Asian Journal of Research in Medicine and Medical Science

Antibacterial Activity of Selected Medicinal Plant Extracts and Their Interactions with Antibiotics against Serratia marcescens and Pseudomonas aeruginosa

Bhanupratap Vishwakarma — 2026-02-06

The emergence of antimicrobial resistance to Gram-negative isolates has rekindled interest in new approaches that would potentiate the activity of traditional antibiotics, such as plant extracts for medicinal purposes. Antibacterial activity of some selected medicinal plant extracts in tandem with standard antibiotics against Pseudomonas aeruginosa and Serratia marcescens was studied. The aqueous crude extracts of the plants (R.aculeata, C.bursa-pastoris, I.coccinea and P.olerecea) were screened individually as well as in combination with ampicillin, ciprofloxacin, erythromycin and amoxicillin in 1:1 proportions by agar-well diffusion technique. On Serratia marcescens, against which all the extracts exhibited moderate activity with inhibition zones of diameter of 12-18 mm, Randia aculeata and Ixora coccinea displayed significant potential among others, Portulaca oleracea was moderately active while Capsella bursa pastoris showed a negative result. Ciprofloxacin exhibited excellent antibacterial activity (28 mm), whereas the other antibiotics showed resistance. Synergistic effects of combinations were not identified and in some cases the inhibitory zones of some antibacterial agents were found to be decrease partners with antagonistic interactions. For P. aeruginosa, none of plant extracts had antibacterial activities and least effective against them were antibiotics (except ciprofloxacin with inhibition zone diameter = 24 mm). Its antibacterial activity decreased even more when combined with plant extracts. Such results indicate that the selected medicinal plant extracts had no synergistic effect on, and even inhibited, antibacterial activity of antibiotics (something like conventional antibiotic-potentiating effects) against Serratia marcescens and Pseudomonas aeruginosa. The study emphasises the need for systematic assessment of plant-antibiotic interaction and caution in concurrent use of plant extracts with antibiotics without prior determination of their interaction.

Prevalence and Associated Factors of Hepatitis C Virus Infection among HIV Positive Patients Receiving HAART at a Tertiary Hospital in Makurdi, Benue State, Nigeria

Shawon Fredrick Akpagher — 2026-02-17

Introduction: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infection affects approximately 2.3 million people globally, with people living with HIV (PLWH) having a sixfold higher risk of HCV infection compared to those without HIV.

Aim: This study aimed to determine the prevalence and predictors of HCV co-infection among HIV-positive patients on highly active antiretroviral therapy (HAART) at the Federal Medical Centre, Makurdi.

Methods: A cohort study design was conducted with 250 study participants using a consecutive sampling method. A structured self-administered questionnaire, which was pre-tested, was utilized to gather data on socio-demographic and risk factors from participants over a period of 3 months, spanning from September to November 2023. The prevalence of HCV co-infection was assessed using serum samples from the participants. Chi-square was utilized to examine the relationship between socio-demographic factors and HCV/HIV co-infection. Binary regression analysis was employed to examine independent predictors of HCV co-infection. All experiments were conducted at 95% confidence level using SPSS version 27.0.

Results: The prevalence of HCV/HIV co-infection was 4.0%, with a mean participant age of 44 years and a male-to-female ratio of 1:3. No significant differences were found in co-infection rates by sex, age, religion, or marital status (p > 0.05). However, significant associations were observed with education level (p = 0.022) and employment status (p = 0.013), with higher prevalence among patients with primary education (9.7%) and those unemployed (6.3%). Independent predictors of co-infection included primary education (AOR=3.419, p=0.001), unemployment (AOR=3.200, p=0.001), and sharing sharps (AOR=3.071, p=0.004).

Conclusion: This 4.0% co-infection rate indicates an endemic situation, underscoring the necessity for strengthened public health education to reduce risk behaviours and promote extensive HCV testing among HIV patients. Although limited by its single-centre scope and reliance on self-reported data, the findings provide valuable local epidemiological information and offer guidance for future research aimed at addressing HCV/HIV co-infection in Nigeria and comparable environments.

A Time Series Model for Short-term Prediction of Onchocerciasis among Farmers in Benue State-Nigeria

Ortaver Godwin Tyavyar — 2026-02-21

Aims: The aim of this study is to apply time series modeling to predict short-term trends in Onchocerciasis infection among farmers in Benue State, Nigeria, and to generate reliable forecasts that can inform public health planning and agricultural productivity interventions.

Place and Duration of Study: The study was conducted in Benue State, Nigeria, using monthly Onchocerciasis infection data obtained from the Benue State Epidemiological Unit, Makurdi, covering the period from January 2009 to June 2025.

Methodology: The study employed descriptive statistics, the Ng-Perron modified unit root test, the Ljung-Box Q-statistic test, and the Autoregressive Moving Average (ARMA(p,q)) modeling framework. Model selection was based on information criteria and log-likelihood values, while forecast accuracy was evaluated using Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), and Theil’s Inequality Coefficient (TIC).

Results: Descriptive analysis revealed a mean monthly infection of 928 persons, with evidence of non-normality due to skewness and leptokurtosis. The Ng-Perron test confirmed stationarity of the series at level. The ARMA(3,3) model was identified as the best-fitting specification, explaining about 78.35% of the variation and exhibiting dynamic stability. Forecast evaluation showed strong predictive performance with low RMSE (0.2200), MAE (0.1883), MAPE (2.77%), and a near-zero TIC (0.0162). Analysis of model roots indicated an angular displacement of 44.75°, corresponding to an estimated Onchocerciasis life cycle of approximately eight months. Forecasts for July 2025 to June 2027 project an average monthly infection of about 865 persons (95% CI: 549-1,378), with a total of approximately 20,771 cases over the two-year period. The forecasts suggest that Onchocerciasis will persist at a steady level, underscoring the need for sustained drug distribution, strengthened vector control, continuous surveillance, and integrated health-agricultural policies to support effective disease control, protect farmers’ productivity, and improve food security in Benue State.

Conclusion: The study concluded that Onchocerciasis infection among farmers in Benue State exhibits a chronic and persistent pattern, with forecasts indicating a sustained public health burden. The ARMA(3,3) model provided a robust and reliable framework for monitoring and forecasting infection trends. Strengthening community-based surveillance, sustaining vector control and mass drug administration, integrating agricultural support programmes, enhancing farmer health education, and promoting intersectoral collaboration are essential for reducing the disease burden and its impact on postharvest crop losses in the state.

Time Series Modeling of Human African Trypanosomiasis Incidence in Nigeria Using ARIMA Model

David Adugh Kuhe — 2026-03-25

Aim: To model and forecast the morbidity incidence of Human African Trypanosomiasis (HAT) in Nigeria using the Autoregressive Integrated Moving Average (ARIMA) time series approach.

Study Design: A retrospective longitudinal time series study design was adopted.

Place and Duration of Study: The study was conducted in Nigeria using annual reported cases of Human African Trypanosomiasis from 1960 to 2024.

