Systematic Reviews

  1. Variability and transferability of cost and cost-effectiveness of breast cancer screening: an overview of systematic reviews

    Multiple reviews have explored the characteristics of breast cancer screening (BCS) programs. These systematic reviews demonstrated high variability in cost and cost-effectiveness outcomes among studies leading to different conclusions and recommendations. No overview in our knowledge has summarized the current evidence on determinants of cost and cost-effectiveness of the most used BCS approaches or tried to explain differences in conclusions of systematic reviews on this topic. This systematic review aims to assess the degree of variability and transferability of determinants for (a) costs and (b) cost-effectiveness of BCS programs using mammography, clinical breast examination, breast self-examination, ultrasonography or their combinations among the general population.

    Group member involved: Obinna Ekwunife
    Collaborator: (1) Stefan Lhachimi, Collaborative Research Group for Evidence-Based Health Care, BIPS/ Bremen University, Germany; (2) Olena Mandrik, International Agency for Research on Cancer, France

Clinical Research

  1. Conditional economic incentives and motivational interviewing to improve adolescents' retention and adherence to antiretroviral therapy in south-east Nigeria: a cluster randomized trial

    Adolescent HIV patients face enormous challenges in accessing HIV care services. Given their vulnerability to risk-taking behaviour, this group also have worse treatment outcomes compared to other age groups. Poor treatment outcomes will impact negatively on HIV/AIDS management and control particularly in sub-Saharan Africa (SSA) as more than 80% global HIV-infected adolescents live in this region of the world. Limited evidence exists on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on antiretroviral therapy (ART) and adherence to ART.

    This study is designed to evaluate the impact of conditional economic incentives coupled with motivational interviewing on adolescents' linkage, retention and adherence to ART and HIV care in Anambra State, south-east Nigeria.

    Group members involved: Obinna Ekwunife, Maureen Anetoh
    Funder:European and Developing Countries Clinical Trial Partnership (EDCTP)

    Funder: EDCTP and EU

  2. Level of adherence to antiretroviral therapy and retention in care by adolescents in Nigeria

    Adherence to ART has been found to be low among adolescents. No data has been generated in Nigeria specifically on adolescents’ level of HIV testing, adherence to ART and retention in HIV care as well as on possible interventions to promote HIV testing, adherence to ART and retention in HIV care of adolescents. Thus the major objective of this study is to determine the baseline level of adherence of the adolescents HIV (ALHIV) patient to ART in selected settings in Nigeria. Other minor objectives are: to ascertain the difference in adherence between adolescents who acquired HIV perinatally and those who acquired it through early sexual debut and other means; to determine the facilitators and barriers to adherence in the study participants; and to determine the effect geographical location has on adherence level and retention in care of ALHIV.

    Group members involved: Maureen Anetoh, Sunday Nduka, Obinna Ekwunife

  3. Impact of Community Pharmacy-based diabetes monitoring and education program for diabetes management: a cluster randomized controlled trial

    The objective of this study is to assess the impact of community pharmacy-based diabetes monitoring and education program on type 2 diabetes patients. Other specific objectives include: to examine the short-term impact of a continuing education (CE) program on community pharmacists’ knowledge and competency for managing diabetic patients; to evaluate a community pharmacist-based diabetes patient management program, and to assess the cost-benefit of the pharmacist-based diabetes patient management program to the community pharmacists.

    Group members involved: Samuel Uzodimma, Sunday Nduka, Obinna Ekwunife

  4. Effectiveness of Community Pharmacists' involvement in primary prevention of cardiovascular Disease in Nigeria: a cluster randomized controlled trial

    Non-communicable diseases and injuries are generally on the rise in Nigeria. Community pharmacists could participate in abating cardiovascular disease (CVD) risks factors by applying pharmacy-based interventions targeting major risks factors for CVD in Nigeria. The objectives of this study are: (1) to assess the effectiveness of a primary CVD prevention intervention in Nigerian community pharmacy setting by measuring changes to cardiovascular health for patients receiving the community pharmacy-based CVD prevention intervention; (2) to assess patients willingness-to-pay for the CVD prevention intervention and the cost-benefit of the CVD prevention intervention to the pharmacy.

    Group members involved: Sunday Nduka, Obinna Ekwunife
    Collaborator:(1) Stefan Lhachimi, Collaborative Research Group for Evidence Based Health Care, BIPS/ Bremen University, Germany; (2) Valentine Okelu, May & Baker Limited, Nigeria

  5. Evaluation of the efficacy and safety or artemisinin-based combination therapies coadministered with albendazole in Plasmodium berghei infected mice.

    Concurrent use of albendazoles (ABZ) and some antimalarial agents may increase the risk of drug-drug interactions due to potent modulation of cytochrome P450 enzymes in the liver and intestine by ABZ and its active metabolite. About 90% of children with hookworm infections are at risk of coincident co-infection with P. falciparum resulting in the concomitant use of anthelmintic and antimalarial agents. ABZ, the first-line agent used in the treatment of hookworm infection has been shown to inhibit and induce cytochrome P450 enzymes while most antimalarials especially the artemisinin-based combination therapies (ACTs), which are the gold standard agents in malaria treatment are mostly substrates for CYP 450 enzymes mainly CYP 3A4 and 2B6. Since drug interactions nvolving oral medications are principally influenced by modulation of CYP 450 enzymes, this study is designed to determine the effect of albendazole on the efficacy and safety of selected ACTs in uncomplicated P. falciparum malaria.

    Group members involved: Lizette Njide, Sunday Nduka