Socioeconomic and Environmental Determinants of Opportunistic Viral Infections: Implications for Vulnerable Populations
DOI:
https://doi.org/10.31632/bn5bxk89Keywords:
Environmental Determinants , HIV/AIDS, Immunocompromised Populations, Opportunistic Viral Infections, Public Health, Risk Factors, Socioeconomic Factors, Transplant RecipientsAbstract
The opportunistic viral infections (OVIs) disproportionately affect immunocompromised populations, including individuals living with HIV/AIDS, transplant recipients, and patients undergoing chemotherapy or immunosuppressive therapies. While host immunity is a primary determinant of susceptibility, socioeconomic and environmental factors critically influence exposure risk, infection severity, and clinical outcomes. This review synthesizes current evidence on how poverty, education, healthcare access, occupational and lifestyle factors, housing conditions, urbanization, climate, and environmental pollution impact the incidence and progression of OVIs in Nigeria and other developing countries. Socioeconomic deprivation often amplifies environmental risks, creating synergistic effects that elevate infection rates. Interventions targeting social determinants of health such as improving healthcare access, nutrition, sanitation, and education alongside environmental control measures, can reduce the burden of OVIs. Integrating socioeconomic and environmental considerations into clinical management and public health strategies is essential to mitigate morbidity and mortality associated with opportunistic viral pathogens, particularly in low- and middle-income countries.
References
Adebayo, F. A., Itkonen, S. T., Öhman, T., Kiely, M., Cashman, K. D., Lamberg-Allardt, C., & Odin Consortium. (2021). Safety of vitamin D food fortification and supplementation: evidence from randomized controlled trials and observational studies. Foods, 10(12), 3065. https://doi.org/10.3390/foods10123065
Aemiro, A., Girma, A., & Beletew, D. (2025). Prevalence of Opportunistic Infections and Determinants Among HIV‐Positive Patients in Ethiopia: A Systematic Review and Meta‐Analysis. Health Science Reports, 8(2), e70418. https://doi.org/10.1002/hsr2.70418
Akintunde, T. S., & Olaniran, O. D. (2022). Financial development, public health expenditure and health outcomes: evidence from Nigeria. Journal of Economics and Allied Research, 7(1), 13-24. ISSN: 2536-7447
Althaus, C. L. (2014). Estimating the reproduction number of Ebola virus (EBOV) during the 2014 outbreak in West Africa. PLoS Currents, 6, ecurrents-outbreaks. https://doi.org/10.1371/currents.outbreaks.91afb5e0f279e7f29e7056095255b288
Amisu, B. O., Oksanna, O. J., Olaleke, N. O., Ologun, C. O., Lucero-Prisno, D. E., Ogunwale, V. O., ... & Mewara, A. (2023). Socio-environmental determinants of parasitic intestinal infections among children: A cross-sectional study in Nigeria. Journal of Global Health Science, 5(1). https://doi.org/10.35500/jghs.2023.5.e6
Angell, B., Sanuade, O., Adetifa, I. M., Okeke, I. N., Adamu, A. L., Aliyu, M. H., ... & Abubakar, I. (2022). Population health outcomes in Nigeria compared with other west African countries, 1998–2019: a systematic analysis for the Global Burden of Disease Study. The Lancet, 399(10330), 1117-1129. https://www.thelancet.com/journals/lancet/article/piis0140-6736(21)02722-7/fulltext
Bannister-Tyrrell, M., Meyer, A., Faverjon, C., & Cameron, A. (2020). Preliminary evidence that higher temperatures are associated with lower incidence of COVID-19, for cases reported globally up to 29th February 2020. MedRxiv, 2020-03. https://doi.org/10.1101/2020.03.18.20036731
