conditions. Key performance metrics, including relative mobility, node degree, partition count, link duration, packet delivery ratio (PDR), throughput, and average end-to-end delay, were analysed. Results demonstrate that it is feasible to concatenate existing mobility models into a coherent hybrid framework. Among the developed models, Real2 exhibited superior performance in most test conditions, yielding higher PDR, lower delay, and more stable connectivity than its constituent models. These findings confirm that the performance of MANETs is highly dependent on mobility realism. Consequently, selecting a model that accurately reflects the behavioural characteristics of the target scenario is essential for credible MANET performance evaluation in emergency response contexts.

Water utilities are vital for urban health and economic growth, but face sustainability challenges, especially in low- and middle-income countries. In Nigeria, despite long-term investment, urban water utilities struggle with operational inefficiencies, frequent service interruptions, high non-revenue water, and low customer satisfaction. This study examined how performance monitoring can improve the operational sustainability of State Water Utilities in Nigeria. The objectives were to assess institutional performance monitoring practices and to evaluate the use of key performance indicators in tracking operations. A mixed-methods, cross-sectional case study was conducted in six urban utilities across six states. The data was collected in September 2022 through document re-views, structured questionnaires, and in-depth interviews. Descriptive statistics was used to analyze quantitative data; NVivo facilitated qualitative thematic analysis. Findings show all utilities have functional M&E departments responsible for performance monitoring activities, but M&E plan implementation varies (50%), with notable capacity gaps, inconsistent data management (only one utility has a Data Management Plan), and 7–22 indicators per utility. Baseline and target-setting are weak (pre-sent in 50% of utilities), and dissemination beyond internal reporting is limited. Recommendations include institutional reforms, capacity development, allocating 10% of budgets to performance monitoring, and embedding adaptive learning to enhance sustainability, effectiveness, and public trust.

ABSTRACT This paper presents the structured process developed by the World Health Organization (WHO) to systematically scale up actions in environment, climate change, and health at the country level. The process is designed to implement evidence-based and data-driven actions tailored to local contexts and to bring together diverse stakeholders from various sectors such as health, environment, energy, and transport. It contains three steps: (1) analysing the country’s current situation regarding environmental exposures and associated health impacts, (2) matching priorities with effective actions integrated with ongoing activities, and (3) assisting with implementation and monitoring. Various resources support these steps, including data scorecards, checklists, and a catalogue of interventions. These also cover effective communication with stakeholders and ways for sustaining change. Country examples are presented to illustrate the practical application of this process. In conclusion, this paper highlights the critical role of upstream approaches to disease prevention and provides practical advice for advancing WHO’s goal of leaving no one behind in achieving the highest possible level of health as well as the human right to a clean, healthy, and sustainable environment.

Abstract Tilapia ( Oreochromis niloticus ) production and distribution play a crucial role in providing essential animal protein and socio-economic benefits that support growth and development in riverine communities. This study examines the tilapia value chain (TVC) in Abeokuta, Ogun State, Nigeria, using a multistage sampling approach. A total of 195 actors were selected, including 3 fish seed producers, 3 feed suppliers, 3 grow-out tilapia farmers, 25 fish processors, 30 wholesalers, 30 retailers, and 101 consumers, with data collected via structured questionnaires. Results show that fish processing is primarily driven by women, with the majority of processors aged between 31 and 40 years. Likewise, fish marketing is predominantly managed by women, most of whom fall within the 41 to 50 age range. A considerable number of processors are members of cooperatives, work part-time, and rely on charcoal for smoking fish. Among fish marketers both wholesalers and retailers, 52.0% fund their businesses through personal savings, and 73.3% source fish directly from farmers. Additionally, 56.7% employ paid labor, and 66.7% operate within local markets. Gender roles are clearly defined along the value chain revealing that women mainly handle pre-processing activities such as washing, descaling, and degutting, while men dominate fish seed production, feed supply, and grow-out tilapia farming. Fish transportation is exclusively undertaken by men, whereas both men and women are involved in fish folding and sticking. Notably, there is no record of farmed tilapia being exported. Key challenges facing the sector include the high cost of processing equipment and fuel/charcoal, poor fish quality, and limited market information, all of which hinder effective fish processing and marketing. Furthermore, the high cost of fish feed remains a major constraint for fish seed producers, feed suppliers, and grow-out farmers.

