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Oni OI, Osho PO, Odesanmi TM, Raji HM, Oluranti FT, Ibina D. SARS-CoV-2 vaccine breakthrough infection and the evaluation of safety precaution practice before and after vaccination among healthcare workers in South West, Nigeria. BMC Public Health 2024; 24:1259. [PMID: 38720278 PMCID: PMC11077696 DOI: 10.1186/s12889-024-18663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Worldwide, it has been reported that fully vaccinated people still die of COVID-19-associated symptoms, generating public uncertainty about the safety and effectiveness of the vaccines. Hence, this research is aimed at assessing the incidence of COVID-19 breakthrough infection among vaccinated Health Workers and the possible effect of changes in the practice of post-vaccination safety precautions. METHOD This was a Health facility-based descriptive cross-sectional study. Data were collected using self-administered questionnaires distributed at the participant's work unit across the selected health facilities. The nasopharyngeal specimen was also obtained from the participants and analysed using STANDARD Q COVID-19 Ag Test rapid chromatographic immunoassay for the detection of antigens to SARS-CoV-2. All data were input and analyzed using SPSS version 20. RESULTS There was a statistically significant relationship between the vaccination status of respondents and the post-vaccination test result (χ2 = 6.816, df = 1, p = 0.009). The incidence of COVID-19 infection among the vaccinated and unvaccinated HCWs was 2% and 8% respectively. 5 of the 15 respondents who tested positive for COVID-19 had been fully vaccinated. However, all 5 of them did not practice safety measures after vaccination. None of the respondents who practised safety measures after vaccination tested positive for COVID-19. The remaining 10 respondents that tested positive for COVID-19 had not been vaccinated though they practised safety precautions. CONCLUSION Vaccination and the practice of safety precautions will go a long way to preventing future COVID-19 breakthrough infections.
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Affiliation(s)
| | - Patrick Olanrewaju Osho
- Department of Haematology and Immunology, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | | | | | | | - Demian Ibina
- Suddan United Mission Hospital, Abakaliki, Ebonyi State, Nigeria
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Ahmat A, Okoroafor SC, Asamani JA, Jean M, Mourtala AI, Nyoni J, Mwinga K. Health workforce strategies during COVID-19 response: insights from 15 countries in the WHO Africa Region. BMC Health Serv Res 2024; 24:470. [PMID: 38622621 PMCID: PMC11017512 DOI: 10.1186/s12913-024-10942-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic unveiled huge challenges in health workforce governance in the context of public health emergencies in Africa. Several countries applied several measures to ensure access to qualified and skilled health workers to respond to the pandemic and provide essential health services. However, there has been limited documentation of these measures. This study was undertaken to examine the health workforce governance strategies applied by 15 countries in the World Health Organization (WHO) Africa Region in responding to the COVID-19 pandemic. METHODS We extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo. RESULTS All 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health (HRH) activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited additional 35,812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision. CONCLUSION Strengthening multi-sector engagement in the development of public health emergency plans is critical as this promotes the development of holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination. It also ensures optimized utilization based on competencies, especially for the existing health workers.
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Affiliation(s)
- Adam Ahmat
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Sunny C Okoroafor
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo.
| | - James Avoka Asamani
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
- Centre for Health Professions Education, North-West University, Potchefstroom, South Africa
| | - Millogo Jean
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Abdou Illou Mourtala
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Jennifer Nyoni
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Kasonde Mwinga
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Tefera Y, Kumie A, Hailemariam D, Wakuma S, Abegaz T, Tamire M, Yirsaw S. Impact of Covid -19 incidence rate and government-initiated risk communication measures on individual's NPI practices. PLoS One 2024; 19:e0283294. [PMID: 38483912 PMCID: PMC10939235 DOI: 10.1371/journal.pone.0283294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 02/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPI) are the most widely recognized public health measures recognized globally to prevent the spread of Covid-19. NPIs' effectiveness may depend on the type, combination of applied interventions, and the level of proper public compliance with the NPIs. The expected outcome of behavioural practices varies relative to the intervention duration. OBJECTIVES This study aimed to assess the trend of community compliance to NPI with Covid-19 incidence and government-initiated interventions, and its variation by residence and sociodemographic characteristics of people. METHODS A weekly non-participatory field survey on individuals' NPI practices was observed from the 41st epidemiological week of October 5th, 2020, to the 26th epidemiological week of July 4th, 2021, a total of 39 weeks. The survey covered all 14 regional and national capital cities in Ethiopia. Data collection for the three NPI behaviours (i.e., respiratory hygiene, hand hygiene, and physical distance) was managed weekly at eight public service locations using the Open Data Kit (ODK) tool. The Covid- 19 incidence data and public health measures information from August 3rd, 2020 to July 4th, 2021 were obtained from the Ethiopian Public Health Institute (EPHI). RESULTS More than 180,000 individuals were observed for their NPI practice, with an average of 5,000 observations in a week. About 43% of the observations were made in Addis Ababa, 56% were male and 75% were middle age group (18-50 years). The overall level of NPI compliance was high at the beginning of the observation then peaked around the 13th- 15th epidemiological weeks then declined during the rest of the weeks. The peak NPI compliance periods followed the high Covid-19 death incidence and government-initiated intensive public health measures weeks. Respiratory hygiene had the highest compliance above 41% whereas hand hygiene was the lowest (4%). There was a significant difference between residents of the capital city and regional cities in their level of compliance with NPI. Females comply more than males, and individuals had increased NPI compliance at the bank service and workplaces compared to those in the transport services at P = 0.000. CONCLUSION An increased level of compliance with NPI was observed following intensive government-initiated Covid-19 prevention measures and an increased Covid-19 death incidence. Therefore, the intensity of government-initiated risk communication and public advocacy programs should be strengthened, possibly for similar respiratory disease pandemics in the future.
