Publications

Healthcare debts in the United States: a silent fight

This paper analyzes the growing burden of medical debt in the United States and its implications for health equity and financial protection. It frames healthcare debt as a structural public health issue with long-term consequences for access, well-being, and social stability.

Cervical cancer, HPV, and HPV vaccine knowledge and willingness among Nepali girls

This multi-center study explores HPV-related knowledge, perceptions, and vaccine willingness among adolescent girls in Nepal. Findings reveal critical knowledge gaps alongside high potential acceptability, underscoring opportunities for targeted vaccination and health education strategies.

Impact of Menstrual Health Literacy (MHL) and Menstrual Hygiene Management (MHM) in Latin America

This scoping review synthesizes evidence on how menstrual health literacy and hygiene management influence girls’ and women’s social participation, education, and broader development outcomes across Latin America. It highlights persistent structural, cultural, and policy gaps and underscores the need to integrate menstrual health into gender, education, and development agendas.

Integration of Chronic Disease Services in Primary Healthcare Settings in Nigeria

This systematic review examines how chronic disease services have been integrated into primary healthcare in Nigeria, identifying effective models, implementation barriers, and system-level gaps. It offers evidence-informed insights to support more coordinated, equitable, and sustainable chronic care delivery within primary health systems.

Experiences with facility delivery services in Gombe State, Northeast Nigeria

This qualitative study explored women’s experiences with facility-based delivery services within a maternal and neonatal health project that significantly increased facility delivery uptake in Gombe State. Women reported strong preferences for facility delivery due to perceived quality, respectful care, and provider competence, regardless of provider gender. Persistent barriers included transportation costs, distance, staff absenteeism, and delays in care, alongside socio-cultural factors such as reliance on traditional birth attendants. The study underscores the importance of addressing both health system and socio-economic constraints to sustain gains in maternal health service utilization.

Patent Medicine Vendors in driving Community Tuberculosis Case Finding

Authors Summary: Patent medicine vendors, often called PMVs, are the health providers many Nigerians meet first when they feel unwell. During COVID-19, when clinics were overwhelmed, movement was restricted, and many people feared visiting hospitals, this first point of contact became even more important. This article reviews existing research to explain how PMVs, who run small medicine shops in markets and neighborhoods, can help spot possible tuberculosis early by noticing signs like a cough that will not go away, weight loss, fever, and night sweats, then guiding clients to proper testing and treatment. Across the studies reviewed, PMVs appear to help keep TB case finding going in communities, especially where access to formal health care is limited. At the same time, the evidence shows real gaps that can slow progress, like uneven knowledge of TB, weak referral links, and limited support from the formal system. The review points to practical steps that can make PMVs more effective partners in TB control during outbreaks, including regular training, clear referral pathways, supportive supervision, and simple tools that help them share accurate TB and COVID-19 information while connecting suspected cases to nearby TB services quickly.

Evaluation of Sub-national Malaria Elimination Programs in Nigeria: Cross River State

This study assesses the institutional, coordination, and financing capacities of Cross River State’s malaria elimination program. It identifies structural gaps in sub-national program management and offers practical recommendations to strengthen governance, sustainability, and implementation effectiveness.

Gender Inequality and Public Health: Exploring the Negative Impacts

This article examines how gender inequality shapes health outcomes through social, economic, and structural pathways. It highlights the public health consequences of inequitable systems and calls for gender-responsive policies as a core strategy for improving population health.

Probing Dermal Immunity to Mycobacteria through a Controlled Human Infection Model

This study successfully demonstrated that using a controlled BCG skin challenge is a valuable way to safely study the complex immune response to mycobacteria in the skin. The findings highlight the significant role that common, non-immune skin cells play in the initial defense against TB. This new understanding could eventually help researchers design better drugs or novel vaccines that target these early pathways to fight TB.