Methodology: Human African Trypanosomiasis (HAT), also known as sleeping sickness, is a vector-borne parasitic disease caused by Trypanosoma brucei species and transmitted by infected tsetse flies. Annual time series data of HAT infection cases in Nigeria covering the period 1960–2024 were analyzed. The time series properties of the data were examined using graphical plots and the Phillips–Perron unit root test to determine stationarity. The results indicated that the series was integrated of order two, I(2). Following the Box–Jenkins modeling procedure, several ARIMA (p, d, q) models were estimated, and model selection was based on diagnostic and goodness-of-fit criteria. The ARIMA (3,2,3) model emerged as the most appropriate model for capturing the dynamics of HAT incidence in Nigeria.

Results: The selected ARIMA (3,2,3) model was dynamically stable and accounted for 76.31% of the variability in HAT infection cases. Forecasts generated for an 11-year period (2025–2035) revealed a consistent decline in the number of reported HAT cases, with an average projected annual incidence of approximately 146 cases. The downward trend suggests that sustained interventions—including improved disease surveillance, enhanced treatment accessibility, and strengthened vector control strategies—may have contributed to the reduction in infection rates.

Conclusion: The findings of this study indicate a declining trajectory of Human African Trypanosomiasis in Nigeria over the forecast period. Nevertheless, continuous surveillance, application of predictive time series modeling, intensified vector control measures, and sustained public health awareness campaigns remain essential to consolidate gains and prevent potential resurgence of the disease.

Assessing the Effectiveness of Digital Tools (Mobile Apps, Tele-dentistry, and Online Platforms) in Promoting Preventive Oral Health Behaviors

Omolayo Yetunde Abimbola — 2026-03-30

Background: The proliferation of digital health technologies has transformed healthcare delivery, yet their effectiveness in promoting preventive oral health behaviors remains inadequately assessed. This study evaluates the impact of mobile applications, tele-dentistry platforms, and online educational tools on oral hygiene practices and screening behaviors.

Methods: A systematic evaluation of digital oral health interventions was conducted, analyzing data from 2,847 participants distributed across three intervention groups: mobile health application users, tele-dentistry platform users, and online educational platform users, alongside corresponding control groups. Behavioral outcomes were tracked over an 18-month follow-up period to assess sustained engagement and long-term effectiveness. The study employed a mixed-methods approach combining quantitative usage analytics, behavioral outcome measurements, and qualitative user feedback assessments.

Results: Mobile oral health applications demonstrated significant improvements in brushing frequency (p<0.001), with 67.3% of users maintaining twice-daily brushing habits compared to 42.1% in control groups. Tele-dentistry consultations increased preventive dental visit completion rates by 34.8%. Online educational platforms showed modest effects on knowledge acquisition (effect size d=0.58) but stronger impacts on intention-behavior translation among younger demographics.

Conclusions: Digital tools exhibit substantial promise for scaling preventive oral health interventions, particularly when incorporating gamification, personalized feedback mechanisms, and integrated appointment systems. However, effectiveness varies significantly across demographic groups, with digital literacy and socioeconomic factors influencing engagement patterns.

Acute Ocular Toxicity of Syngonium Podophyllum Extract on Corneal Tissue in Rats

Ubogu Joseph Aforkoghene — 2026-04-08

Introduction: The human eye is recognized as one of the most intricate and sensitive sensory organs, making it particularly vulnerable to damage from environmental toxins, including plant-derived irritants.

Aim: This study aims to investigate the acute ocular toxicity of Syngonium podophyllum extract on corneal tissue in rats.

Study Design: This study adopted an experimental laboratory-based research design.

Methodology: The experimental procedures were conducted at the Department of Human Anatomy and Cell Biology Laboratory, Delta State University, Abraka, while histological processing was carried out at the Histology Unit of the Department. Prior to the commencement of the experimental work, ethical approval was obtained from the Department of Human Anatomy and Cell Biology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka. A total of 12 adult Wistar rats (weighing 180-220 g) were randomly divided into two groups. Group 1 served as the control group and was administered normal rat chow and water. Group 2 received 1 ml (5000 mg/kg) of the extract dissolved in DMSO (dimethyl sulfoxide), and observations were carried out for 15 days. Quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 26.0.

Results: The results obtained from this study indicate that SP administration generally increased erythrocyte sedimentation rate (ESR), as evidenced by significantly higher ESR levels compared to the control group. This finding suggests a potential inflammatory effect of the plant extract. Specifically, the data revealed that as the SP dosage increased, the levels of malondialdehyde (MDA), a marker of oxidative damage, also increased significantly. These findings therefore suggest that SP exposure induces oxidative stress in the rats’ corneal tissues, leading to cellular damage due to an imbalance between the production of reactive oxygen species and antioxidant defense mechanisms.

Conclusion: This study concludes that Syngonium podophyllum extract produces significant physiological, biochemical, and histopathological changes in a dose-dependent manner.

Dose-Dependent Effects of Aqueous Extract of Xylopia aethiopica on Lipid Profile and Hepatorenal Biomarkers in Wistar Rats

Malachy Nwaeze Ezenwaeze — 2026-04-22

This study investigated the dose-dependent effects of aqueous fruit extract of Xylopia aethiopica on lipid profile and hepatorenal biomarkers in albino Wistar rats. A total of 24 rats (n = 6 per group) were randomly assigned into four groups: control and three treatment groups administered 100, 200, and 300 mg/kg body weight of the extract orally for 28 days.

Serum lipid profile, liver function indices, renal biomarkers, and histopathological changes in liver and kidney tissues were evaluated using standard biochemical and histological techniques. Data were expressed as mean ± standard deviation (SD) and analyzed using one-way analysis of variance (ANOVA) followed by Tukey’s post hoc test, with p < 0.05 considered statistically significant.

Results showed a significant dose-dependent improvement in lipid profile at 200 and 300 mg/kg, evidenced by reductions in total cholesterol, triglycerides, low-density lipoprotein (LDL-C), and very low-density lipoprotein (VLDL-C), alongside increased high-density lipoprotein (HDL-C) (p < 0.05). However, higher doses (≥ 200 mg/kg) produced significant elevations in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin, with concomitant decreases in albumin and total protein, indicating hepatotoxicity.

Renal function assessment revealed reductions in urea and creatinine levels, accompanied by significant electrolyte imbalances, including decreased sodium, potassium, and chloride, and increased bicarbonate (p < 0.05). Histopathological findings corroborated biochemical results, showing dose-dependent hepatic injury ranging from mild inflammation to necrosis, and progressive renal structural alterations at higher doses.

Additionally, while aqueous extract of Xylopia aethiopica exhibits significant hypolipidemic effects with potential cardio-protective benefits, its use at higher doses may induce hepatotoxicity and disrupt renal function. These findings highlight the importance of dose regulation and the need for further studies to establish its safety profile and therapeutic window.