Bayissa, M. W., & Techane, D. (2022). Multi-Lingual Mobile Application to Improve the Pharmaceutical Care of Patients in Ethiopia. International Journal of Computer and Information Technology, 11(5), 184-189. https://doi.org/10.24203/ijcit.v11i5.290
Bello-Morales, R., Ripa, I., & López-Guerrero, J. A. (2020). Extracellular vesicles in viral spread and antiviral response. Viruses, 12(6), 623. https://doi.org/10.3390/v12060623
Bhatt, P., Padhi, A., Agarwal, A., & Katoch, C. D. S. (2024). Global environmental and socioeconomic drivers influencing contemporary viral disease emergence and transmission. Discover Viruses, 1(1), 4. https://doi.org/10.1007/s44370-024-00004-7
Bisaga, W., Wieczorek, M., Pawlinski, J., Jonczyk, K., Malicki, D., Starnawski, P., Janczura, J. (2025). Environmental and socioeconomic factors influencing hepatotropic virus transmission. Medical Science Pulse, 19. https://doi.org/10.5604/01.3001.0055.1648
Centers for Disease Control and Prevention. (2020). Coronavirus disease 2019 (COVID-19) https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/about-COVID-19.html
Chiziba, C., Mercer, L. D., Diallo, O., Bertozzi-Villa, A., Weiss, D. J., Gerardin, J., & Ozodiegwu, I. D. (2024). Socioeconomic, demographic, and environmental factors may inform malaria intervention prioritization in urban Nigeria. International Journal of Environmental Research and Public Health, 21(1), 78. https://doi.org/10.3390/ijerph21010078
Cuadros, D. F., Kiragga, A., Tu, L., Awad, S., Bwanika, J. M., & Musuka, G. (2025). Unpacking social and digital determinants of health in Africa: a narrative review on challenges and opportunities. Mhealth, 11, 41. https://doi.org/10.21037/mhealth-24-73
Farayibi, A., & Asongu, S. (2020). The economic consequences of the COVID-19 pandemic in Nigeria. European Xtramile Centre of African Studies, WP/20/042 (2020). https://dx.doi.org/10.2139/ssrn.3637668
Feachem, R. G., Bradley, D. J., Garelick, H., & Mara, D. D. (2023). Sanitation and disease: Health aspects of excreta and wastewater management. John Wiley & Sons, Singapore. https://documents1.worldbank.org/curated/en/704041468740420118/pdf/multi0page.pdf .
Gona, P., Van Dyke, R. B., Williams, P. L., Dankner, W. M., Chernoff, M. C., Nachman, S. A., & Seage, G. R. (2006). Incidence of opportunistic and other infections in HIV-infected children in the HAART era. Jama, 296(3), 292-300. https://doi.org/10.1001/jama.296.3.292
Gorbalenya, A. E., Baker, S. C., Baric, R. S., de Groot, R. J., Drosten, C., Gulyaeva, A. A., ... & Ziebuhr, J. (2020). Severe acute respiratory syndrome-related coronavirus: The species and its viruses–a statement of the Coronavirus Study Group. BioRxiv. http://dx.doi.org/10.1038/s41564-020-0695-z
Graham, H., & White, P. C. (2016). Social determinants and lifestyles: integrating environmental and public health perspectives. Public Health, 141, 270-278. https://doi.org/10.1016/j.puhe.2016.09.019
Hellewell, J., Abbott, S., Gimma, A., Bosse, N. I., Jarvis, C. I., Russell, T. W., ... & Eggo, R. M. (2020). Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. The Lancet Global Health, 8(4), e488-e496. https://doi.org/10.1016/S2214-109X(20)30074-7
Isaac, O. N. (2020). Africa: COVID 19 and the future of economic integration. Available at SSRN 3607305. https://dx.doi.org/10.2139/ssrn.3607305
Ishola, D. A., & Phin, N. (2011). Could influenza transmission be reduced by restricting mass gatherings? Towards an evidence-based policy framework. Journal of Epidemiology and Global Health, 1(1), 33-60. https://doi.org/10.1016/j.jegh.2011.06.004