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Affiliation(s)
- Yifokire Tefera
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Damen Hailemariam
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Samson Wakuma
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teferi Abegaz
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mulugeta Tamire
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Shibabaw Yirsaw
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Gidado S, Musa M, Ba'aba AI, Francis MR, Okeke LA, Bukar FL, Nguku PM, Hadejia IS, Hassan IA, Bande IM, Onuoha M, Usman R, Ugbenyo G, Godwin N, Ilori E, Abulfathi AA, Mshelia LA, Mohammed AM, Abdullahi MM, Bammami MI, Nuorti P, Atkins S. Knowledge, risk perception and uptake of COVID-19 vaccination among internally displaced persons in complex humanitarian emergency setting, Northeast Nigeria. BMC Public Health 2024; 24:634. [PMID: 38419036 PMCID: PMC10902942 DOI: 10.1186/s12889-024-18164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Owing to crowded and unsanitary conditions, internally displaced persons (IDPs) have an increased risk of COVID-19 infection. Adoption of COVID-19 preventive measures among this population is premised on accurate information, adequate knowledge, and risk perception. We assessed COVID-19 knowledge and risk perception and investigated the association between risk perception and COVID-19 preventive measures, including vaccination among IDPs in Northeast Nigeria. METHODS We conducted a cross-sectional study during July-December 2022 and sampled 2,175 IDPs using stratified sampling. We utilized a 12-point assessment tool to evaluate COVID-19 knowledge. Participants who scored ≥ 6 points were considered to have adequate knowledge. We used a 30-item Risk Behavior Diagnosis Scale to assess COVID-19 risk perception and evaluated each item on a 5-point Likert scale. Participants were divided into risk perception categories by the median of Likert scale scores. We performed weighted logistic regression analysis to identify factors associated with risk perception. Pearson's chi-squared with Rao-Scott adjustment was used to determine the relationship between risk perception and COVID-19 preventive measures. RESULTS Of 2,175 participants, 55.7% were 18-39 years old, 70.9% were females, and 81.7% had no formal education. Among the IDPs, 32.0% (95% CI: 28.8 - 35.0) were considered to have adequate COVID-19 knowledge, and 51.3% (95% CI: 47.8 - 54.8) perceived COVID-19 risk as high. Moreover, 46.3% (95% CI: 42.8 - 50.0) had received one dose of COVID-19 vaccine, and 33.1% (95% CI: 29.8 - 36.0) received two doses. Adequate knowledge (Adjusted Odds Ratio (AOR) = 2.10, [95% CI: 1.46 - 3.03]) and post-primary education (AOR = 3.20, [95% CI: 1.59 - 6.46]) were associated with risk perception. Furthermore, high risk perception was significantly associated with wearing face masks (χ2 = 106.32, p-value < .001), practicing hand hygiene (χ2 = 162.24, p-value < .001), physical distancing (χ2 = 60.84, p-value < .001) and vaccination uptake (χ2 = 46.85, p-value < .001). CONCLUSIONS This study revealed gaps in COVID-19 knowledge, risk perception, and vaccination uptake but demonstrated a significant relationship between risk perception and COVID-19 preventive practices. Health education and risk communication should be intensified to improve knowledge, elicit stronger risk perception, and enhance COVID-19 preventive practices.
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Affiliation(s)
- Saheed Gidado
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Melton Musa
- African Field Epidemiology Network, Borno State Field Office, Maiduguri, Nigeria
| | | | - Mark Rohit Francis
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Lilian Akudo Okeke
- African Field Epidemiology Network, Adamawa State Field Office, Yola, Nigeria
| | - Fatima Lawan Bukar
- Department of Community Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Patrick M Nguku
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Idris Suleman Hadejia
- Department of Community Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Isa Ali Hassan
- Borno State Ministry of Health, Maiduguri, Borno State, Nigeria
| | - Ibrahim Muhammad Bande
- Department of Disease Control and Immunization, Yobe State Primary Health Care Board, Damaturu, Yobe State, Nigeria
| | - Martins Onuoha
- Nigerian Correctional Service, Adamawa State Office, Yola, Adamawa State, Nigeria
| | | | - Gideon Ugbenyo
- African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Ntadom Godwin
- Epidemiology Division, Federal Ministry of Health, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
| | - Aisha Aliyu Abulfathi
- Department of Community Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Lawi Auta Mshelia
- Borno State Primary Health Care Development Agency, Maiduguri, Borno State, Nigeria
| | | | | | | | - Pekka Nuorti
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Salla Atkins
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Ojielo NC, Uguru NP, Okeke CC, Onwujekwe OE. Analysis of the availability, effectiveness and equity of deployment of resources in the health system response to COVID-19 in Nigeria. Trans R Soc Trop Med Hyg 2024; 118:12-17. [PMID: 37480291 DOI: 10.1093/trstmh/trad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/03/2023] [Accepted: 06/28/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics. METHODS The study was conducted at the federal level and in two states in Nigeria. The states were Lagos in the southwest and Enugu in the southeast. In-depth interviews were undertaken with 34 key informants. NVivo version 12 software was used for coding and thematic analysis. RESULTS There were inadequate, inequitable and suboptimal resources (human, financial, equipment and materials) for the response. In some of the countermeasures, only people that were employed in the formal sector benefitted from the distribution of welfare materials and financial packages; the informal sector, which constitutes the majority of the poor population in Nigeria, was excluded. CONCLUSIONS Inequity and suboptimal availability of resources to control COVID-19 led to reduced effectiveness of the health system response to the disease in Nigeria. Such negative factors must be mitigated in future responses to pandemics in the country.
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Affiliation(s)
- Nwadiuto C Ojielo
- University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria401402
| | - Nkolika P Uguru
- University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria401402
- University of Nigeria Nsukka, Enugu State, Nigeria401402
| | - Chinyere C Okeke
- University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria401402
- University of Nigeria Nsukka, Enugu State, Nigeria401402
| | - Obinna E Onwujekwe
- University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria401402
- University of Nigeria Nsukka, Enugu State, Nigeria401402
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Farag D, Akpede N, Waterson H, Asogun D, Faustina Funmilayo B, Nnadi C, Azi M, Achioyamen O, Achioyamen D, Sahu A, Verma A, Williams G. The impact of education level on Knowledge, Attitudes and Practices towards COVID-19 in Edo State, Nigeria. J Public Health (Oxf) 2023; 45:i63-i70. [PMID: 38127562 DOI: 10.1093/pubmed/fdac142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/11/2022] [Accepted: 10/14/2022] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND For effective Public Health measures, factors that influence Knowledge, Attitudes and Practices (KAP) need to be understood. In this paper, we document the relationship between levels of education on the KAP towards COVID-19 among the population of Edo State, Nigeria. METHODS A cross-sectional KAP questionnaire was delivered across 13 communities. The study population was dichotomized into those who had or had not completed secondary education. Chi-square tests were conducted to determine statistical significance. RESULTS Of the 538 participants, 30% had completed secondary education. Those with secondary education were significantly more likely to recognize symptoms of COVID-19 (P < 0.001). For attitudes, only one option showed a statistically significant association with 78.4% of those who did not complete secondary education having a high confidence in the church compared with 66% of those who had (P = 0.022). For practices, those who have completed secondary education practiced all of the supplied measures more than those who had not, except for taking herbal supplements. DISCUSSION Higher levels of education impacts on knowledge and practices but has less impact on attitudes regarding how well certain individuals/organizations can handle the pandemic. Findings highlighted the importance of tailoring public health communication and strategies to local populations to improve the efficacy.