Attitude of Health Information Managers towards Patients in Nigeria: Evidence from Three Selected Teaching Hospitals

Eidah Sule Yahaya — 2026-05-23

Background: Health Information Managers (HIMs) occupy a pivotal role in Nigeria's tertiary healthcare system, yet their attitudes towards patients remain understudied. This study assessed HIM attitudes and the factors shaping them across three major teaching hospitals.

Methods: A mixed-methods descriptive cross-sectional survey design was employed, integrating quantitative and qualitative data collection and analysis approaches. Data were collected from 300 HIMs across the University of Ilorin Teaching Hospital (UITH), Ahmadu Bello University Teaching Hospital (ABUTH), and Obafemi Awolowo University Teaching Hospital (OAUTH) using a validated structured questionnaire. Descriptive statistics, Pearson's correlation, multiple regression, Chi-square tests, and thematic analysis were applied.

Results: All 300 respondents (100%) self-reported positive attitudes; however, this finding should be interpreted cautiously given the well-documented potential for social desirability bias in self-report healthcare surveys. Technological resources were widely rated adequate and positively influenced attitudes. Training participation was moderate (mean frequency 2.50–2.80), yet 90–95% strongly believed that continuous professional development (CPD) improves attitude. A statistically significant association was found between communication practices and patient feedback frequency (χ² = 26.72, df = 16, p < 0.05). Qualitative analysis revealed three key themes: ethical breaches in confidentiality, systemic morale constraints, and aspirations for digital transformation.

Conclusion: Despite universally positive self-reported attitudes, underlying systemic, technological, and organisational challenges critically impair HIM service delivery. Integrated investment in ICT infrastructure, mandatory CPD, and patient-centred communication protocols is urgently recommended.

Placental Abruption: A Five-Year Experience at a Tertiary Health Facility in Enugu State University Teaching Hospital, Parklane, South-East Nigeria

Kelvin Emeka Ortuanya — 2026-05-28

Background: Placental abruption is a serious obstetric complication associated with significant maternal and perinatal morbidity and mortality, particularly in low-resource settings. Despite advances in obstetric care, outcomes remain poor due to late presentation and limited diagnostic and management facilities.

Objective: To review the risk factors, clinical presentation, management, and maternal and perinatal outcomes of placental abruption at Enugu State University Teaching Hospital (ESUTH), Parklane, over a five-year period.

Methods: This was a retrospective descriptive study conducted at ESUTH, Enugu, Nigeria, reviewing cases of placental abruption from January 2021 to December 2025. Data were obtained from labour ward registers, case notes, theatre records, and neonatal records using a structured proforma. Variables analyzed included socio-demographic characteristics, clinical features, obstetric parameters, and maternal and neonatal outcomes. Data were analyzed using SPSS version 25.0, with results presented as frequencies and percentages. Chi-square test was used to assess associations, with significance set at p < 0.05.

Results: A total of 108 cases were analyzed. The majority of patients were aged 30–39 years (50%), married (62%), unemployed (56.5%), and of low socioeconomic status. Most patients (63.9%) were unbooked. The most common clinical features were abdominal pain (99.1%) and uterine hypertonicity (97.2%), while vaginal bleeding occurred in 55.6% of cases. Hypertensive disorders were present in 48.1% of patients. Most women were multiparous (72.2%), and 66.7% of pregnancies were at term. Caesarean section was the predominant mode of delivery (71.3%). Maternal complications included blood transfusion (30.6%), disseminated intravascular coagulation (5.6%), shock (9.3%), and acute kidney injury (1.9%), with a maternal mortality rate of 7.4%. Perinatal outcomes showed a mortality rate of 7.4% and NICU admission rate of 11.1%. Low Apgar scores (<5) were observed in 8.3% of neonates.

Conclusion: Placental abruption remains a major obstetric emergency at ESUTH, associated with significant maternal and perinatal morbidity and mortality. Hypertension and lack of antenatal care were key contributing factors. Improved antenatal surveillance, early diagnosis, and prompt intervention are essential to improving outcomes.

Neurorestorative and Antidiabetic Effects of Chromolaena odorata Leaf-extract on the Substantia Nigra of Diabetic Rats Exposed to Mercury: A Histopathological Study

Ifeanyichukwu Maxwell Ama — 2026-06-05

Diabetes and exposure to heavy metals like mercury chloride are known to induce oxidative stress-mediated neurodegeneration, particularly in vulnerable brain regions like the substantia nigra. Medicinal plants such as Chromolaena odorata extract possess antioxidant and neurorestorative properties that may mitigate such damage. This study investigated Neurorestorative and Antidiabetic Effects of Chromolaena odorata Extract on the Substantia Nigra of Diabetic Rats Exposed to Mercury. A Histopathological Study. The study was conducted in Ebonyi State University, Abakaliki and the study lasted for 35 days. Thirty-six (36) male Wistar rats weighing between 250g-300g used for the study were randomly divided into six groups (n = 6): Control (A), diabetic + Hgcl₂ (B), diabetic + Hgcl₂+ metformin (C) and diabetic + Hgcl₂ treated with 200 (D), 400 (E) and 600mg/kg (F) of the extract. Diabetes was induced using a single dose of alloxan monohydrate (150mg/kg) intraperitoneally. 72 hours after diabetes confirmation (glucose ≥200 mg/dL), mercury chloride (3mg/kg), was administered orally daily for 14 days followed by treatment with the administration of the extract to the experimental groups. At the end of the experimental period, animals were humanely sacrificed, the substantia nigra excised and processed for histological evaluation using H&E staining. Data obtained were analyzed using ANOVA followed by Tukey’s post hoc test with P-value at (P = .05). Group B showed significant weight loss and hyperglycemia (370 ± 32 mg/dl) compared to Group A (95 ± 7mg/dl). Histologically, the nigral section revealed severe neurodegenerative changes, vacuolation, and pyknotic nuclei indicative of apoptosis. Treatment with Chromolaena. odorata extract significantly improved glycemic control and restored nigral histoarchitecture in a dose-dependent manner, with the 600 mg/kg showing near-normal morphology comparable to metformin. In conclusion, Chromolaena odorata extract exhibits significant neurorestorative and antidiabetic effects against combined diabetic and mercury neurotoxicity.

Evaluation of Craniometric Parameters for Sex Determination Using Computed Tomography in a Nigerian Population

Okoro Ogheneyebrorue Godswill — 2026-06-06

Sex estimation remains a fundamental aspect of forensic anthropology and medico-legal identification, particularly in situations involving incomplete skeletal remains. Cranial morphometric analysis using computerized tomography (CT) has emerged as a reliable and non-invasive approach for evaluating sexually dimorphic cranial traits. This study assessed the predictive value of selected cranial chord measurements (frontal chord, parietal chord, and occipital chord) for sex determination among individuals in Edo and Delta States, Nigeria, using computerized tomographic images. A descriptive cross-sectional design was adopted for the study. Frontal chord, parietal chord, and occipital chord measurements were extracted from CT images and analyzed using the Statistical Package for the Social Sciences (SPSS), version 27.0. Statistical analyses included descriptive statistics, independent sample t-test, and discriminant function analysis. The findings revealed sexual dimorphism across all three cranial chord parameters, with males demonstrating significantly higher mean values compared to females (p < 0.001). Discriminant function analysis demonstrated strong differentiation between male and female skulls (Wilks’ Lambda = 0.117, p < 0.001), with an overall classification accuracy of 99.4%. The study showed that frontal chord, parietal chord, and occipital chord exhibited high standardized discriminant coefficients, indicating their strong predictive capacity for sex determination. However, the study is limited by its regional sample scope and reliance on available CT scans, which may restrict the generalizability of the findings to other populations. These findings further validate the utility of CT-based cranial morphometry as an accurate and non-invasive method for sex estimation in forensic and anthropological investigations.