Rotavirus remains a leading cause of severe diarrhea and preventable deaths in children under five, despite safe and effective vaccines being available for more than two decades. Globally, the infection causes an estimated 150,000 deaths and millions of hospital admissions each year, with the greatest toll in low- and middle-income countries. Children in sub-Saharan Africa are over 40 times more likely to die from rotavirus than their counterparts in high-income settings—an inequity that persists despite proven tools for prevention. By December 2023, 43 of 47 countries in the World Health Organization African Region had introduced rotavirus vaccines, increasing regional coverage from 5% in 2012 to 61% in 2023. Yet progress remains uneven: coverage ranges from 48% in Central Africa to 73% in Southeast Africa, and an estimated 257 million eligible doses were missed between 2012 and 2023. Nigeria, for instance, only began phased introduction in 2022. Barriers such as delayed national rollouts, weak cold-chain systems, funding shortfalls, and reduced vaccine effectiveness in high-mortality settings continue to limit impact. Misinformation and vaccine hesitancy further erode public confidence. To close the rotavirus immunity gap, coordinated action is urgently needed—accelerating vaccine introduction in unserved countries, strengthening delivery systems, securing sustainable financing, and implementing catch-up campaigns for missed infants. Investment in next-generation vaccines with improved heat stability, broader serotype coverage, and simplified dosing is equally essential. Bridging this gap is not only a moral imperative but also central to advancing global child health and achieving Sustainable Development Goals 3 and 10.

Dengue virus (DENV) infection has not been previously reported from Bayelsa State, Nigeria. We aimed to determine the prevalence of dengue virus (DENV) infection, malaria, and coinfection, and other pathogens among febrile patients in the capital city, Yenagoa.We conducted a cross-sectional study among persons aged ≥1 year who presented with acute febrile illnesses (AFI) at four hospitals in Bayelsa State during 20 May - 15 June 2022. Blood samples from 443 participants were tested for DENV seromarkers (NS1, IgM, IgG), using serology and RT-PCR, and malaria was diagnosed by thick smear microscopy. Sociodemographic and risk factor data were collected using electronic questionnaires administered via smart phones/tablets and analyzed using univariate and multivariate methods. Metagenomic libraries were prepared and enriched by viral target capture and sequenced by NGS. The seroprevalence of acute DENV infection was 14.5% (n = 64) while the prevalence of malaria was 42.4% (n = 188); 6.5% (n = 29) of participants were coinfected with acute DENV infection and malaria. An additional 17.6% (n = 78) of participants had markers for past DENV infection. Rural/suburban residence and age ≥ 31 years were significantly correlated with having any dengue seromarker. Residence in a larger household (≥5 persons), and borehole water-use were predictors for malaria fever. RT-PCR results revealed multiple DENV serotypes, with serotype 3 dominant. Sequencing of unknown AFI cases revealed numerous viral causes such as adenovirus, EBV, and hepatitis A, as well as additional dengue and malarial infections missed by conventional testing. Of interest were Coxsackievirus A5 (hand, foot and mouth disease; HFMD) which has been diversifying locally for years in Nigeria and an mPox clade IIb (lineage A.2.3) strain that emerged in Nigeria during the 2022 global outbreak. The results of this study provide the first documentation of human DENV infection in Bayelsa State, Nigeria and suggests that dengue is an emerging and important cause of febrile illness in this area. Our findings support the need for routine testing to identify DENV among patients who present with acute febrile disease. Metagenomic NGS results highlight the benefits of unbiased surveillance to identify circulating and emerging pathogens.

Introduction: Lassa fever remains a significant public health threat in West Africa. While vaccine candidates are advancing through the pipeline, efforts in planning timely and sufficient supply have been constrained by limited understanding of demand. This challenge is compounded by the shifting global financing landscape and unclear country-level investment capacity in the vaccine product and the implementation activities required to achieve appropriate coverage. Methods: A demand forecast model for a Lassa fever vaccine was developed. The model includes five implementation scenarios across endemic and non-endemic at-risk countries, accounting for diverse use cases such as integration into routine immunization, targeted geographic campaigns, occupational group campaigns, and reactive use through stockpiles. Key inputs included vaccine characteristics, coverage rates, market entry timing, and policy timelines. Assumptions were developed through literature review and will be refined via workshops and consultations with global, regional, and country experts. Results: Forecasts present a heterogenous vaccine demand picture between 2031 and 2036, driven primarily by differences in countries’ ability to invest. In more conservative scenarios, vaccine demand is initially limited to high-burden regions with gradual scale-up over time, focusing on high-risk groups. Demand is further influenced by product characteristics, such as well as ultra-cold chain capacity. Conclusion: The initial analysis reveals that demand is not solely a function of disease burden but is highly sensitive to country-level prioritization, funding availability, the strategic choices countries make around vaccine introduction. Understanding and anticipating Lassa fever vaccine demand is critical for guiding investment in manufacturing for product developers, in delivery systems for countries, and in policy advocacy for community groups. Demand forecasts must remain flexible, incorporating real-time inputs from country stakeholders and evolving financing landscapes. The ability and prioritisation of countries to invest in both vaccine procurement and implementation strategies will be the primary determinant of demand.