Asian Journal of Medicine and Health

Utilisation of HIV Self-Testing Services in Sub-Saharan Africa: A Scoping Review of Delivery Models, Barriers and Outcomes

Daniel Asogun — 2026-02-03

Background: Sub-Saharan Africa remains the epicenter of the HIV epidemic, with persistent gaps in testing access, particularly among key and underserved populations. HIV self-testing (HIVST) has emerged as a complementary strategy to facility-based testing.

Objectives: This scoping review examines the utilization of HIVST services, associated barriers and facilitators, and reported outcomes among general and key populations across the region.

Methods: A scoping review was conducted using Joanna Briggs Institute manual for evidence synthesis, guided by PRISMA-ScR guidelines. A systematic search of PubMed, Google Scholar, ScienceDirect, and AJOL identified peer-reviewed articles published between 2010 and 2025. Studies were screened and charted, with data synthesized narratively across utilization trends, barriers, facilitators, and outcomes.

Results: A total of 51 studies from 20 countries met the inclusion criteria. HIVST uptake varied widely—from as low as 1.2% in passive distribution settings to over 160% in studies involving peer-led or home-based or community-based delivery models reflecting secondary distribution, repeat testing, and program-specific denominators rather than unique individuals tested. High utilization was consistently reported among men who have sex with men, sex workers, and young adults when testing was made accessible through trusted peer networks or community-based programs. Key enablers included ease of use, confidentiality, and peer support, while common barriers were low awareness, fear of positive results, stigma and lack of post-test counselling. Outcomes showed varied linkage to care, prompt ART initiation when reported, good HIV prevention and status disclosure practices and positive behavioral attitudes

Conclusion: HIVST demonstrates high potential for expanding HIV testing in Sub-Saharan Africa, particularly when delivery is tailored to community preferences. Optimizing awareness, support systems, and linkage pathways is essential to fully leverage HIVST’s public health impact.

The Role of Chemical Pathology in Maternal and Neonatal Health: A Review of Diagnostic Applications and Clinical Outcomes

Ogonnaya, Chinemerem Cynthia — 2026-02-17

Background: Chemical pathology (clinical biochemistry) is central to perinatal medicine, delivering objective data from maternal blood, urine, and neonatal samples to detect, monitor, and manage disorders affecting pregnancy and new-born health. Pregnancy induces major physiological changes in renal, hepatic, endocrine, metabolic, and electrolyte systems, requiring trimester-specific reference intervals to distinguish normal adaptations from pathology and prevent diagnostic errors.

Key Diagnostic Applications: Biochemical testing enables early identification of preeclampsia (elevated uric acid, proteinuria), gestational diabetes mellitus (~14–17% global prevalence; glucose tolerance testing), intrahepatic cholestasis of pregnancy (total serum bile acids ≥19 μmol/L non-fasting), thyroid dysfunction (trimester-adjusted TSH/free thyroxine), and hypertriglyceridemia. Timely interventions reduce maternal complications (hypertensive crises, acute kidney injury up to 30%, HELLP syndrome) and foetal/neonatal risks (macrosomia, preterm birth, and stillbirth).

Neonatal and Emerging Roles: Tandem mass spectrometry–based new-born screening detects treatable inborn errors of metabolism and congenital hypothyroidism from dried blood spots, achieving 50–90% reductions in mortality and severe morbidity in affected cases. Postnatal monitoring of glucose, bilirubin, and electrolytes supports high-risk infants. Emerging biomarkers to prenatal exposures (PFAS, phthalates, and heavy metals) are associated with growth restriction and developmental delays.

Evidence and Challenges: Gestational diabetes screening reduces macrosomia and caesarean rates by 20–30%; integrated biochemical care lowers perinatal morbidity by 20–41%. Challenges include inconsistent reference intervals, assay interferences, access disparities in low-resource settings, and limited environmental toxin monitoring. This review advocates standardized guidelines, equity-focused research, AI integration, and expanded screening to optimize global maternal and neonatal outcomes.