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Affiliation(s)
- Doaa Farag
- The University of Manchester Faculty of Biology Medicine and Health, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, the University of Manchester, Oxford Road, Manchester, UK
| | - Nosa Akpede
- Precious Gems Africa, HOD, Public Health Department, Irrua Specialist Teaching Hospital, Edo State, Nigeria
| | - Hannah Waterson
- The University of Manchester, Epidemiology and Public Health Group (EPHG), Heavitree Road, Exeter, UK
| | - Danny Asogun
- Precious Gems Africa, Precious Gems, Public Health Department, Irrua Specialist Teaching Hospital, Edo State, Nigeria
| | - Blackie Faustina Funmilayo
- Precious Gems Africa, Precious Gems, Public Health Department, Irrua Specialist Teaching Hospital, Edo State, Nigeria
| | - Chinelo Nnadi
- Precious Gems Africa, Precious Gems, Public Health Department, Irrua Specialist Teaching Hospital, Edo State, Nigeria
| | - Michael Azi
- Precious Gems Africa, Precious Gems, Public Health Department, Irrua Specialist Teaching Hospital, Edo State, Nigeria
| | | | | | - Anjana Sahu
- The University of Manchester, Epidemiology and Public Health Group (EPHG), Heavitree Road, Exeter, UK
| | - Arpana Verma
- University of Manchester, Clinical Epideniology and Public Health Unit, Manchester, UK
| | - Greg Williams
- The University of Manchester, Division of Population Health, Health Services Research and Primary Care, Manchester, UK
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Neill R, Peters MA, Bello S, Dairo MD, Azais V, Samuel Jegede A, Adebowale AS, Nzelu C, Azodo N, Adoghe A, Wang W, Bartlein R, Liu A, Ogunlayi M, Yaradua SU, Shapira G, Hansen PM, Fawole OI, Ahmed T. What made primary health care resilient against COVID-19? A mixed-methods positive deviance study in Nigeria. BMJ Glob Health 2023; 8:e012700. [PMID: 37984895 PMCID: PMC10660915 DOI: 10.1136/bmjgh-2023-012700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/01/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The SARS-CoV-2 (COVID-19) pandemic overwhelmed some primary health care (PHC) systems, while others adapted and recovered. In Nigeria, large, within-state variations existed in the ability to maintain PHC service volumes. Identifying characteristics of high-performing local government areas (LGAs) can improve understanding of subnational health systems resilience. METHODS Employing a sequential explanatory mixed-methods design, we quantitatively identified 'positive deviant' LGAs based on their speed of recovery of outpatient and antenatal care services to prepandemic levels using service volume data from Nigeria's health management information system and matched them to comparators with similar baseline characteristics and slower recoveries. 70 semistructured interviews were conducted with LGA officials, facility officers and community leaders in sampled LGAs to analyse comparisons based on Kruk's resilience framework. RESULTS A total of 57 LGAs were identified as positive deviants out of 490 eligible LGAs that experienced a temporary decrease in PHC-level outpatient and antenatal care service volumes. Positive deviants had an average of 8.6% higher outpatient service volume than expected, and comparators had 27.1% lower outpatient volume than expected after the initial disruption to services. Informants in 12 positive deviants described health systems that were more integrated, aware and self-regulating than comparator LGAs. Positive deviants were more likely to employ demand-side adaptations, whereas comparators primarily focused on supply-side adaptations. Barriers included long-standing financing and PHC workforce gaps. CONCLUSION Sufficient flexible financing, adequate PHC staffing and local leadership enabled health systems to recover service volumes during COVID-19. Resilient PHC requires simultaneous attention to bottom-up and top-down capabilities connected by strong leadership.
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Affiliation(s)
- Rachel Neill
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Michael A Peters
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Segun Bello
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Magbagbeola David Dairo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Viviane Azais
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Ayodele Samuel Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Ayo Stephen Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Ngozi Azodo
- Nigeria Federal Ministry of Health, Abuja, Nigeria
| | | | - William Wang
- Exemplars in Global Health, Gates Ventures LLC, Kirkland, Washington, USA
| | - Rebecca Bartlein
- Exemplars in Global Health, Gates Ventures LLC, Kirkland, Washington, USA
| | - Anne Liu
- Exemplars in Global Health, Gates Ventures LLC, Kirkland, Washington, USA
| | - Munirat Ogunlayi
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Saudatu Umma Yaradua
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Gil Shapira
- Development Research Group, World Bank, Washington, District of Columbia, USA
| | - Peter M Hansen
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tashrik Ahmed
- The Global Financing Facility for Women, Children, and Adolescents, Washington, District of Columbia, USA
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Shehu N, Okwor T, Dooga J, Wele A, Cihambanya L, Okonkon I, Gadanya M, Sebastine J, Okoro B, Okafor O, Abejegah C, Oragunye D, Olayinka A. Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria. Heliyon 2023; 9:e21978. [PMID: 38034678 PMCID: PMC10682610 DOI: 10.1016/j.heliyon.2023.e21978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Background The first case of COVID-19 in Nigeria was reported on February 27, 2020, and over time, spread across the country leading to many healthcare worker infections. The risk of transmission of COVID-19 within healthcare facilities makes it necessary to establish infection prevention and control measures. The World Health Organisation supported the Nigeria Centre for Disease Control to conduct a train-the-trainers workshop on infection prevention and control for key healthcare workers across Nigeria. Aim/Objectives This study aims to describe the process and results of train-the-trainers as an intervention for national capacity building in infection prevention and control for COVID-19 among healthcare workers in Nigeria. Methods Eight-hour sessions were held over three days with face-to-face instruction and practical hands-on experience in April 2020. A total of 61 healthcare workers participated across the six geographic zones of Nigeria: North Central, North East, North West, South West, South East, and South South. The training included slide presentations, case-based scenarios, and practical hands-on sessions with plenary discussions. Pre- and post-test assessments were used to evaluate knowledge of COVID-19, triage, and infection prevention and control among healthcare workers. Finding/Results 69 % (42) of the participants were male 31 % (19) were female, and the majority (67 %) were medical doctors. Others attending were nurses or health administrators. Of the 70 % (26) of the states with existing infection prevention and control structures within the COVID emergency response, only 40 % were functional. The average percentage of pre-test and post-test scores were 60.8 ± 13.4 and 67.8 ± 9 0.3 respectively, showing a statistically significant difference (p > 0.001) in trainee knowledge. Additionally, 70 % of participants evaluated the training workshop as "satisfactory" or higher in training format, relevance for daily clinical work, active participation, learning new concepts, and logistics. Conclusion Nationwide infection prevention and control training is feasible during a national health crisis. Infection prevention and control is cardinal in the containment of epidemic-prone diseases like COVID-19 and is invaluable in the prevention of healthcare-associated infections in healthcare settings.
