Oluwafunmilayo Tosin Ogundeko-Olugbami

Antimicrobial resistance (AMR) represents a growing public health challenge in Nigeria. The pervasive misuse of antibiotics, insufficient regulatory frameworks, and inadequate surveillance systems exacerbate this issue. The existing methods for antibiotic monitoring are fragmented and inefficient, hindering the ability to detect real-time resistance patterns. This review delves into the role of digital surveillance technologies in combating AMR, taking advantage of electronic medical records (EMRs), mobile health (mHealth) applications, AI-powered analytics, and cloud-based databases to enhance data collection, prescription tracking, and policy interventions. Research conducted in low- and middle-income countries (LMICs), including India and Kenya, demonstrates digital tools' efficacy in addressing antimicrobial resistance (AMR). Despite these advantages, Nigeria continues to face significant challenges related to data privacy, infrastructure limitations, financial sustainability, and a digital divide between urban and rural regions. Addressing these limitations requires implementing strategic investments in health technology, establishing robust regulatory frameworks, and fostering multi-sectoral collaboration among government agencies, private sector stakeholders, healthcare institutions, and research organisations. In this review, we strongly advocate for an approach that integrates a data-driven antimicrobial resistance (AMR) surveillance system, facilitating real-time monitoring and policy-driven strategies. Nigeria can enhance antibiotic stewardship, mitigate resistance, and protect public health by evolving into a robust digital health ecosystem.

The principle of Undetectable = Untransmittable (U=U) posits that people living with the human immunodeficiency virus (HIV) who are able to achieve and maintain a viral load of <200 copies/mL by regularly taking antiretroviral drugs (ARVs) are considered virally suppressed and cannot transmit the HIV virus to other individuals through sex. This groundbreaking message has emerged as a key HIV prevention strategy for eliminating transmission risks and enhancing the quality of life of people living with HIV. This narrative review explores the clinical foundation of U=U, the level of awareness and acceptance of the message globally, and the psychosocial impact on people living with HIV. It has been discovered that this message minimizes stigma, improves mental health, promote treatment adherence and good disclosure behaviors among people living with HIV. Evidence has shown that despite the U=U revolution for HIV prevention, there are significant differences in awareness and acceptance of the message among different population groups. The challenges noted were poor communication by healthcare providers, limitations in the health system, and stigma issues. Nevertheless, the inclusion of U=U in mainstream HIV services has proven to increase awareness and enhance its adoption. The urgent need in the present review is to advocate for strategies to increase the equitable distribution of U=U to harness its full potential in public health.

<b>Background:</b> Serodiscordant couples are relationships where one sexual partner is HIV-positive and the other is HIV-negative. Such couples experience complex relational and psychosocial challenges that significantly influence treatment adherence and health outcomes. Despite biomedical advances such as Antiretroviral Therapy (ART) and Pre-Exposure Prophylaxis (PrEP), the relational dynamics within these relationships remain underexplored in HIV intervention strategies.<br /> <b>Objective:</b> To systematically review how HIV status disclosure and partner reactions impact treatment outcomes among serodiscordant couples.<br /> <b>Method:</b> A systematic review of qualitative and mixed-methods studies published between 2010 and 2025 was conducted using databases including PubMed, PsycINFO, CINAHL, Scopus, and Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist, and thematic synthesis was employed to analyze findings.<br /> <b>Findings and Discussion:</b> Ninety four studies met the inclusion criteria. Key themes included HIV status disclosure, communication, partner reactions, partner support and impact on treatment adherence. Challenges such as stigma and fear of rejection hindered disclosure and engagement in care in some relationships. However, support from partners was key in boosting confidence and continuity in care. <br /> <b>Conclusion:</b> HIV status disclosure is a crucial public health issue, as it has significant impact on the trajectory of serodiscordant relationships, treatment outcomes and psychosocial wellbeing of PLHIV. Building culturally sensitive, couple-centered interventions that emphasizes increased HIV awareness and knowledge is essential for improving health outcomes among serodiscordant couples.

There are a number of challenges facing the Health System in Nigeria such as poor structure of facilities, low manpower, and limited funds. This is where public health policy comes in, as public health policy is essential in addressing these challenges and improving health outcomes. This scoping review aims to provide an in-depth overview of the existing literature on public health policies in Nigeria, and particularly their effects on health systems in terms of infectious disease surveillance, maternal and child health, as well as healthcare access. A comprehensive database search (such as in PubMed and Dimensions), and a grey literature search, were carried out to identify applicable studies on public health policies in Nigeria and health related issues. The search results were filtered and further screened based on inclusion and exclusion criteria, and 25 publications were included in the review. We retrieved 1535 publications from PubMed, Dimensions, websites and institutions. Following application of inclusion/exclusion criteria and the removal of one duplicate, 97 articles were retained. Thirty-one studies were excluded after title and abstract review, and seven were not retrieved in full-text. Following a full text review of 59 papers, 33 were excluded, resulting in 25 articles that were included in the review. The review reports on the progress made by Nigeria in the implementation of public health policies for responding to major health problems. Policies such as the National Health Act, the National Health Promotion Policy, and diseases control initiatives have been instrumental in driving health outcomes. However, challenges such as limited funding, poor infrastructure, and insufficient human resources remain. Better health outcomes require stronger policy execution, increased financing, and capacity building. This study gives a complete overview, identifying information gaps that will help inform future policy and research.