Aims: This study was conducted to evaluate the prevalence, co-infection and socio-demographic determinants of malaria and typhoid fever among pregnant women attending antenatal care at a primary health care facility in Central Nigeria. Study Design: The study was a cross sectional study. Place and Duration of Study: Keffi, Nasarawa State, between January and October, 2020. Methodology: Blood sample (4 ml) was collected from each of the 429 consenting pregnant women attending antenatal care at Primary Healthcare Centre main market, Keffi, Nasarawa State. Malaria parasite was detected from the blood samples using one-step malaria rapid diagnostic test kit (SD Bioline, Inc, USA) and was confirmed by Gimesa stained thin and thick film microscopy while typhoid fever was diagnosed using Cromatest widal commercial antigen suspension (Linear Chemicals, Barcelona, Spain). Data collected were analysed using Smith’s Statistical Package (version 2.8, California, USA) and P value of ≤ 0.05 was considered statistically significant. Results: Of the 429 pregnant women screened, 123(28.7%) had malaria, 33(7.7%) had typhoid fever while 12(2.8%) had malaria-typhoid co-infection. Malaria-typhoid co-infection was found to be higher among pregnant women aged ≤30 years (3.5%), traders (3.9%), with primary education (3.2%) and who were from rural areas (6.3%). However, only location of the pregnant women was associated with the rate of malaria-typhoid co-infection (P< 0.05) whereas age, educational status and occupation were independent of the co-infection (P> 0.05). Conclusion: We confirmed the presence of malaria-typhoid co-infection among pregnant women in the study area. Considering it adverse effects on pregnancy and it outcome, there is need for more efforts towards it prevention, control and management.

Background Nigeria has the second highest burden of HIV in children younger than 15 years (220 000) and adolescents 10-19 years (230 000) in the world. Unfortunately, fewer than a quarter of these children and adolescents are identified and given access to treatment. Decentralisation of HIV testing services to high-yield service delivery points can facilitate identification of undiagnosed HIV-positive children and adolescents. However, decentralisation of testing services is still uncommon, partly due to existing health-care professional boundaries. We evaluated the effectiveness of task-shifting HIV testing services from specialised laboratory personnel to nurses to improve HIV case identification in paediatric and adolescent clients. Methods We established a testing point for patients aged 0-19 years in the inpatient ward at a secondary health-care facility in a rural district with high prevalence of HIV in north-central Nigeria. Paediatric nurses were trained by laboratory personnel to provide HIV testing to children and adolescents admitted to the ward. We reviewed the hospital ward admission records and laboratory HIV testing records for patients aged 0-19 years to establish a pre-intervention baseline. Findings In the 3 months before the intervention when HIV testing services were provided only by laboratory personnel, 276 children and adolescents were admitted (mean 92•0 admissions/month), of whom only 22 patients (8%) underwent HIV testing and no positive cases were identified. However, in the 4-month intervention period between April and July, 2018, 179 paediatric or adolescent clients were admitted (44•8 admissions/month), of whom 169 (94%) were tested for HIV by nurses and four HIV-positive children were newly identified (a 2•4% yield). Linkage to care and antiretroviral therapy initiation was achieved for all newly identified children within 24 h of diagnosis. Interpretation Task-shifting of paediatric and adolescent inpatient HIV-testing services to nurses was more effective in HIV case identification than was testing by laboratory personnel. In settings where limited human resources remains a major challenge, implementation and scale-up of task shifting for testing services can significantly improve HIV case identification and, therefore, treatment coverage in children and adolescents. Funding CDC-PEPFAR.