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Affiliation(s)
- N.Y. Shehu
- West African Center for Emerging Infectious Diseases (WAC-EID), Jos University Teaching Hospital, Nigeria
| | - T. Okwor
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - J. Dooga
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - A.M. Wele
- University of Port Harcourt Teaching Hospital, Nigeria
| | - L. Cihambanya
- World Health Organization AFRO Regional Office, Brazzaville, People’s Republic of Congo
| | | | - M. Gadanya
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - J. Sebastine
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - B. Okoro
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - O. Okafor
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | | | - D. Oragunye
- Nigeria Centre for Disease Control and Prevention (NCDC), Nigeria
| | - A. Olayinka
- World Health Organization AFRO Regional Office, Brazzaville, People’s Republic of Congo
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OWUSU ISAAC, ACHEAMPONG GIDEONKWARTENG, AKYEREKO ERNEST, AGYEI NIIARYEETEY, ASHONG MAWUFEMOR, AMOFA ISAAC, MPANGAH REBECCAANN, KENU ERNEST, ABOAGYE RICHARDGYAN, ADU COLLINS, AGYEMANG KINGSLEY, NSIAH-ASARE ANTHONY, ASIEDU-BEKOE FRANKLIN. The role of digital surveillance during outbreaks: the Ghana experience from COVID-19 response. J Public Health Afr 2023; 14:2755. [PMID: 38020270 PMCID: PMC10658462 DOI: 10.4081/jphia.2023.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/30/2023] [Indexed: 12/01/2023] Open
Abstract
Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the 'Surveillance Outbreak Response Management and Analysis System (SORMAS)', the digitalized health declaration form, ArcGIS Survey123, Talkwalker, 'Lightwave Health information Management System' (LHIMS), and the 'District Health Information Management System (DHIMS)'. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation.
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Affiliation(s)
| | | | - ERNEST AKYEREKO
- Ghana Health Service, Headquarters
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | | | | | | | | | - ERNEST KENU
- Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana
| | - RICHARD GYAN ABOAGYE
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - COLLINS ADU
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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Mukherjee S, Asthana S, Ukponu W, Ihueze AC, Gobir IB, Phelan AL, Standley CJ. National and subnational governance and decision-making processes during the COVID-19 pandemic in Nigeria: an empirical analysis. BMJ Glob Health 2023; 8:e012965. [PMID: 37696545 PMCID: PMC10496651 DOI: 10.1136/bmjgh-2023-012965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023] Open
Abstract
Governance of the COVID-19 pandemic required decision-makers to make and implement decisions amidst uncertainty, public pressure and time constraints. However, few studies have attempted to assess these decision-making processes empirically during health emergencies. Thus, we aimed to understand governance, defined as the process of decision-making and implementation of decisions, during the COVID-19 pandemic in Nigeria. We conducted key informant interviews and focus group discussions with national and subnational government officials, civil society organisation (CSO) members, development partners and academic experts. Our study identified several themes on governance and decision-making processes. First, Nigeria established high-level decision-making structures at the federal and state levels, providing clear and integrated multisectoral decision-making mechanism. However, due to the emergence of conflicts between government levels, there is a need to strengthen intergovernmental arrangements. Second, while decision-makers relied on input from academic experts and CSOs, additional efforts are required to engage such stakeholders in decision-making processes, especially during the early stages of health emergencies. Third, Nigeria's previous experiences responding to disease outbreaks aided the overall response, as many capacities and coordination mechanisms for cohesive action were present. Fourth, while decision-makers took a holistic view of scientific, social and economic factors for decision-making, this process was also adaptive to account for rapidly evolving information. Lastly, more efforts are needed to ensure decisions are inclusive, equitable and transparent, and improve overall public trust in governance processes. This study provides insights and identifies opportunities to enhance governance and decision-making processes in health emergency responses, aiding future pandemic preparedness efforts.
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Affiliation(s)
- Sanjana Mukherjee
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Sumegha Asthana
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | | | | | - Ibrahim B Gobir
- Center for Global Health Practice and Impact, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Alexandra L Phelan
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Center for Health Security, Johns Hopkins University, Baltimore, Maryland, USA
| | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
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Guedegbe T, Adelaja A, George J. Resilience, endogenous policy responses to COVID-19, and their impacts on farm performance. WORLD DEVELOPMENT 2023; 168:106254. [PMID: 37038591 PMCID: PMC10076512 DOI: 10.1016/j.worlddev.2023.106254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/09/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
Policy measures aimed at containing the spread of the COVID-19 pandemic had unintended consequences on economic activities globally. In this study, we isolate and investigate the short-term partial impacts of six such measures on the farm and nonfarm incomes of agricultural households and examine the related resilience factors. Using Nigeria as a case study, we find that the COVID containment measures had mixed effects on farm and non-farm incomes in the short run. These varying effects are due to households' resilience and vulnerability factors, including land size, wealth, income diversification, involvement in processing activities, and reliance on hired labor. Our findings highlight the need for more targeted health crisis containment measures which consider the uniqueness, diversity, and regional heterogeneity of agriculture, especially the potential implications for farm viability.
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Affiliation(s)
| | - Adesoji Adelaja
- Department of Agricultural, Food and Resource Economics (AFRE), Michigan State University (MSU), East Lansing, MI, USA
| | - Justin George
- Department of Agricultural, Food and Resource Economics (AFRE), Michigan State University (MSU), East Lansing, MI, USA
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12
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Elebesunu EE, Effiong FB, Asika MO, Fadele PK, Onyeogalu FA, Okafor CA, Scott GY. Combating the zoonotic trio of Ebola virus disease, Lassa fever, and COVID-19 in Nigeria: a retrospection of the challenges and lessons. Ann Med Surg (Lond) 2023; 85:3955-3959. [PMID: 37554890 PMCID: PMC10406064 DOI: 10.1097/ms9.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 08/10/2023] Open
Abstract
Various infectious disease outbreaks linked to zoonotic sources have been recorded over the years, some of which have resulted in epidemics on a national, regional, or global scale. In Africa, a number of such outbreaks occur intermittently, especially in countries like Nigeria with a high-risk of epidemiological transmission. Three viral outbreaks with zoonotic links have hit the Nigerian healthcare system hardest, which are the Ebola virus disease, Lassa fever and Coronavirus disease 2019. Due to the fragile nature of the Nigerian health system, several challenges were encountered in the process of responding to these viral outbreaks, some of which included inadequate healthcare infrastructure, limited diagnostic capacity, unfledged nature of emergency response, unsatisfactory remuneration of health workers, misinformation trends, amongst others. By reminiscing on the challenges and lessons learnt from these viral disease outbreaks, the Nigerian government and policymakers will be able to adopt more effective approaches towards emergency preparedness for future outbreaks of infectious diseases.