Lifestyle Behaviours and Self-Awareness Practices among Women with Polycystic Ovary Syndrome (PCOS) in the Sub-Himalayan Region

Pooja Yadav — 2026-06-23

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age and is associated with reproductive, metabolic and psychological concerns. Lifestyle behaviour and self-awareness practices are important in the day-to-day management of PCOS, yet regional evidence from the Sub-Himalayan context remains limited. Objective: This study aimed to analyse lifestyle care and self-awareness practices among women with PCOS and to examine the association between nutritional awareness and daily meal-consumption patterns.

Methods: A cross-sectional descriptive survey was conducted among 300 women aged 18-40 years from the Sub-Himalayan region of Pauri, Uttarakhand, India. Data were collected using a pre-tested structured questionnaire covering physical activity, nutrition, beverage consumption, sleep, stress, glucose awareness and related self-care practices. Descriptive statistics, including the mean, median and standard deviation, were used to summarise lifestyle and awareness variables. The Pearson chi-square test was used to assess the association between nutritional awareness and meal-consumption patterns, with statistical significance set at p < 0.05.

Results: The findings showed variation in lifestyle care and self-awareness practices. Participants reported comparatively high engagement in several physical activities, including yoga asanas, jogging, aerobic exercise and walking, but lower conceptual knowledge of physical activity. Nutrition and healthy lifestyle awareness were moderate, whereas glucose monitoring, meal-interval knowledge and sleep-pattern awareness showed areas for improvement. The chi-square analysis demonstrated a statistically significant association between nutritional awareness and daily meal-consumption patterns (χ² = 9.161, df = 2, p = 0.010).

Conclusion: The study indicates that lifestyle practices and health-related awareness among women with PCOS in the Sub-Himalayan region are uneven. Strengthening region-specific health education may support improved nutritional practices, self-monitoring and sustainable lifestyle care.

Factors Associated with Nutritional Knowledge among Women Attending Antenatal Clinics in Selected Primary Healthcare Centers in Port Harcourt

Barikpe Ka-Alenebari Gloria — 2026-07-18

The nutritional status of pregnant women has long-term implications for maternal and child health. This study assessed factors associated with nutritional knowledge among women attending antenatal clinics in selected primary healthcare centres in Port Harcourt. A descriptive survey design was adopted. The study population comprised 1,200 pregnant women who attended antenatal care services in selected primary healthcare centres across Port Harcourt from February 2025 to September 2025. A sample of 330 pregnant women was selected using the Yamane sample size determination formula, and simple random sampling was used to select participants. Data were collected using a researcher-made questionnaire, and the instrument was subjected to test-retest reliability assessment, which yielded a reliability coefficient of 0.89. The findings showed that most respondents were aged 25-29 years, representing 100 (30.30%) of the sample, followed by those aged 18-24 years and 35 years and above, each representing 80 (24.24%). Respondents aged 30-34 years had the lowest representation, with 70 (21.21%). Most women were single, 150 (45.45%), followed by married women, 120 (36.36%); divorced and widowed women each accounted for 30 (9.09%). The level of nutritional knowledge among pregnant women attending antenatal clinics in Port Harcourt LGA was moderate. Educational background, socio-economic status and access to healthcare services were associated with women’s understanding of pregnancy nutrition. The study concludes that targeted nutritional education during antenatal visits is needed, particularly for women with lower educational attainment and those from lower socio-economic backgrounds, to improve nutritional knowledge and dietary practices.

Parental Awareness and Attitude Towards Health Effects of Prolonged Screen Time on Children in Enugu, Nigeria

Ukwuani, Miriam Chinelo — 2026-08-08

Background: Screen time behaviour in young children is strongly influenced by parental attitudes towards screen use.

Objective: This study evaluated parents' awareness of, and attitudes towards, the health consequences of excessive screen time among children.

Method: A cross-sectional descriptive survey was conducted in three selected cottage hostels in Enugu metropolis among 137 parents attending child welfare clinics. Information was obtained using a structured questionnaire, and the collected data were analysed using descriptive statistics.

Results: The study showed that overall parental awareness was low (2.39), although parents recognised some immediate risks, such as reduced movement, sleep disturbances, unhealthy snacking, delayed language development and behavioural problems. However, awareness of long-term consequences, including addiction, obesity, reduced academic performance and adverse effects on vision, the heart, muscles, bones and memory, was grossly insufficient. Attitudes towards setting limits on screen time were largely negative (2.09), indicating limited personal commitment or role-modelling in regulating screen use; many parents believed that excessive exposure would cause no harm if the children appeared well. Comparison of parental awareness with support for limiting screen time showed a moderate correlation, suggesting that higher awareness may be associated with greater parental concern about the amount of time children spend using digital media. The findings reveal a considerable disconnect between knowledge, attitudes and practice, indicating that parents' responses may depend more on practical realities than on awareness alone and that environmental factors require further analysis.

Conclusion: Clinic-based awareness programmes should be practice-oriented. Home-based sessions, training and seminars, in addition to clinic-based education, should guide parents and guardians towards healthier screen-related practices and improved child health in urban Nigeria.

Prevalence and Impact of Perceived Job Stress on Work Output among Public Health Nurses in Selected Healthcare Facilities in Yenagoa, Bayelsa State, Nigeria

Adikabue Imomosumu — 2026-08-08

Aim: This study assessed the prevalence and impact of perceived job stress on work output among public health nurses in selected healthcare facilities in Yenagoa, Bayelsa State.

Methods: A descriptive survey design was used. Three hundred and four public health nurses were selected from an estimated population of 900 nurses working in public healthcare facilities in Bayelsa State using the Taro Yamane sample size determination formula. Data were collected with a structured questionnaire, validated by the researcher’s supervisor. Reliability was assessed using Cronbach’s alpha, which yielded an index of 0.85. Data were analysed using simple percentages, while chi-square statistics were used to test the null hypotheses at the 0.05 level of significance.

Results: Respondents were predominantly female (179; 58.88%), while 125 (41.12%) were male. The largest age group was 35–44 years (99; 32.57%), followed by those aged 55 years and above (61; 20.06%). The findings indicated a high prevalence of perceived job stress among the nurses. Perceived job stress was associated with reduced efficiency, reduced quality of care, low job satisfaction, impaired focus, mental exhaustion and difficulties in communication and decision-making.