Kabalimu, T. K., Kibwengo, C. F., Sungwa, E. E. (2025). Opportunistic infections and associated factors among HIV infected patients on anti-retroviral treatment at Bombo hospital in tanga region, Tanzania. African Journal of Health Sciences, 35(3), 252-262. https://ojs.ajhsjournal.or.ke/index.php/home/article/view/267
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., ... & Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England Journal of Medicine, 382(13), 1199-1207. https://doi.org/10.1056/NEJMoa2001316
Liu, P., Jiang, J. Z., Wan, X. F., Hua, Y., Li, L., Zhou, J., ... & Chen, J. (2020). Are pangolins the intermediate host of the 2019 novel coronavirus (SARS-CoV-2)?. PLoS pathogens, 16(5), e1008421. https://doi.org/10.1371/journal.ppat.1009664
Mateus, A. L., Otete, H. E., Beck, C. R., Dolan, G. P., & Nguyen-Van-Tam, J. S. (2014). Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review. Bulletin of the World Health Organization, 92, 868-880D. http://dx.doi.org/10.2471/BLT.14.135590
Mequanente, D. A., Srinivasan, P., Mallika, G., Thamimul Ansari, P. M., & Wale, M. (2022). Incidence of opportunistic infections among HIV-infected children on ART at Gondar University Specialized Hospital, Ethiopia. Indian Journal of Science and Technology, 15(34), 1675-1682. https://doi.org/10.17485/IJST/v15i34.1073
Merler, S., & Ajelli, M. (2010). The role of population heterogeneity and human mobility in the spread of pandemic influenza. Proceedings of the Royal Society B: Biological Sciences, 277(1681), 557-565. https://doi.org/10.1098/rspb.2009.1605
Moges, N. A., & Kassa, G. M. (2014). Prevalence of opportunistic infections and associated factors among HIV positive patients taking anti-retroviral therapy in DebreMarkos Referral Hospital, Northwest Ethiopia. Journal of AIDS and Clinical Research 5(5), 1–300. https://doi.org/10.4172/2155-6113.1000301
Mohamud, A. K., Ahmed, O. A., Mohamud, A. A., & Dirie, N. I. (2023). Magnitude of opportunistic infections and associated factors among adult people living with human immune deficient virus on art at selected public hospital, mogadishu somalia: cross-sectional study. Annals of Medicine and Surgery, 85(7), 3364-3371. https://doi.org/10.1097/MS9.0000000000000880
Nansseu, J. R. N., & Bigna, J. J. R. (2017). Antiretroviral therapy related adverse effects: Can sub-Saharan Africa cope with the new “test and treat” policy of the World Health Organization?. Infectious Diseases of Poverty, 6(1), 24. https://doi.org/10.1186/s40249-017-0240-3
Ochube, G. A. & Usman, U. (2023). Globalization and its implications on the nigerian health system. International Journal of Law, Politics & Humanities Research Published by Cambridge Research and Publications, 27(6). https://www.cambridgenigeriapub.com/wp-content/uploads/2023/04/CJLPHR_VOL27_NO6_MAR-2023-1.pdf
Onsongo, S., & Kagotho, E. (2024). Applications, Opportunities, and Challenges. A Comprehensive Overview of Telemedicine, 26, 1-18. https://doi.org/10.5772/intechopen.1005094
Olatunji, O. A., Omoruyi, E. C., Olisa, O., & Fowotade, A. (2024). The Diagnostic Performance of an HBeAg-based Test for HBV Infection. African Journal of Biological Sciences. 6 (4) ISSN: 2663-2187
DigitalUHC Consortium, & Quentin, W., & Kyobuutungi, C. (2022). Round table: Digital innovations in health financing: Experiences from sub-Saharan Africa. European Journal of Public Health, 32(Supplement_3), ckac129-496. https://doi.org/10.1093/eurpub/ckac129.496
Phillips, P., Nazari, N., Dharwadkar, S., Filion, A., Akaribo, B. E., Stephens, P., & Sundaram, M. (2025). Socioeconomic and Eco-Environmental Drivers Differentially Trigger and Amplify Bacterial and Viral Outbreaks of Zoonotic Pathogens. Microorganisms, 13(3), 621. https://doi.org/10.3390/ microorganisms13030621