SARS-CoV-2 Infection Risk Factors in King County Homeless Shelters

The study emphasizes that routine, all-person testing (regardless of symptoms) is absolutely necessary in crowded, congregate settings like homeless shelters to accurately find and manage the true burden of SARS-CoV-2 infections, most of which would otherwise go undetected due to a lack of symptoms.

Influenza test-and-treat study among residents of homeless shelters

Our findings establish the feasibility of an on‐site influenza test‐and‐treat strategy in shelters that has the potential to be applied during influenza epidemics and pandemics. Our genomic data suggest that intra‐shelter spread of influenza viruses is common and is responsible for a large proportion of symptomatic influenza virus infections in shelters.

MASI Smartphone App for Treatment Adherence (HIV): Protocol for Pilot RCT

This protocol describes a pilot randomized controlled trial evaluating the feasibility and acceptability of MASI, a culturally adapted smartphone app designed to support ART adherence among adolescents and young adults with HIV. The intervention integrates social support, education, and adherence tools tailored to the South African context. The study aims to generate preliminary evidence to inform scalable digital health interventions for adolescent HIV care.

Interventions to Improve Adolescent HIV Care Outcomes

This scoping review synthesized evidence from 65 studies evaluating interventions aimed at improving HIV care outcomes among adolescents. Effective approaches emphasized community-based models, integrated services, mental health support, and attention to social determinants of health. The review underscores the need for comprehensive, individualized interventions and stronger implementation evidence to support equitable scale-up.

Supporting Adolescents With HIV through an Adherence-Supporting App: Beta-Testing

This mixed-methods beta-testing study assessed the usability and engagement of the MASI smartphone app among adolescents with HIV in South Africa. Participants reported generally positive experiences, with strong engagement metrics and usability scores above average for digital health tools. Findings informed refinements to both the app and its implementation strategy ahead of a pilot randomized trial.

Access to Maternal-Child Health in Nigeria: Male Partner Perspective

This qualitative study examined male partners’ perspectives on women’s access to maternal-child health and HIV services in North-Central Nigeria. While participants acknowledged the importance of maternal-child healthcare, entrenched gender norms and male-dominated decision-making were identified as key influences on service access. Barriers included financial constraints, male-unfriendly clinic environments, and negative provider attitudes, while positive couple relationships facilitated shared decision-making. The findings highlight the importance of engaging men, community leaders, and health systems in promoting gender-equitable access to care.

Acceptability of Village Health Workers' roles in Gombe State

This study assessed women’s perceptions of the Village Health Worker (VHW) program implemented to improve maternal, neonatal, and child health service uptake in Gombe State. Women reported high acceptance of VHWs due to their community embeddedness, home-based support, and role in facilitating facility linkage and family buy-in. Participants perceived improvements in health literacy and MNCH service utilization attributable to VHW engagement. The findings support the feasibility and scalability of community-based lay health worker models.

Increasing isoniazid preventive therapy in people living with HIV in north central Nigeria

Author’s summary: People living with HIV face a high risk of tuberculosis, yet in many clinics in Nigeria, a proven prevention medicine, isoniazid preventive therapy (IPT), is still rarely used. In a tertiary hospital in Keffi, north central Nigeria, a clinic quality improvement team found that only 3% of eligible patients had received IPT, then tackled the real, everyday reasons behind the gap. Clinicians needed clearer guidance and confidence about IPT, patients needed repeated education, and the clinic needed a simple way to stop eligible people from being missed during busy consultations. Over four weeks, the team trained staff, added IPT messages to routine health talks, posted clear reminders in waiting and consulting areas, and reviewed patient folders before visits, marking eligible files with a sticker so providers could act fast. This practical, low cost approach led to IPT being prescribed for every eligible patient who came to the clinic, and 86% actually received the medicine, with the main remaining barrier being drug stock outs, which stopped some patients from getting IPT even after it was prescribed.

