BackgroundTuberculosis (TB) remains a leading cause of death in much of sub-Saharan Africa despite available effective treatment. Prompt initiation of TB treatment and access to antiretroviral therapy (ART) remains vital to the success of TB control. We assessed time to mortality after treatment onset using data from a large treatment centre in Nigeria.MethodsWe analysed a retrospective cohort of TB patients that commenced treatment between January 2010 and December 2014 in Aminu Kano Teaching Hospital. We estimated mortality rates per person-months at risk (pm). Cox proportional hazards model was used to determine risk factors for mortality.ResultsAmong 1,424 patients with a median age of 36.6 years, 237 patients (16.6%) died after commencing TB treatment giving a mortality rate of 3.68 per 100 pm of treatment in this cohort. Most deaths occurred soon after treatment onset with a mortality rate of 37.6 per 100 pm in the 1st week of treatment. Risk factors for death were being HIV-positive but not on anti-retroviral treatment (ART) (aHR 1.39(1 · 04–1 · 85)), residence outside the city (aHR 3 · 18(2.28–4.45)), previous TB treatment (aHR 3.48(2.54–4.77)), no microbiological confirmation (aHR 4.96(2.69–9.17)), having both pulmonary and extra-pulmonary TB (aHR 1.45(1.03–2.02), and referral from a non-programme linked clinic/centre (aHR 3.02(2.01–4.53)).ConclusionsWe attribute early deaths in this relatively young cohort to delay in diagnosis and treatment of TB, inadequate treatment of drug-resistant TB, and poor ART access. Considerable expansion and improvement in quality of diagnosis and treatment services for TB and HIV are needed to achieve the sustainable development goal of reducing TB deaths by 95% by 2035.

Malaria in pregnancy is associated with substantial risk of maternal and fetal morbidity and mortality. The uptake of preventive antimalarials is low in malaria endemic countries, including Nigeria. Using a crosssectional study design, we assessed factors associated with uptake and adherence to intermittent preventive treatment for malaria in pregnancy (IPTp) among antenatal attendees in primary health centers in Kano, northern Nigeria (n5239). A total of 137 respondents (57.3%) reported receiving preventive antimalarials, but only 88 respondents (36.8%) [95% confidence interval (CI): 30.7–43.3%] reported ingesting pills in the clinic under supervision. Factors associated with adherence to IPTp after adjustment for potential confounding included: advanced maternal age [adjusted odds ratio (AOR) (95%CI)52.1 (1.3–6.37)], higher educational attainment [AOR (95%CI)53.2 (1.32–6.72)], higher parity [AOR (95%CI)51.6 (1.07–3.94)], lower gestational age at booking [AOR (95% CI)51.72 (1.24–3.91)], and use of insecticidetreated nets [AOR (95%CI)52.03 (1.13–3.26)]. There is a need for strengthening health systems and addressing cultural factors that impede efforts at expanding coverage of malaria prevention strategies in Nigeria.

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Background:Kano State is the most populous state, and one of those states pronounced with the highest prevalence of drug abuse in Nigeria. However, there is lack of documented data to back the assertion.Objective:We determined the pattern, awareness and perceptions of the adult residents of Kano metropolis about self medication.Materials and Methods:We used a descriptive cross-sectional design to study a random sample of 380 adult in Kano metropolis. Data was collected using semi-structured questionnaires that were pretested outside the study area. Data analysis was with Epi Info® 3.5.1.Results:The mean age of the subjects was 35.43 ± 15.10 years, majority were males (66.32%), singles (47.11%) and had at least secondary education (67.63%). About three-quarter (78.95%) admitted using drug (s) in the past without prescription. Drugs commonly consumed were antimalarials (42.10%), analgesics (40.56%), antibiotics (29.41%), and cough mixtures (13.31%). Common sources of drugs were patent medicine stores (62.54%) and the market (19.81%). Common reasons for self medication were long queues in the hospitals (38.39%), and in-accessibility to doctors (25.08%). About two-thirds (65.00%) correctly perceived that self medication could be hazardous; and half (51.58%) were aware of at least one hazard of self medication.Conclusion/Recommendations:Irrational drug use is a growing challenge to public health in Kano, Nigeria. Thus, drug regulatory agencies in Nigeria should work together to ensure that all drug retail outlets and drug sellers are registered, controlled drugs are dispensed only on prescription of the physicians; and the laws safeguarding drug use are duly enforced. Health authorities should also strengthen efforts towards health educating the public.