Pigott, D. M., Deshpande, A., Letourneau, I., Morozoff, C., Reiner, R. C., Kraemer, M. U., ... & Hay, S. I. (2017). Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis. The Lancet, 390(10113), 2662-2672. https://www.thelancet.com/journals/lancet/article/piis0140-6736(17)32092-5/fulltext
Popoola, T. O. (2018). Health outcomes in sub-Saharan Africa Countries: an analysis of key determinants. Modern Health Science, 1(1), p8-p8. https://doi.org/10.30560/mhs.v1n1p8
Redding, D. W., Atkinson, P. M., Cunningham, A. A., Lo Iacono, G., Moses, L. M., Wood, J. L., & Jones, K. E. (2019). Impacts of environmental and socio-economic factors on emergence and epidemic potential of Ebola in Africa. Nature Communications, 10(1), 4531. https://doi.org/10.1038/s41467-019-12499-6
Sabin, N. S., Calliope, A. S., Simpson, S. V., Arima, H., Ito, H., Nishimura, T., & Yamamoto, T. (2020). Implications of human activities for (re) emerging infectious diseases, including COVID-19. Journal of Physiological Anthropology, 39, 29. https://doi.org/10.1186/s40101-020-00239-5
Saidu, A. S., Bunza, M., Abubakar, U., Adamu, T., Ladan, M., & Fana, S. (2009). A survey of opportunistic infections in HIV seropositive patients attending major hospitals of Kebbi State, Nigeria. Bayero Journal of Pure and Applied Sciences, 2(1), 70-74. https://doi.org/10.4314/bajopas.v2i1.58466
Shekar, M., McDonald, C., Okorosobo, T., Subandoro, A., Eberwein, J. D., Mattern, M., ... & Karamba, W. (2015). Costed plan for scaling up nutrition in Nigeria (No. 98286). The World Bank. https://ideas.repec.org/p/wbk/hnpkbs/98286.html
Tavares, J. (2021). Electronic health record patient portals and the blockchain technology. In Political and Economic Implications of Blockchain Technology in Business and Healthcare (pp. 218-227). IGI Global. https://doi.org/10.4018/9781-7998-7363-1.ch008
Tegegne, K. D., Cherie, N., Tadesse, F., Tilahun, L., Kassaw, M. W., & Biset, G. (2022). Incidence and predictors of opportunistic infections among adult HIV infected patients on anti-retroviral therapy at Dessie comprehensive specialized hospital, Ethiopia: A retrospective follow-up study. HIV/AIDS-Research and Palliative Care, 14, 195-206. https://doi.org/10.2147/HIV.S346182
Tufon, E. N., Bih, A. D., & Alice, M. (2014). Occurrence and Risk Factors for Opportunistic Infections in HIV Patients Attending the Bamenda Regional Hospital, Cameroon. International Journal of Nursing Education and Research, 2(4), 381-384. https://ijneronline.com/AbstractView.aspx?PID=2014-2-4-24
Wakil, S., Isa M. A., Mustafa A., GIde, S., ……….. Ali, M. U. (2022). The Non-Pharmaceutical Interventions to Control the Spread of Covid-19. Arid Zone Journal of Basic and Applied Research, 1(1), 133-143. https://azjournalbar.com/the-non-pharmaceutical-interventions-to-control-the-spread-of-covid-19/
Woldegeorgis, B. Z., Zekarias, Z., Adem, B. G., Obsa, M. S., & Kerbo, A. A. (2023). Prevalence and determinants of opportunistic infections among HIV-infected adults receiving antiretroviral therapy in Ethiopia: A systematic review and meta-analysis. Frontiers in Medicine, 10, 1087086. https://doi.org/10.3389/fmed.2023.1087086
Yin, W., & Couzin, O. (2019). HIV-Related Stigma and Discrimination in China. In: Wu, Z., Wang, Y., Detels, R., Bulterys, M., McGoogan, J. (eds) HIV/AIDS in China. Springer, Singapore. https://doi.org/10.1007/978-981-13-8518-6_28
Zsichla, L., & Mueller, V. (2023). Risk factors of severe COVID-19: a review of host, viral and environmental factors. Viruses, 15(1), 175. https:/ /doi.org/10.3390/v15010175
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