Conclusion: The study found that perceived job stress was a relevant concern among public health nurses in the selected facilities and had implications for work output. Excessive workload, long working hours, emotional strain, inadequate resources, insufficient management support and staffing shortages were identified as key contributors.

Exploring the Sociocultural Factors Influencing HPV Vaccine Hesitancy in Uyo Metropolis, Akwa Ibom State, Nigeria

Maxwell, Maria Emmanuel — 2026-08-08

Background: Human papillomavirus (HPV) vaccination is an important strategy for preventing cervical cancer, yet vaccine hesitancy may limit uptake. This study explored the sociocultural factors influencing HPV vaccine hesitancy in Uyo Metropolis, Akwa Ibom State, Nigeria.

Methods: An exploratory mixed-methods design was used. For the quantitative component, 412 adolescents were selected from an estimated population of 6,000 using Taro Yamane’s sample-size formula. Eighteen respondents participated in the qualitative component. Data were collected using a structured questionnaire and interview guide. The questionnaire was validated by the researcher’s supervisor and two experts, and test–retest assessment yielded a reliability coefficient of 0.89. Quantitative data were analysed using frequencies, percentages, means, standard deviations, and inferential statistics, while qualitative data were analysed thematically.

Results: HPV vaccine hesitancy was moderate, with an overall mean score of 2.77. Participants generally recognised the importance of HPV vaccination, but willingness and reported uptake remained moderate. Sociocultural influences included cultural beliefs (mean = 2.7, SD = 0.61), religious beliefs (mean = 3.7, SD = 0.62), misconceptions linking vaccination with promiscuity (mean = 2.8, SD = 0.80), and negative influence from family or community leaders (mean = 2.5, SD = 0.30). Regression analysis indicated a significant relationship between sociocultural factors and HPV vaccine hesitancy (R = 0.58, R² = 0.34, p < 0.05).

Conclusion: HPV vaccine hesitancy in Uyo Metropolis was moderately shaped by sociocultural influences. Culturally appropriate education, engagement with religious and community leaders, and reliable local vaccine access may improve acceptance.

Influence of Health Education Intervention by Nurses on Immunization Uptake among Mothers with Under-Five Children in Alex Ekwueme Federal University Teaching Hospital Abakaliki

Chidozie Ozioma Faustin — 2026-08-08

Background: Immunisation remains an important public health intervention for reducing vaccine-preventable morbidity and mortality among children under five years of age. Maternal knowledge and attitudes are important factors influencing adherence to childhood immunisation schedules. This study assessed the influence of a nurse-led health education intervention on knowledge and attitudes towards immunisation among mothers of children under five attending Alex Ekwueme Federal University Teaching Hospital Abakaliki.

Methods: A quasi-experimental pre-test/post-test control-group design was used. A total of 197 mothers completed the study, comprising 96 participants in the control group and 101 participants in the intervention group at endline. Data were collected using a structured questionnaire and analysed using descriptive statistics and chi-square tests. Knowledge and attitude scores were compared before and after the intervention.

Results: At baseline, knowledge was comparable between the control and intervention groups. In the intervention group, the proportion of mothers with good knowledge increased from 75.0% at baseline to 99.0% at endline, while poor knowledge declined from 25.0% to 1.0%. This improvement was statistically significant (χ² = 25.932, p < 0.001). Attitudes also improved in the intervention group, with positive attitudes increasing from 46.3% at baseline to 69.3% at endline, while negative attitudes decreased from 53.7% to 30.7% (χ² = 11.303, p = 0.001). In the control group, knowledge remained largely unchanged, while positive attitudes declined from 49.1% to 35.4%.

Conclusion: The findings indicate that nurse-led health education was associated with improved maternal knowledge and attitudes towards childhood immunisation. Integrating structured health education into routine maternal and child health services may support greater immunisation-related awareness and acceptance among mothers.

Compliance with the Who’s Maternity Healthcare Waste Management Guidelines among Nurses and Midwives in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Nwankwo, Marycynthia Nneamaka — 2026-08-26

This study assessed compliance with WHO maternity healthcare waste management guidelines among nurses and midwives at Nnamdi Azikiwe University Teaching Hospital, Nnewi. A descriptive cross-sectional design was used, and the study population comprised 70 nurses and midwives working in the maternity section of the hospital. A census sampling method was adopted because of the manageable population size. Data were collected using a self-structured questionnaire, which was subjected to reliability testing through the test–retest method and yielded a reliability index of 0.89. Descriptive statistics, including frequencies, percentages and mean scores, were used to answer the research questions, while the hypothesis was tested using an independent-samples t-test at the 0.05 level of significance. The findings showed that the largest age group among respondents was 18–28 years, accounting for 55.7% of the sample. Most respondents were female (84%), while 16% were male. The majority of respondents (85.7%) demonstrated high knowledge of healthcare waste management, while 14.3% had low knowledge. Similarly, 78.6% of respondents reported high compliance with healthcare waste disposal practices, while 21.4% reported low compliance. Major factors affecting proper waste disposal included inadequate posting of healthcare waste disposal signs and the absence of a supervisory or monitoring nurses’ group for healthcare waste management. The study concluded that healthcare waste management practices among nurses and midwives in the maternity section were generally aligned with WHO guidelines. Regular training, adequate resources and improved supervision are recommended to sustain compliance.

Knowledge, Perceptions, and Practices of Food Hygiene among Urban Street Vendors in Abakaliki Metropolis

Iyare Beatrice Ehigiator — 2026-08-28

Background: Foodborne diseases remain a public health concern in Nigeria, and unsafe food handling among street vendors may contribute to contamination risks. Street-vended foods are widely consumed in urban settings, but information on food hygiene knowledge, perceptions and practices among vendors in Abakaliki metropolis remains limited. This study assessed these outcomes among street food vendors in Abakaliki metropolis and examined socio-demographic predictors.

Methods: A descriptive cross-sectional survey was conducted among street food vendors in Abakaliki, Ebonyi State. A sample size of 358 was selected, and 355 questionnaires were returned, completed, and included in the analysis, giving a response rate of 99.2%. Data were collected using a structured interviewer-administered questionnaire adapted from WHO and FAO guidance and previous studies. Descriptive statistics summarised socio-demographic characteristics, knowledge, perceptions and practices. Chi-square tests and logistic regression were used to examine associations and predictors, with statistical significance set at p < 0.05.

Results: Most respondents were female (79.4%) and married (53.2%), and 40.3% had tertiary education. Overall, 89.3% demonstrated excellent knowledge of food hygiene, although only 79.4% acknowledged the need for regular medical examination. Perceptions were generally positive (mean = 3.42 ± 0.23), but 76.6% were classified as having less positive perceptions. Hygiene practices were strong (mean = 3.85 ± 0.22), with 91.3% demonstrating excellent compliance. Excellent knowledge was more likely among vendors aged 41 years and above (aOR = 8.35, 95% CI: 1.658-42.055), females (aOR = 3.742, 95% CI: 1.717-8.157) and those with tertiary education (aOR = 8.716, 95% CI: 2.911-26.098). Marital status predicted perceptions, while no significant predictors were identified for hygiene practices.