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Affiliation(s)
- Emmanuel E. Elebesunu
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology
| | | | - Marvellous O. Asika
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology
| | | | | | - Charles A. Okafor
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology
- Chester Medical School, University of Chester, Cheshire, United Kingdom
| | - Godfred Y. Scott
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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13
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Evens E, Ambrose A, Bello B, Murray K, Tefouet N, Fatusi A, Nwagbara B, Riungu M, Maji T, Khamofu H, Fotso JC, Prata N. "Africans, we know how to adapt indeed": Adaptations to family planning and reproductive health services in humanitarian settings in Nigeria during the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002104. [PMID: 37432922 DOI: 10.1371/journal.pgph.0002104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/04/2023] [Indexed: 07/13/2023]
Abstract
On March 30, 2020, the Government of Nigeria implemented its first COVID-19 related lockdown. We worked with two humanitarian projects in Nigeria, the Integrated Humanitarian Assistance to Northeast Nigeria (IHANN II) in Borno State and the United Nations High Commissioner for Refugees South-South Health and Nutrition Intervention (UNHCR-SS-HNIR) for Cameroon Refugees and vulnerable populations in Cross River State, to document the programmatic adaptations to Family Planning/Reproductive Health (FP/RH) services in response to COVID-19 and identify successes and challenges of those adaptations. A mixed methods approach including quantitative analysis of data from routine programmatic activities, qualitative data from in-depth interviews (IDIs) with project staff and process documentation of programmatic activities and modifications was used to 1) identify modifications in FP/RH services due to COVID-19, 2) understand staff perception of their utility and impact, and 3) gauge trends in key FP/RH in-service delivery indicators to assess changes prior to and after the March 2020 lockdown. Monitoring data shows notable declines in service utilization after lockdowns in antenatal care, postnatal care, and outreach campaigns, followed by a return to pre-lockdown levels by July 2020. Results show projects introduced numerous COVID-19 precaution strategies including: community sensitization; triage stations and modification of service flow in facilities; and appointment scheduling for essential services. Findings from IDIs speak to a well-coordinated and implemented COVID-19 response with project staff noting improvements in their time management and interpersonal communication skills. Lessons learned included the need to better sensitize and educate communities, maintain FP commodities and increase support provided to health workers. Deliberate adaptations in IHANN II and UNHCR-SS-HNIR projects turned challenges to opportunities, ensuring continuity of services to the most vulnerable populations.
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Affiliation(s)
- Emily Evens
- FHI 360, Durham, North Carolina, United States of America
| | - Ashley Ambrose
- Evidence for Sustainable Human Development Systems in Africa, Yaoundé, Cameroon
| | | | - Kate Murray
- FHI 360, Durham, North Carolina, United States of America
| | - Nadia Tefouet
- Evidence for Sustainable Human Development Systems in Africa, Yaoundé, Cameroon
| | | | | | | | | | | | | | - Ndola Prata
- Evidence for Sustainable Human Development Systems in Africa, Yaoundé, Cameroon
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Akokuwebe ME, Idemudia ES. Fraud within the Nigerian health system, a double threat for resilience of a health system and the response to the COVID-19 pandemic: a review. Pan Afr Med J 2023; 45:116. [PMID: 37745915 PMCID: PMC10516760 DOI: 10.11604/pamj.2023.45.116.36979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/08/2023] [Indexed: 09/26/2023] Open
Abstract
As Nigeria battles the COVID-19 pandemic, systemic fraud within the health system may undermine the efforts to halt the devastating effect of the disease and the fight against COVID-19. Fraud is a major concern worldwide, especially in developing countries such as Nigeria, where it is widespread within the health system. The vulnerability of the Nigerian health system despite several efforts from relevant stakeholders, has consistently been underscored before the pandemic arose, raising serious concerns. These concerns include fraud, embezzlement, and mismanagement of funds, exploitation, lack of transparency in policymaking, cutting corners in procurement processes, and taking advantage of the healthcare workforce for personal benefits. Also, other involvements in the vulnerability of the Nigerian health system that are worrisome include stakeholders using the pandemic to their advantage to increase their private benefits, a short supply of vital health resources, fraudulent recruitment of the health workforce, and ineffective crisis management. This study explores fraud within the Nigerian health system, its impact and implications for health-system resilience as well as its response to the COVID-19 pandemic. Guided by agency theory, causes and impacts of fraud in the health system and its implications on the response to COVID-19 were explained. Systematic review method was employed; out of 1462 articles identified and screened dated from 1991 to 2021, sixty articles were included in the analysis and interpretation. Specific fraud interventions should focus on a weak and vulnerable health system, service delivery, high-risk institutionalized health workforce, and addressing issues of fraud within and outside the health system in order to curb the dreaded COVID-19 and its variants in Nigeria.