Non-Biological Determinants of Hypertensive Disorders in Pregnancy in Low- and Middle-Income Countries: A Systematic Review

Abuhuraira Ado Musa — 2026-02-04

Hypertensive disorders of pregnancy (HDP) remain a major contributor to maternal and perinatal morbidity and mortality in low- and middle-income countries (LMICs). While clinical risk factors are well-described, non-biological determinants including environmental, psychosocial, and health-system factors play a critical but underexplored role. This systematic review synthesizes evidence on these determinants, with particular focus on Kano State Northern Nigeria and sub-Saharan Africa. A systematic review was conducted following PRISMA 2020 guidelines. Key electronic databases were searched, including PubMed, Scopus, and Web of Science, along with grey literature sources such as WHO, ACOG, and the Nigerian Federal Ministry of Health, for studies published between 2000 and 2025. Observational and mixed-methods studies reporting on hypertensive disorders of pregnancy (HDP) and non-biological determinants in low- and middle-income countries (LMICs) were included. Data on study characteristics, HDP prevalence, maternal and neonatal outcomes, and environmental, psychosocial, and health-system exposures were extracted. Study quality was assessed using standardized checklists appropriate for observational studies, and findings were synthesized narratively and, where feasible, quantitatively. Forty-eight studies involving over 138 women met the inclusion criteria. In Nigeria, HDP prevalence ranged from 6% to 17%, with preeclampsia at 4–8% and eclampsia at 1–2%. Key non-biological determinants included psychosocial stressors (chronic stress, domestic violence, low social support), socioeconomic disadvantage (low education, poverty), environmental exposures (ambient heat, household air pollution), and health-system constraints (limited antenatal care, delayed booking, inadequate monitoring, insufficient referral systems). These factors were linked to delayed diagnosis, severe maternal complications (eclampsia, HELLP syndrome, renal impairment). This study highlights a critical and underexplored dimension of hypertensive disorders of pregnancy (HDP) by examining non-biological determinants in low- and middle-income countries (LMICs). By synthesizing evidence on psychosocial, environmental, and health-system factors, it broadens the understanding of HDP beyond traditional clinical risk factors. The focus on Kano State Northern Nigeria and sub-Saharan Africa provides context-specific insights for regions with high maternal morbidity and mortality. These findings are valuable for researchers, clinicians, and policymakers, informing the design of targeted interventions, the strengthening of antenatal care services, and the implementation of community-based strategies. Ultimately, this work contributes to improving maternal and neonatal health outcomes and advancing Sustainable Development Goal 3 by 2030.

The Impact of Malnutrition on Respiratory Function: A Systematic Review

Alanoud K. Albanna — 2026-02-14

Malnutrition has a significant impact on lung health, directly affecting the respiratory muscle, immune function, and the progression of chronic lung conditions. This review article finds the primary effects of malnutrition on respiratory function, muscle performance, the immune system, the incidence of respiratory infections, and its impact on patients with chronic lung disease. The Developmental Origins of Health and Disease (DOHaD) theory posits that environmental factors, particularly inadequate nutrition during critical early life stages, can have lasting effects on health. People who did not get enough nutrients during pregnancy or right after giving birth are more likely to get chronic obstructive pulmonary disease (COPD) and asthma as adults. Poor ventilation and worse outcomes in COPD, asthma, interstitial lung disease, and idiopathic pulmonary fibrosis can result from the effects of malnutrition on the contractile capacity of the respiratory muscles. This also interferes with the body’s defense, increasing the risk of infection through compromised T-cell activity, reduced antibody production, and deficiencies in essential micronutrients, such as vitamins D, A, and zinc. Acute respiratory infections increase, recovery takes longer, and death rates rise in seriously ill patients due to these changes. In chronic lung diseases, malnutrition weakens muscles and causes them to become inflamed, resulting in decreased exercise, a lower quality of life, and shorter survival. Targeted nutrition, such as supplements and feeding plans, improves clinical outcomes and reduces mortality for children with recurrent infections and adults with advanced COPD. The high rate of malnutrition in respiratory patients emphasizes the need for nutrition care in respiratory treatment.

Assessing the Association Between Anxiety and ADHD Symptoms: A Risk Analysis Among Primary School Students In Jakarta

Salsabila Putri Syarifah — 2026-01-31

Aims: Anxiety frequently co-occurs with Attention-Deficit/Hyperactivity Disorder (ADHD) and may exacerbate core ADHD symptoms such as inattention, hyperactivity, and impulsivity. This study aimed to evaluate the association and risk of anxiety with ADHD symptoms among primary school students.

Study Design: An analytical observational study with a quantitative cross-sectional design to assess the association between anxiety and ADHD symptoms.

Place and Duration of Study: This study was conducted at a public elementary school in Jakarta from November 10 to 28, 2025.

