Successful treatment of HIV with anti-retroviral therapy (ART) is resulting in more people living with HIV-associated neurocognitive disorder (HAND). In sub-Saharan Africa, this calls for strategic planning and judicious allocation of scarce resources, which requires an accurate estimate of the prevalence of HAND. Estimates of the prevalence of HAND in sub-Saharan Africa vary greatly, between 18.8% and 88.3%. This variability may be explained by factors such as different diagnostic approach, neuromedical examination, ART status, sampling method, substance abuse, assessors’ qualification, depression and outcome measure. Different methods of diagnosing HAND, different outcome measures and non-random sampling techniques make it almost impossible to accurately estimate the prevalence of HAND in sub- Saharan Africa, often resulting in overestimation of the burden of disease. Consumers of health research should consider certain study characteristics and exercise appropriate caution when interpreting burden of disease in sub-Saharan Africa, especially when pursuing policy shift. Underestimating the prevalence of HAND will certainly affect the capacity and speed of containment, while overestimating will draw unnecessary attention and result in the misallocation of scarce resources.

Pregnancy and postpartum periods have been associated with physical changes, mental health problems, including stress, anxiety, depression and psychosis as well as changes in women's quality of life (QOL). 11-13 Some ABSTRACT Background: Antenatal exercise (ANE) has been reported to improve postpartum health outcomes in women. However, postpartum health related outcomes of ANE have been inconsistent in previous studies and have not been studied in a Nigerian population. This study assessed the influence of ANE on postpartum health-related quality of life (HRQOL) of Nigerian women. Methods: 350 purposively selected women participated in this cohort study. During the last two pregnancy trimesters, participants completed a questionnaire assessing ANE practice/pattern while the Short Form (SF-36) questionnaire was used to assess HRQOL during postpartum. Data were analyzed using descriptive and inferential statistics with alpha level set at 0.05. Results: Majority (82.9%) of the women practiced ANE. Women who did not exercise showed significantly (p = 0.001) higher general health scores than those who did not. Women who exercised for <30 mins also showed significantly (p = 0.040) higher general health scores, as compared to those who exercised for ≥30 mins. HRQOL was negatively correlated with each of practice and duration of ANE. Conclusions: It was concluded that ANE practice and patterns did not improve postpartum HRQOL. Improved education and supervision of ANE is recommended for improved postpartum health outcomes.

BACKGROUND: For maternal and infant benefits, cradle, cross-cradle and football hold positions have been recommended and widely utilized by mothers during breastfeeding (BF) tasks. There is paucity of data on the biomechanical costs of these BF positions. OBJECTIVE: This study evaluated the trunk lean angles and electromyographic (EMG) activities of the trunk muscles during these BF positions. METHODS: In this experimental study, 25 nulliparous females carried a 6-kg weighing infant, while simulating BF tasks in each of the three BF hold positions for five minutes respectively. During each task, forward and lateral trunk lean angles were measured with a single inclinometer. Activities of the right and left erector spinae (ES) and external oblique (EO) muscles were also measured via surface electromyography. One-way analysis of variance was used to analyze data at a significance level of 0.05. RESULTS: Cross-cradle position resulted in significantly higher anterior trunk lean and right ES and EO muscle activities. Conversely, cradle position significantly elicited highest activities in the left ES and EO muscles. Left trunk lean angles were highest during the football position. CONCLUSION: Football BF position may pose less risk of BF-related musculoskeletal disorders in nursing mothers, as compared to the cradle and cross-cradle BF positions.

Background Disasters represent substantial health risks to the human population. Proper interventions at all stages of disaster management (DM) are essential for human-related outcomes. The role of physiotherapy in DM should not be underestimated, but unfortunately information on the involvement of physiotherapists in DM is limited in sub-Saharan Africa. Methods One hundred and fifty Nigeria-based and trained physiotherapists were recruited to complete a questionnaire investigating the knowledge, practices and perceived barriers of the role of physiotherapists in DM. Results Physiotherapists had moderate knowledge of their role at every stage of DM. However, their involvement in specific DM-related activities during various stages of DM in the country was low. Major barriers to the involvement of physiotherapists in DM included a lack of established government policies on the integration of physiotherapists in DM (90.0%) and a lack of specialty clinical practice areas in DM (89.3%). For improved involvement of physiotherapists in DM in Nigeria, respondents recommended creating an awareness of the role of physiotherapists in DM (91.3%), providing continuous education programmes on DM (90.6%) and inclusion of DM in physiotherapy training programmes in Nigeria (90.0%). Conclusion Physiotherapists perceived that they are not adequately involved in DM in Nigeria, despite their moderate knowledge of their role during DM.

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