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15
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Ogunsola FT, Ejekam CS, Balogun M, Ugonna I, Odukoya O, Oduyebo O, Adeyemo WL, Oladele RO, Akanmu SA. Universal use of face mask for the prevention of the spread of COVID-19 in community settings in a South-western State of Nigeria: willingness and barriers. Antimicrob Resist Infect Control 2023; 12:64. [PMID: 37408082 PMCID: PMC10324105 DOI: 10.1186/s13756-023-01267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES One of the major drivers of the novel coronavirus (SARS-CoV-2) pandemic is community transmission. Nigeria, like other countries globally, took to strict preventive public health measures including good respiratory and hand hygiene, physical distancing, and the use of face mask to control the spread of COVID-19 disease. Furthermore, the government of Lagos State in Nigeria made a pronouncement on the universal use of face mask in the community. While the use of face masks has proven to be an effective barrier to the transmission of respiratory diseases, its use in the community is uncommon. This study assessed the willingness and compliance with wearing face masks for the reduction of the community spread of COVID-19 and identified possible barriers to use of mask among residents in Lagos State. METHODS This was a descriptive cross-sectional study, that surveyed 552 respondents who were adult residents of Lagos State. Data collection was quantitative, using a pretested, interviewer-administered questionnaire, and findings were presented in frequencies and percentages. Pearson's chi-square and logistic regression analyses were used to test the association between variables. The level of significance was set at 5%. RESULTS A majority (75.7%) of the respondents were willing to wear a face mask in public areas but only 21.9% of the respondents were willing to wear a mask at all times. The most identified barriers to wearing mask were discomfort (72.5%) and inconvenience (77.7%). Two-thirds of the respondents reported they were compliant with always wearing a face mask when leaving home. Only 15.0% of the respondents wore the mask continuously and appropriately, covering the nose and mouth. Having a post-secondary education and being older (40 years and above) were found to be positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing masks continuously and appropriately). CONCLUSION Our findings suggest that willingness to wear a face mask influences compliance, and that having a post-secondary education and being older (> 40 years) were positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing it continuously and correctly). The major barriers to wearing masks were discomfort and inconvenience. Effective risk communication strategies to reach diverse groups for better compliance with public health measures are urgently needed even for the future.
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Affiliation(s)
- Folasade T Ogunsola
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Chioma S Ejekam
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria.
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Igwilo Ugonna
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oyinlola Oduyebo
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Rita O Oladele
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Sulaimon A Akanmu
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
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Fawole OI, Bello S, Adebowale AS, Bamgboye EA, Salawu MM, Afolabi RF, Dairo MD, Namale A, Kiwanuka S, Monje F, Namuhani N, Kabwama S, Kizito S, Ndejjo R, Seck I, Diallo I, Makhtar M, Leye M, Ndiaye Y, Fall M, Bassoum O, Mapatano MA, Bosonkie M, Egbende L, Lazenby S, Wang W, Liu A, Bartlein R, Sambisa W, Wanyenze R. COVID-19 surveillance in Democratic Republic of Congo, Nigeria, Senegal and Uganda: strengths, weaknesses and key Lessons. BMC Public Health 2023; 23:835. [PMID: 37158897 PMCID: PMC10165588 DOI: 10.1186/s12889-023-15708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/19/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION As part of efforts to rapidly identify and care for individuals with COVID-19, trace and quarantine contacts, and monitor disease trends over time, most African countries implemented interventions to strengthen their existing disease surveillance systems. This research describes the strengths, weaknesses and lessons learnt from the COVID-19 surveillance strategies implemented in four African countries to inform the enhancement of surveillance systems for future epidemics on the continent. METHODS The four countries namely the Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda, were selected based on their variability in COVID-19 response and representation of Francophone and Anglophone countries. A mixed-methods observational study was conducted including desk review and key informant interviews, to document best practices, gaps, and innovations in surveillance at the national, sub-national, health facilities, and community levels, and these learnings were synthesized across the countries. RESULTS Surveillance approaches across countries included - case investigation, contact tracing, community-based, laboratory-based sentinel, serological, telephone hotlines, and genomic sequencing surveillance. As the COVID-19 pandemic progressed, the health systems moved from aggressive testing and contact tracing to detect virus and triage individual contacts into quarantine and confirmed cases, isolation and clinical care. Surveillance, including case definitions, changed from contact tracing of all contacts of confirmed cases to only symptomatic contacts and travelers. All countries reported inadequate staffing, staff capacity gaps and lack of full integration of data sources. All four countries under study improved data management and surveillance capacity by training health workers and increasing resources for laboratories, but the disease burden was under-detected. Decentralizing surveillance to enable swifter implementation of targeted public health measures at the subnational level was a challenge. There were also gaps in genomic and postmortem surveillance including community level sero-prevalence studies, as well as digital technologies to provide more timely and accurate surveillance data. CONCLUSION All the four countries demonstrated a prompt public health surveillance response and adopted similar approaches to surveillance with some adaptations as the pandemic progresses. There is need for investments to enhance surveillance approaches and systems including decentralizing surveillance to the subnational and community levels, strengthening capabilities for genomic surveillance and use of digital technologies, among others. Investing in health worker capacity, ensuring data quality and availability and improving ability to transmit surveillance data between and across multiple levels of the health care system is also critical. Countries need to take immediate action in strengthening their surveillance systems to better prepare for the next major disease outbreak and pandemic.
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Affiliation(s)
| | - Segun Bello
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Ayo Stephen Adebowale
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Eniola Adetola Bamgboye
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Mobolaji Modinat Salawu
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Rotimi Felix Afolabi
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Magbagbeola David Dairo
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Alice Namale
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Suzanne Kiwanuka
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Fred Monje
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Noel Namuhani
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Steven Kabwama
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Susan Kizito
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Ibrahima Seck
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Issakha Diallo
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Mamadou Makhtar
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Mbacke Leye
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Youssou Ndiaye
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Manel Fall
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Oumar Bassoum
- Department of Preventive Medicine and Public Health, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Mala Ali Mapatano
- Kinshasa, School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Marc Bosonkie
- Kinshasa, School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Landry Egbende
- Kinshasa, School of Public Health, Kinshasa, Democratic Republic of Congo
| | - Siobhan Lazenby
- Gates Ventures LLC, Exemplars in Global Health, Seattle, WA, USA
| | - William Wang
- Gates Ventures LLC, Exemplars in Global Health, Seattle, WA, USA
| | - Anne Liu
- Gates Ventures LLC, Exemplars in Global Health, Seattle, WA, USA
| | - Rebecca Bartlein
- Gates Ventures LLC, Exemplars in Global Health, Seattle, WA, USA
| | | | - Rhoda Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Onajin-Obembe BOI. Equity in provision and access to obstetric anaesthesia care in Nigeria. Int J Obstet Anesth 2023; 54:103642. [PMID: 36841064 DOI: 10.1016/j.ijoa.2023.103642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
Nigeria has a high maternal mortality rate, yet there is wide variation in the proportion of births by caesarean section between zones, states, and cities within Nigeria. This review examines the pattern of the COVID-19 pandemic and the impact of mitigation measures on women's health in Nigeria. The combined impact of COVID-19 and conflicts on maternal healthcare and access to obstetric care, as well as the availability of obstetric anaesthesia in Nigeria, are discussed. There is a vicious cycle, intensified by unwanted pregnancy, abortion, and preventable maternal death.
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Affiliation(s)
- B O I Onajin-Obembe
- Department of Anaesthesiology, Faculty of Health Sciences, College of Health Sciences, University of Port Harcourt, Rivers State, Nigeria; Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria.