Methodology: A total of 120 students aged 10–12 years participated in this study, selected using consecutive non-random sampling. Sociodemographic data were collected using a structured questionnaire. ADHD symptoms were assessed using the Indonesian Hyperactive Child Behavior Rating Scale (SPPHAI). Anxiety levels were measured using the Revised Children’s Manifest Anxiety Scale (RCMAS). Odds ratio (OR) was used to determine risk. The association between anxiety and ADHD symptoms was analyzed using the chi-square test, with a P-value <0.05 considered statistically significant.

Results: Most participants were female (59.2%), aged 11 years old (51.7%), and in fifth grade (53.3%). Parental characteristics were relatively homogeneous, with most parents being adults and having a secondary level of education. Low-risk ADHD was observed in (74.2%) of participants, while (67.5%) showed typical anxiety levels. A significant association was found between high anxiety and ADHD symptoms (p = 0.028; OR = 2.539; 95% CI = 1.090–5.916).

Conclusion: This research found a significant association between anxiety and ADHD symptoms; students with higher anxiety levels were more likely to exhibit ADHD symptoms. These results underscore the need for early detection and mental health education, involving families, schools, and healthcare professionals, to address anxiety's potential impact on ADHD in children, though further validation of these predictors is necessary.

Prevalence and Risk Factors for Clinically Significant Brain Injury among Patients with Mild Traumatic Brain Injury in Abuja, Nigeria

Selekeowei Peter Kespi KPUDUWEI — 2026-02-07

Background: Mild traumatic brain injury (mTBI) is common, yet a clinically important subset of patients with a Glasgow Coma Scale (GCS) score of 13–15 have intracranial lesions that require admission, close observation, or neurosurgical follow-up. Clinical decision rules exist to guide CT use, but their applicability in settings with constrained CT access and a high prevalence of high-energy mechanisms like road traffic crashes is uncertain.

Objective: To determine the prevalence and describe risk factors of clinically significant brain injury on CT among patients with mTBI presenting to a Nigerian trauma centre.

Methods: We conducted a prospective observational study of 103 consecutive patients aged ≥16 years with mTBI (GCS 13–15) presenting to the National Trauma Centre, National Hospital Abuja (November 2021–July 2022). Demographics, injury mechanism, and clinical features (including loss of consciousness [LOC], post-traumatic amnesia, polytrauma, and GCS) were recorded using a structured proforma. The primary outcome was clinically significant brain injury on non-contrast head CT, defined as any acute intracranial finding warranting admission with neurosurgical follow-up or close neurological observation.

Results: Clinically significant brain injury was present in 45/103 patients (43.7%). Importantly, 88.9% of clinically significant injuries occurred in patients presenting with a GCS of 14 or 15. Key risk factors included male sex, involvement in road traffic crashes (particularly as a pedestrian), and the presence of loss of consciousness.

Conclusion: In similar resource-constrained environments, these features should be used to identify high-risk patients, prompting a low threshold for CT imaging and neurosurgical evaluation.

Effect of Exercise and Age on Lung Volumes, Expiratory Capacity, and Breath-Holding Time in Young and Elderly Adults: A Cross-Sectional Study

Foram Shelat — 2026-02-07

Background: Aging is associated with a progressive decline in lung volumes, expiratory capacity, and respiratory endurance. Regular physical activity has been shown to improve pulmonary function; however, its role in preserving overall lung capacity and breath-holding ability across different age groups remains inadequately explored.

Study Design: Cross-sectional, comparative.

Objectives: The present study aimed to evaluate the effect of exercise and age on lung volumes, expiratory capacity, and breath-holding time in young and elderly adults.

Methods: This cross-sectional study (n=800) used a purposive sampling technique to categorize participants into four groups of n=200 each: Young Exercisers, Young Non-Exercisers, Elderly Exercisers, and Elderly Non-Exercisers. Pulmonary function was assessed using calibrated digital RMS spirometry following standard guidelines. Predicted values were calculated using the Crapo and Pérez Padilla reference equations. Parameters analyzed included FVC, FEV1, MVV, PEF, and BHT. Data were analyzed using Two-way ANOVA.

Results: Exercisers demonstrated significantly higher values of FVC, FEV₁, MVV, PEF, and BHT compared to non-exercisers p<0.01 across both age groups. While elderly participants showed lower values overall compared to the young group, elderly exercisers maintained significantly better function than their sedentary counterparts.

Conclusion: Regular physical activity significantly improves lung volumes, expiratory capacity, and breath holding ability in both young and elderly adults. Exercise appears to mitigate the age-related decline in respiratory function, highlighting its importance as a non-pharmacological strategy for maintaining optimal pulmonary health across the lifespan.