Conclusion: Vendors demonstrated high food hygiene knowledge and strong self-reported practices, but weaker perceptions and medical monitoring gaps require continued training, supportive facilities and routine inspection.

Health Workers' Experience in Women Health Education During Attending Antenatal and Immunization Clinics in Aefutha Ebonyi State, Nigeria

Marcus, Amanda Ijeoma — 2026-08-28

Background: Women’s health education during antenatal and immunisation clinics is an important component of maternal and child health service delivery. Health workers are central to this process, yet their experiences in providing education within tertiary clinical settings require context-specific understanding.

Aim: This study explored health workers’ experiences in delivering women’s health education during antenatal and immunisation clinics at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria.

Methods: A mixed-methods design was adopted. Quantitative data were collected from 79 eligible health workers using a census approach, while qualitative data were obtained through key informant interviews conducted until saturation. Quantitative data were analysed using IBM SPSS Version 30, and qualitative data were analysed thematically with NVivo 15.

Results: Most respondents reported confidence and fulfilment in delivering women’s health education. Specifically, 51.3% strongly agreed and 27.6% agreed that they felt confident, while 48.7% strongly agreed and 39.5% agreed that they felt fulfilled. Reported challenges included heavy workload, staff shortages, low literacy among women, poor infrastructure, language barriers, limited teaching aids, non-conducive environments, and time constraints. Enabling factors included continuous training, positive feedback from women, and management recognition.

Conclusion: Health workers considered women’s health education meaningful and professionally rewarding; however, institutional and systemic constraints limited effective delivery. Improved infrastructure, adequate teaching materials, clear guidelines, supportive supervision, and continuous professional development are needed to strengthen women’s health education during antenatal and immunisation clinics.

Perceptions and Willingness to Use Digital Health Tools among Midwives Working in Hospitals in Onitsha North L.G.A., Anambra State, Nigeria

Uga, Adaora Lawrencia — 2026-08-28

Background: Digital health tools are increasingly being introduced into maternal healthcare, but their effective use depends on healthcare workers’ perceptions, readiness and institutional support.

Objective: This study assessed midwives’ perceptions of, and willingness to use, digital health tools in selected hospitals in Onitsha North Local Government Area, Anambra State, Nigeria.

Methods: A descriptive survey design was adopted. Data were collected from 206 midwives using a structured questionnaire. The instrument assessed socio-demographic characteristics, perceptions of digital health tools and willingness to adopt such tools. Data were analysed using SPSS version 25. Descriptive statistics were used to summarise the responses, while Pearson correlation was used to examine the relationship between perception and willingness.

Results: The findings showed that midwives had positive perceptions of digital health tools, with a grand mean of 4.05. They also demonstrated very high willingness to use digital health tools, with a grand mean of 4.37. Most respondents agreed that digital health tools improve the quality of care, enhance communication, support reliable documentation and are essential to modern midwifery practice. Pearson correlation showed a significant positive relationship between perception and willingness to use digital health tools (r = 0.647, p < 0.05).

Conclusion: Midwives in the study area showed positive perceptions and high willingness to adopt digital health tools, although sustained implementation requires training, institutional support and appropriate technological resources.

Knowledge and Attitude of Cervical Cancer Screening among Female Sex Workers Living with HIV in Benue State, Nigeria

Owoicho Grace Ochanya — 2026-08-28

Background: Cervical cancer remains a major public health concern, particularly among women living with HIV, who are at increased risk of persistent human papillomavirus infection and rapid disease progression. Female sex workers living with HIV represent a highly vulnerable group; however, evidence on their knowledge, attitudes, and uptake of cervical cancer screening in Benue State remains limited.

Aim: This study assessed knowledge, attitudes, uptake, and barriers to cervical cancer screening among this population.

Methodology: A descriptive cross-sectional design was adopted. A total of 440 female sex workers living with HIV were recruited from selected HIV care facilities in Benue State using a structured questionnaire. Data were analysed using descriptive statistics (frequencies and percentages) and inferential statistics (Chi-square test) at a 5% significance level to determine associations between socio-demographic variables, knowledge, attitudes, and screening uptake.

Results: The findings revealed moderately high knowledge, with 43.1% demonstrating good knowledge, 35.1% demonstrating moderate knowledge, and 21.8% demonstrating poor knowledge. Attitudes towards screening were generally positive, as over 70% acknowledged its importance and expressed willingness to recommend it. However, uptake was suboptimal; only 48.3% reported sometimes or always undergoing screening, and 54.9% had missed scheduled appointments. Significant associations were found between screening uptake and age, educational status, income level, knowledge level, and attitude (p < 0.05). Major barriers included inadequate information (64.5%), fear of positive results (61.1%), fear of pain (57.3%), embarrassment (56.4%), and HIV-related stigma (54.0%).

Conclusion: Despite moderately high knowledge and positive attitudes, cervical cancer screening uptake among female sex workers living with HIV in Benue State remains low due to psychological, informational, and socio-demographic barriers.

Recommendation: Integration of routine cervical cancer screening into HIV care services, with strengthened counselling and targeted health education, is recommended to improve uptake.

Cointegration and Causality Analysis of Human Immunodeficiency Virus and Tuberculosis Coinfection in Nasarawa State, Nigeria

Augustine Akyenyi Attah — 2026-08-28

Aim: This study investigated the long-run and short-run dynamics of Human Immunodeficiency Virus (HIV) and tuberculosis (TB) coinfection in Nasarawa State, Nigeria, to provide empirical evidence for integrated disease prevention and control strategies.

Study Design: The study employed a retrospective longitudinal time-series research design using advanced econometric techniques, including descriptive statistics, unit root tests, Johansen cointegration, and Fully Modified Ordinary Least Squares (FMOLS), Vector Error Correction Model (VECM), and Pairwise Granger causality analysis.

Place and Duration of Study: The study was conducted in Nasarawa State, Nigeria, using quarterly surveillance data obtained from the National Tuberculosis and Leprosy Control Programme (NTBLCP) Quarterly Reports on Case Finding. The dataset covered the period from the fourth quarter (Q4) of 2015 to the fourth quarter (Q4) of 2024.

Methodology: The study analysed 37 quarterly observations on HIV infections, TB infections, and HIV/TB coinfections. Descriptive statistics were used to summarise the data, while Augmented Dickey-Fuller and Phillips-Perron unit root tests examined stationarity. Johansen cointegration analysis assessed long-run relationships among the variables. Long-run effects were estimated using FMOLS, short-run dynamics were examined with the VECM, and pairwise Granger causality tests determined the direction of causal relationships.