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Folayan M, Shilton S, Undelikwo V, Alaba O, Amusan R, Ibrahim M, Ogbozor PA, Mojisola O, Batheja D, Banerji A, Ivanova Reipold E, Martínez-Pérez GZ. People's willingness to use COVID-19 self-testing in Nigeria: a cross-sectional survey. BMJ Open 2023; 13:e063323. [PMID: 36717135 PMCID: PMC9887470 DOI: 10.1136/bmjopen-2022-063323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Nigeria has been badly affected by the COVID-19 pandemic, and the poor testing coverage in the country may make controlling the spread of COVID-19 challenging. The aim of this study was to assess the general public's acceptability of SARS-CoV-2 self-testing as an approach which could help to address this gap. SETTING A household-based survey was conducted in five urban and five rural local government areas in the states of Akwa Ibom, Anambra, Benue, Kaduna and Lagos, in mid-2021. PARTICIPANTS 2126 respondents (969 were female) participated. A five-pronged, probabilistic sampling approach was used to recruit individuals older than 17 years and available to participate when randomly approached in their households by the surveyors. A 35-item questionnaire was used to collect data on their values towards SARS-CoV-2 self-testing. Primary outcomes were: likelihood to use a self-test; willingness to pay for a self-test; and likely actions following a reactive self-test result. RESULTS Of the total 2126 respondents, 14 (0.66%) were aware of COVID-19 self-testing, 1738 (81.80%) agreed with the idea of people being able to self-test for COVID-19, 1786 (84.05%) were likely/very likely to use self-tests if available, 1931 (90.87%) would report a positive result and 1875 (88.28%) would isolate if they self-tested positive. Factors significantly associated with the use of a self-test were having a college education or higher (adjusted Odds Ratio (AOR): 1.55; 95% CI: 1.03 to 2.33), full-time employment (AOR: 1.67; 95% CI: 1.06 to 2.63), feeling at moderate/high risk of COVID-19 (AOR: 2.43; 95% CI: 1.70 to 3.47) and presence of individuals at risk of COVID-19 within the household (AOR: 1.38; 95% CI: 1.06 to 1.78). CONCLUSION A majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health on self-testing positive. Self-test implementation research is necessary to frame how acceptability impacts uptake of preventive behaviours following a positive and a negative self-test result.
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Affiliation(s)
- Morenike Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | | | - Oluwatoyin Alaba
- Institute of Public Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Ranmilowo Amusan
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Pamela Adaobi Ogbozor
- Department of Psychology, Enugu State University of Science and Technology, Enugu, Anambra State, Nigeria
| | - Oluyide Mojisola
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Abhik Banerji
- Center for Disease Dynamics Economics & Policy, Delhi, India
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19
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Azanaw J, Endalew M, Zenbaba D, Abera E, Chattu VK. COVID-19 vaccine acceptance and associated factors in 13 African countries: A systematic review and meta-analysis. Front Public Health 2023; 10:1001423. [PMID: 36761336 PMCID: PMC9903367 DOI: 10.3389/fpubh.2022.1001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 12/09/2022] [Indexed: 01/26/2023] Open
Abstract
Background The COVID-19 pandemic has severely affected the entire world, especially sub-Saharan Africa. As a result, researchers and government agencies are working to create effective COVID-19 vaccinations. While vaccination campaigns are moving rapidly in high-income nations, COVID-19 is still ruthlessly affecting people in low-income nations. However, this difference in the spread of the disease is not because of a lack of a COVID-19 vaccine but mainly due to people's reluctance. As a result, this review summarized the data on COVID-19 vaccination adoption and factors related among nations in sub-Saharan Africa. Method Comprehensive searches were conducted using PubMed, Embase, Medline, Web of Science, Google Scholar, and the Cochrane Library databases. The risk of bias and methodological quality of each published article that fit the selection criteria were evaluated using Critical Appraisal Checklist tools. All statistical analysis was done by STATA 16. Results This review was based on 29 studies with 26,255 participants from sub-Saharan Africa. Using a random-effects model, the pooled prevalence of COVID-19 vaccine acceptance among study participants was 55.04% (95 % CI: 47.80-62.27 %), I2 = 99.55%. Being male [POR = 1.88 (95% CI: 1.45, 2.44)], having a positive attitude toward the COVID-19 vaccine [POR = 5.56 (95% CI: 3.63, 8.51)], having good knowledge in the COVID-19 vaccine [POR = 4.61 (95% CI: 1.24, 8.75)], having government trust [POR = 7.10 (95% CI: 2.37, 21.32)], and having undergone COVID-19 testing in the past [POR = 4.41 (95%CI: (2.51, 7.75)] were significant predictor variables. Conclusion This analysis showed that respondents had a decreased pooled prevalence of COVID-19 vaccination acceptance. Sex, attitude, knowledge, government trust, and COVID-19 testing were statistically significantly correlated characteristics that affected the acceptability of the COVID-19 vaccine. All stakeholders should be actively involved in increasing the uptake of the COVID-19 vaccine and thereby reducing the consequences of COVID-19. The acceptance of the COVID-19 vaccination can be increased by using this conclusion as an indicator for governments, healthcare professionals, and health policymakers in their work on attitude, knowledge, government trust, and COVID-19 testing.
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Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mastewal Endalew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Eshetu Abera
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Vijay Kumar Chattu
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technological Sciences, Saveetha University, Chennai, India
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20
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Kashiya Y, Ekofo J, Kabanga C, Agyepong I, Van Damme W, Van Belle S, Mukinda F, Chenge F. Multilevel Governance and Control of the COVID-19 Pandemic in the Democratic Republic of Congo: Learning from the Four First Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1980. [PMID: 36767346 PMCID: PMC9914874 DOI: 10.3390/ijerph20031980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic continues to impose a heavy burden on people around the world. The Democratic Republic of the Congo (DRC) has also been affected. The objective of this study was to explore national policy responses to the COVID-19 pandemic in the DRC and drivers of the response, and to generate lessons for strengthening health systems' resilience and public health capacity to respond to health security threats. This was a case study with data collected through a literature review and in-depth interviews with key informants. Data analysis was carried out manually using thematic content analysis translated into a logical and descriptive summary of the results. The management of the response to the COVID-19 pandemic reflected multilevel governance. It implied a centralized command and a decentralized implementation. The centralized command at the national level mostly involved state actors organized into ad hoc structures. The decentralized implementation involved state actors at the provincial and peripheral level including two other ad hoc structures. Non-state actors were involved at both levels. These ad hoc structures had problems coordinating the transmission of information to the public as they were operating outside the normative framework of the health system. Conclusions: Lessons that can be learned from this study include the strategic organisation of the response inspired by previous experiences with epidemics; the need to decentralize decision-making power to anticipate or respond quickly and adequately to a threat such as the COVID-19 pandemic; and measures decided, taken, or adapted according to the epidemiological evolution (cases and deaths) of the epidemic and its effects on the socio-economic situation of the population. Other countries can benefit from the DRC experience by adapting it to their own context.