Mentor Mothers' Working Relationships with Healthcare Workers in Rural Nigeria

Studies show mentor mothers are women living with HIV who are trained to counsel and support other women with HIV and are effective counsellors. The healthcare system needs to formally recognize and integrate mentor mothers programs nationwide. This recognition should come with stable local funding instead of relying on limited foreign aid.

Pediatric to Adult Healthcare Transitioning for Adolescents Living with HIV in Nigeria

The study found that Nigeria's HIV clinics generally do not have a well-thought-out transition process. Instead, they have an abrupt transfer, where the teen is simply pushed from the children's section to the adult section, often with little preparation. Because most clinics use a non-specialized, family-centered model, the country desperately needs implementation research that will test transition strategies that actually work and are practical for these kinds of clinics.

Evaluating Religious Influences on Maternal Health Utilization in North-Central Nigeria

This study explored whether religious affiliation influenced women’s use of maternal and HIV-related health services in rural and peri-urban Nigeria. Findings showed that religion played a minimal role in service uptake, with distance, socioeconomic dependence, and male partner support emerging as more significant barriers. The study highlights the importance of addressing structural and gender-based constraints rather than assuming religion as a primary determinant of maternal health service utilization.

Barriers to Exclusive Breastfeeding among HIV-positive mothers in sub-Saharan Africa

This scoping review synthesized evidence on socio-economic, cultural, and health system barriers affecting exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa. Key challenges included inadequate counseling, healthcare worker bias, poor guideline knowledge, prevailing mixed-feeding norms, and women’s limited decision-making power. Fear of HIV transmission and inconsistent messaging further undermined adherence to recommended practices. The review calls for stronger provider training and community-level interventions to support sustained exclusive breastfeeding.

Cervical cancer risk factors among HIV-infected Nigerian women

This study analyzed risk factors for cervical pre-cancer and cancer among HIV-positive women participating in screening programs in Nigeria. Findings showed that older age and higher CD4 counts were associated with lower risk, while reproductive history and vaginal abnormalities increased risk. The study contributes to the evidence base informing cervical cancer prevention strategies among women living with HIV in sub-Saharan Africa.

RPS19 and TYMS SNPs and Prevalent High Risk HPV Infection in Nigerian Women

This study examined whether specific human genetic variants are linked to high-risk HPV infection among Nigerian women screened for cervical cancer in Abuja. Among 267 participants, researchers used HPV genotyping and SNP testing and found two variants, rs2305809 in RPS19 and rs2342700 in TYMS, associated with prevalent high-risk HPV infection. After adjusting for key demographic and behavioral risk factors, the TYMS variant remained statistically significant, suggesting host genetics may influence susceptibility. The findings support the need for larger, genome-wide studies to better understand genetic risk for high-risk HPV across diverse populations.

HIV associated high-risk HPV infection among Nigerian women

This study assessed HIV and high-risk HPV co-infection among women attending a cervical cancer screening program in Abuja, Nigeria (April to August 2012). Compared with HIV-negative women, HIV-positive women had a much higher prevalence of any high-risk HPV and multiple high-risk HPV infections, even after adjusting for age and education. Among HIV-positive participants, HPV35 and HPV56 were most common, while HPV52 and HPV68 were most common in HIV-negative participants, highlighting a type distribution that differs from the usual focus on HPV16/18. The authors conclude that vaccines and prevention strategies for African settings should consider broader protection beyond HPV16 and 18.

Digital cervicography and cold coagulation for cervical cancer screening in Nigeria

This study evaluated a nurse-led, screen-and-treat cervical cancer program integrated into HIV care at two PEPFAR-supported sites in Nigeria. Using visual inspection with acetic acid (VIA), digital cervicography, and cold coagulation, the program demonstrated that non-physician providers could deliver effective screening and treatment with strong quality assurance support. Over one year, more than 2,000 women living with HIV were screened, with diagnostic concordance between nurses and gynecologists improving to 100 percent within three months. The findings show that low-cost, nurse-led cervical cancer screening is a feasible and scalable public health intervention in resource-constrained settings.