Results: Descriptive analysis showed that the mean number of HIV infections was approximately 133 cases, TB infections averaged 1,043 cases, and HIV/TB coinfection averaged 115 cases, with TB exhibiting the highest variability (SD = 536 cases). Unit root tests confirmed that all variables were integrated of order one, I(1), supporting cointegration analysis. Johansen cointegration identified three long-run equilibrium relationships among HIV, TB, and HIV/TB coinfection. FMOLS estimates revealed that a one-unit increase in HIV infection increased HIV/TB coinfection by 0.981 units, while a one-unit increase in TB infection increased HIV/TB coinfection by 0.512 units, both statistically significant at the 1% level. The VECM produced a significant error correction coefficient of −0.579, indicating that approximately 58% of deviations from long-run equilibrium were corrected within one quarter. Short-run results showed that changes in HIV infection significantly increased HIV/TB coinfection, whereas TB infection exhibited negative short-run effects. Pairwise Granger causality analysis established unidirectional causality from HIV infection to TB infection (F = 8.746, p = 0.0012), from HIV infection to HIV/TB coinfection (F = 6.826, p = 0.0074), and from TB infection to HIV/TB coinfection (F = 5.423, p = 0.0098).

Conclusion: HIV and TB infections exhibit strong long-run equilibrium relationships and significant short-run causal interactions in Nasarawa State, with HIV serving as the primary driver of TB infection and HIV/TB coinfection. These findings underscore the need for strengthened integrated HIV-TB surveillance, prevention, early diagnosis, treatment programmes, and sustained investment in healthcare systems to reduce the burden of coinfection.

Healthy Ageing for People Living with HIV: A Long-Standing Latency of Geriatric Care Integration in Senegal, West Africa

Alassane Ndiaye — 2026-05-01

With the global increase in life expectancy among people living with HIV, ageing-related health challenges have become an emerging priority in healthcare systems. This commentary discusses the need and relevance of incorporating Comprehensive Geriatric Assessment (CGA) into HIV care for older adults to improve health outcomes and quality of life, with a focus on addressing gaps in Senegal’s current health strategy. The country bears a burden of old people living with HIV (OPLWH) which is rapidly increasing, reaching one third of the national cohort as of 2022. Despite the existence of different models of care to integrate geriatric approach in HIV settings to inform high-quality care, major challenges in implementing strategies to meet the needs of OPLWH persist. Strengthening the integration of geriatric approaches into HIV care, particularly for older people living with HIV (OPLWH), represents a critical opportunity to enhance quality of care, optimise functional outcomes, and build upon the significant progress already achieved in HIV treatment and survival.

Nanoparticle-based Drug Delivery Systems: Design Strategies, Formulation Advances, Mechanistic Insights, Clinical Applications, and Translational Challenges

Vishwakarma Bhanupratap Harishchandra — 2026-02-09

Nanoparticle (NP)-based drug delivery systems have emerged as a promising strategy. NP-based drug delivery systems also improve the pharmacokinetics of chemotherapeutics by prolonging circulation and enhancing tumour accumulation. The aim of this review is to systematically cover the progress, limitations, as well as future perspectives of nano drug-delivery systems with a view to alter drug efficacy and toxicity. The main focus of the review has been on evolution over time, formulation methods and biomedical applications of various types of nanoparticle systems to protect against drug degradation and to improve solubility/ bioavailability for safe targeted delivery in vivo. This review utilises a comprehensive analysis through the literature in the primary and secondary sources are integrated. A qualitative and quantitative analysis of the published literature was done to identify developments in nanoparticle formulation design, mechanisms of action and technological improvements associated with drug carriers. Nanoparticle-based formulations, such as liposomes, polymeric nanoparticles and dendrimers, are reported to enhance controlled drug release, bioavailability and target therapy for cancer, infectious diseases and chronic conditions. Nevertheless, they face multiple challenges, such as formulation toxicity and commercial scale-up constraints as well as strict regulatory barriers, which compromise their clinical translation. Nanoparticle-mediated drug delivery technology has brought about a concept in precision medicine and clinical practice, with groundbreaking approaches to circumvent the problems of absorption, distribution, metabolism, and excretion of chemical drugs. The next generation of smart and metabolizable nanocarriers should drive the therapeutic performance and advance development in both drug delivery systems and healthcare approaches.

Pigment Histochemistry: A Review

Tobor Kennedy Emmanuel — 2026-02-27

Pigments are among the most visually and diagnostically significant biomolecules present in both human and animal tissues. From the dark hues of melanin in the skin to the golden-brown tones of hemosiderin in the spleen or liver, pigments often serve as vital histological indicators of normal physiology, pathological transformation, or environmental exposure. This review synthesizes findings from recent studies conducted between 2018 and 2025 to explore the current state of histochemical pigment detection and its applications in research and clinical practice. To ensure a comprehensive, transparent, and scientifically rigorous review of histochemical studies on pigments, this work was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive literature search was performed between May and June 2025 using four major scientific databases: PubMed, Scopus, Web of Science, and Google Scholar. The search covered a publication window from January 2018 to May 2025. Boolean search operators were used in combinations such as: Pigment and Histochemistry, Melanin and histological stain, Lipofuscin and Sudan Black B, Hemosiderin and Perls stain, Tattoo ink and tissue reaction, Pigment and immunohistochemistry, Pigment detection and ("AI" OR "machine learning" OR "imaging"). All identified records were first exported into Zotero for reference management. Duplicates were removed manually. Titles and abstracts of the remaining studies were screened for relevance. Two independent reviewers then conducted full-text screening using a standardized review protocol. In cases of disagreement, consensus was reached through discussion or consultation with a third expert. A total of 198 records were initially retrieved. After de-duplication and abstract screening, 34 articles were selected for full-text evaluation. Finally, 12 studies met all inclusion criteria and were included in the review. In conclusion, pigments are far more than colored deposits on a microscope slide; they are molecular signposts that trace physiological processes, disease evolution, environmental exposure, and even cellular aging. As methods continue to improve in accuracy, speed, and objectivity, the field of pigment histochemistry will only become more integral to pathology and translational research in the years to come.

Hepato-Protective Effects of Some Medicinal Plants of Uganda

Ahumuza Patience — 2026-03-13

Introduction: Hepatic diseases have become common, difficult to treat, and a big health challenge in Ugandan communities. Possibly these hepatic diseases are being caused by much alcohol consumption which is prevalent in our society, by poison consumption, pathogenic microbes e.g. hepatitis B which is a viral disease and chemotherapeutic agents e.g. thioacetamide, fluconazole, acetaminophen, diclofenac, rifampin and Isoniazid; which cause destruction and inflammation of the liver especially on prolonged use. Protecting the liver from damage is important because the liver has major metabolic functions in the body. Though prescription medications are available for their hepatoprotective effects, these often come with many other side effects. This puts our attention on medicinal plants which are available, reliable and cheap to get; as better alternative for hepatic therapy than the existing and expensive drugs. This paper is a literature review of existing information on medicinal plants around Uganda with hepatoprotective effects. Their chemical components, uses and local names according to the regions they are found in were also highlighted.

