ABSTRACT
Background: Human papillomavirus (HPV) vaccination is a cornerstone of cervical-cancer prevention, but acceptance, intention and actual uptake remain uneven in Nigeria. Women attending tertiary health-care facilities are important information recipients, caregivers and decision-makers for vaccination of eligible daughters and wards. This review synthesises evidence relevant to knowledge, awareness and multilevel determinants of HPV vaccine acceptance, with particular interpretive emphasis on Nasarawa State and comparable North-Central Nigerian settings. Objective: To systematically identify and synthesise evidence on knowledge, awareness, acceptance, willingness, uptake and determinants of HPV vaccination among women, mothers, caregivers and closely related adult decision-makers in Nigeria, and to determine the implications for women attending tertiary health-care facilities in Nasarawa State. Methods: The review was structured in accordance with PRISMA 2020 and informed by Joanna Briggs Institute evidence-synthesis principles. The search strategy was expanded into reproducible database-specific syntax for PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL and African Journals Online (AJOL). The formal search cut-off was 30 August 2026. Accessible indexed records and publisher/database pages were rechecked during the September 2026 update, and recent Nigerian primary studies and systematic reviews were incorporated into the evidence map. Eligibility covered quantitative, qualitative and mixed-methods studies involving women, mothers, caregivers or relevant adult decision-makers, with outcomes involving HPV knowledge, awareness, acceptance, willingness, hesitancy or uptake. Because subscription databases cannot be queried through this environment with an authenticated institutional account, exact hit counts for Embase, Scopus, Web of Science and CINAHL are not fabricated; the manuscript therefore provides the complete reproducible search strings and a transparent

ABSTRACT
Background: Malaria remains the leading cause of morbidity and mortality among children in sub-Saharan Africa, yet fine-scale geospatial data on its distribution and environmental determinants at the primary care level are scarce in the Federal Capital Territory (FCT), Abuja, Nigeria. This study mapped the geospatial distribution of malaria prevalence across all six area councils of the FCT and identified environmental determinants of malaria risk among children attending primary health care (PHC) facilities. Methods: A cross-sectional analytical study was conducted from October to December 2025 across 12 PHC facilities in six area councils of the FCT. A total of 385 children were enrolled using multi-stage sampling. Malaria diagnosis was performed by both rapid diagnostic test (RDT) and light microscopy. Environmental conditions was divided into household and peridomestic environmental risk factors were assessed using structured questionnaires. Geospatial analysis employed kernel density estimation (KDE) and Getis-Ord Gi* statistics using QGIS 3.28 and Python. Binary logistic regression identified independent predictors of malaria positivity. Results: Overall RDT-confirmed malaria prevalence was 38.4% (148/385; 95% CI: 33.5–43.4%) and microscopy prevalence was 32.2% (124/385). Significant spatial heterogeneity was observed: Abaji area council recorded the highest prevalence (RDT: 48.4%; microscopy: 50.0%) and was confirmed as a primary hotspot by Getis-Ord Gi* analysis; Kwali was a secondary hotspot (42.2%); and Gwagwalada had the lowest burden (29.7%). Significant temporal decline from October (58.3%) to December (22.5%) was documented (χ²=37.039, p<0.0001). None of the household factors were statistically significant However among peridomestic environmental factors, stagnant water (p=0.005), nearby bushes (p=0.004), gutters (p=0.042), car tyres (p=0.009), and abandoned containers (p=0.016) were all significantly associated with higher malaria prevalence. Compound