Methods: Literature search was carried out, especially on articles of pharmacognosy and pharmacology; about hepato protective effects of some medicinal plants, not only in our country but also worldwide as available in different databases. This was done using mostly Google scholar and Pub Med. The Uganda clinical guideline 2023 was used to relate the diseases.

Results: While specific studies on the hepatoprotective effects of Ugandan plants are limited especially by the cost of research and paucity of funding, several species used in Ugandan traditional medicine were reported to have shown potential liver-protective properties. These include; Allium cepa, Terminalia macroptera, Phyllanthus amarus, Kalanchoe pinnata, Curcuma longa, Boerhavia diffusa, Silybum marianum, Woodfordia fruticosa, Solanum nigrum, Phyllanthus muellarianus, Capsicum annuum and Moringa oleifera.

Discussion and Conclusion: Scientific validation of these hepatoprotective herbs should be encouraged by the government to investigate their comparative efficacy and toxicity with the imported drugs. Where they are found to be better alternatives to the imported medicines, these herbs can be approved legally to be inculcated in the mainstream health setting. Local pharmaceutical companies should also be encouraged to identify the extracts from these herbs as possible drug candidates and use them in local drug manufacture not only for internal consumption but also for export.

Animal Vaccines as a Tool to Combat Antimicrobial Resistance: One-Health Perspective and Systematic Review

Md. Rimon Bhuiyan — 2026-06-03

Background: Antimicrobial resistance (AMR) is a growing global health challenge driven in part by extensive antimicrobial use (AMU) in livestock production. Animal vaccination has been proposed as a One Health strategy to reduce infection-related antimicrobial use and mitigate the emergence and spread of AMR. However, the evidence supporting this relationship has not been comprehensively synthesized.

Aim: To systematically evaluate evidence on the impact of animal vaccination on AMU and AMR-related outcomes across livestock production systems and identify critical research gaps.

Methods: A systematic review was conducted following PRISMA 2020 guidelines. Five electronic databases and grey-literature sources were searched for studies published between January 2003 and March 2026. After screening and eligibility assessment, 74 studies and institutional reports were included. Data on vaccination interventions, antimicrobial use, and AMR-related outcomes were extracted and narratively synthesized. Study quality was assessed using ROBINS-I and Cochrane RoB 2.0 tools.

Results: Evidence consistently demonstrated that vaccination reduces antimicrobial use across aquaculture, swine, poultry, and cattle production systems. The strongest quantitative evidence was reported from Norwegian salmon aquaculture, where antibiotic consumption declined from 876 mg/kg biomass in 1987 to 0.43 mg/kg in 2024 following long-term vaccination programs. Similar reductions in therapeutic and metaphylactic antibiotic use were reported in vaccinated swine and cattle populations. Nevertheless, direct evidence linking vaccination to reductions in antimicrobial resistance remains limited. No randomized controlled trial identified in this review used AMR-specific endpoints such as resistome composition, antimicrobial resistance gene prevalence, or resistant pathogen burden. Most available evidence originated from high-income countries, with limited data from low- and middle-income regions.

Conclusion: Animal vaccination is an effective preventive strategy for reducing antimicrobial use in livestock and represents a promising component of One Health efforts to combat AMR. However, robust evidence demonstrating direct impacts on antimicrobial resistance remains insufficient. Future research should prioritize AMR-focused randomized trials, integrated One Health surveillance, longitudinal resistome studies, and greater investment in vaccine research and implementation, particularly in low- and middle-income countries.

Sustainable Pharmaceutical Manufacturing and Packaging from Design to Disposal: A Critical Narrative Review of Technologies, Trade-offs and Circularity

Lolla Siddhartha — 2026-08-24

Pharmaceutical sustainability cannot be reduced to a single manufacturing metric or a recyclable pack. Environmental burdens arise across molecular and process design, active pharmaceutical ingredient synthesis, formulation, utilities, primary and secondary packaging, distribution, use, and end-of-life management. This critical narrative review integrates evidence on sustainable pharmaceutical manufacturing and packaging to examine where technological interventions genuinely prevent burdens and where they may merely shift them between life-cycle stages. Literature published mainly from 2000 to 9 June 2026 was identified through accessible scholarly indexes and verified against bibliographic and DOI landing pages, with additional evidence from authoritative regulatory and public-health sources. The strongest evidence supports prevention-oriented manufacturing strategies: route simplification, solvent substitution and recovery, catalysis and biocatalysis, process intensification, continuous manufacturing, and the systematic use of process mass intensity alongside broader life-cycle assessment. Emerging approaches such as mechanochemistry and greener-by-design active ingredients are promising but remain constrained by scale-up, quality, toxicological and regulatory evidence gaps. Packaging studies show that material choice alone does not determine sustainability; protection performance, fill efficiency, sterilisation, transport, medicine wastage, collection infrastructure and end-of-life fate can reverse apparent advantages. Multi-layer blisters and sterile formats illustrate the tension between product protection and material circularity. At disposal, take-back systems can reduce uncontrolled release and improve recovery or controlled destruction, but evidence for behavioural uptake, system coverage and environmental benefit remains geographically uneven. Antibiotic manufacturing emissions demonstrate why end-of-pipe control and environmental quality criteria must complement green process design. Overall, the evidence favours a design-to-disposal governance model in which quality, safety and access constraints are treated as boundary conditions while material, energy, toxicity, emissions and circularity outcomes are evaluated together. Priority research needs include harmonised pharmaceutical life-cycle inventories, comparative studies at commercial scale, packaging performance–environment trade-off testing, and procurement or regulatory mechanisms that reward verified life-cycle improvement without compromising medicine quality or supply resilience.

Respiratory Syncytial Virus in Yemen: A Minireview of Epidemiology, Surveillance Gaps, and Vaccine Readiness

Halah A. Alkorbi — 2026-02-05

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in infants and young children worldwide. Hospital studies show high RSV rates, while community cases remain underreported. This Minireview seeks to address the critical data gap by synthesizing available RSV literature within the context of Yemen’s health system. It explores national and regional epidemiological patterns, identifies risk factors unique to the Yemeni population, and examines barriers to effective surveillance and immunization. Factors like indoor air pollution, tobacco smoke, poor nutrition, and crowded living conditions make the problem worse. Yemen’s health system struggles to respond due to conflict, limited resources, and weak surveillance. While new tools like RSV vaccines and monoclonal antibodies are now available in wealthy countries, Yemen is not yet ready to use them. Unlike Spain, which rolled out RSV protection successfully, Yemen lacks plans and funding to do the same. Moreover, the country is not integrated into the WHO's Global Influenza Surveillance and Response System, depriving policymakers of seasonality data critical for vaccine timing. Without proper data and tracking, it’s hard to know when and where the virus spreads. This review calls for better surveillance, training for healthcare workers, and stronger public health planning. Global partnerships and support are key to helping Yemen join the fight against RSV. Improving awareness and preparing the country for future vaccine rollouts will protect vulnerable children and close the gap between Yemen and other countries.