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Affiliation(s)
- Yves Kashiya
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa 127, Democratic Republic of the Congo
| | - Joel Ekofo
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Chrispin Kabanga
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Irene Agyepong
- Public Health Faculty, Ghana College of Physicians and Surgeons, Accra MB 429, Ghana
| | - Wim Van Damme
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | | | - Fidele Mukinda
- School of Public Health, University of Western Cape, Cape Town 7530, South Africa
| | - Faustin Chenge
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
- School of Public Health, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
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21
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Ayandipo EO, Babatunde D, Afolayan O, Kalejaye O, Obembe T. Assessing the knowledge and practices of primary healthcare workers on malaria diagnosis and related challenges in view of COVID-19 outbreak in a Nigerian Southwestern metropolis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000625. [PMID: 36962957 PMCID: PMC10021342 DOI: 10.1371/journal.pgph.0000625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023]
Abstract
The clinical features of COVID-19 and malaria are interrelated. Due to the similarity of symptoms between the two disease states, patients can be incorrectly diagnosed with the other ailment in areas with limited health resources. There is a dearth of knowledge of co-infection between COVID-19 and malaria from healthcare providers' perspective. Hence, this study assessed the ability of primary healthcare workers to diagnose malaria infection correctly from COVID-19 infection. A multistage sampling technique was used to select health care workers who were directly involved in malaria case management at 261 government-owned primary health facilities in Oyo State. Socio-demographic characteristics of respondents, knowledge and practices, COVID-19 differential diagnosis and challenges that healthcare workers face regarding malaria diagnosis were obtained using a standardized electronic structured questionnaire. Descriptive statistics, bivariate and multivariate analysis were conducted on data collected and significant results were interpreted at a 5% level of significance. A good percentage of the respondents (81.6%, 74.3%) had good knowledge about malaria and COVID-19. However, the knowledge gained did not translate to practice, as majority (86.2%) of respondents had poor malaria diagnosis practices. Practices relating to COVID-19 differential diagnosis in 69.7% of respondents were also poor. Most of the respondents attributed poor practices to the unavailability of Malaria Rapid Diagnostic Test (mRDT), inadequate training and continuous capacity improvement. Only 12.3% of the respondents have not had any form of training on malaria diagnosis and treatment in the last five years. Harmonization of regular trainings and continuous on-the job capacity building is essential to improve case identification, diagnosis and management of both ailments. Also, uninterrupted supplies of essential commodities such as mRDT in laboratories will reduce missed opportunities for malaria diagnosis.
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Affiliation(s)
| | | | | | | | - Taiwo Obembe
- Claremont Graduate University, Claremont, California, United States of America
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22
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Ihekweazu C. Lessons from Nigeria's Adaptation of Global Health Initiatives during the COVID-19 Pandemic. Emerg Infect Dis 2022; 28:S299-S301. [PMID: 36502443 DOI: 10.3201/eid2813.221175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Nigeria receives funds from several global health initiatives that are aimed at addressing elevated risks and overall burden of infectious disease outbreaks. These funds include the Global Fund to Fight AIDS, Tuberculosis and Malaria; US President's Emergency Plan for AIDS Relief; US President's Malaria Initiative; and Global Polio Eradication Initiative. These initiatives have contributed to a substantial reduction in illness and death from HIV, tuberculosis, malaria, and polio. However, Nigeria has experienced mixed success with leveraging the capacities built through these donor-funded vertical programs to respond to new health threats. This report describes experiences using resources from vertical disease programs by the Nigeria Centre for Disease Control in response to the 2014-2016 Ebola outbreak in West Africa and the COVID-19 pandemic. Integrating resources from different disease programs with government-led systems and institutions will improve responses to endemic outbreaks and preparedness for future pandemics in Nigeria.
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23
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Bolu O, Mustapha B, Ihekweazu C, Muhammad M, Hassan A, Abdulwahab A, Asekun AA, Nsirim R, Okechukwu E, Attah I, Swaminathan M, Greby S, Adebiyi A, Alex-Okoh M, Okwor T, Ilori E, Mba N, Mutah J, Akujobi J, Battah N, Haggai W, Okatubo G, Okigbo A, Castle E, Abubakar I, Akataobi C, Adekunle O, Aliyu SH. Effect of Nigeria Presidential Task Force on COVID-19 Pandemic, Nigeria. Emerg Infect Dis 2022; 28:S168-S176. [PMID: 36502390 DOI: 10.3201/eid2813.220254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Nigeria had a confirmed case of COVID-19 on February 28, 2020. On March 17, 2020, the Nigerian Government inaugurated the Presidential Task Force (PTF) on COVID-19 to coordinate the country's multisectoral intergovernmental response. The PTF developed the National COVID-19 Multisectoral Pandemic Response Plan as the blueprint for implementing the response plans. The PTF provided funding, coordination, and governance for the public health response and executed resource mobilization and social welfare support, establishing the framework for containment measures and economic reopening. Despite the challenges of a weak healthcare infrastructure, staff shortages, logistic issues, commodity shortages, currency devaluation, and varying state government cooperation, high-level multisectoral PTF coordination contributed to minimizing the effects of the pandemic through early implementation of mitigation efforts, supported by a strong collaborative partnership with bilateral, multilateral, and private-sector organizations. We describe the lessons learned from the PTF COVID-19 for future multisectoral public health response.
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24
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Adeniran AA, Hamill LC, Selby R, Downs P. COVID-19: A unique opportunity to improve laboratory capacity for neglected tropical diseases in sub-Saharan Africa. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.984906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
While many public health and university laboratories have become involved in COVID-19 testing during the pandemic, these laboratories now run the risk of being underutilized as COVID-19 testing wanes. This is particularly true of established COVID-19 laboratories in many low- and middle-income countries (LMICs). In this article, we make a case for repurposing many of these laboratories to support control programs for neglected tropical diseases (NTDs) in endemic countries as they contemplate how to strengthen laboratory capacity for all endemic and emerging epidemiological diseases.
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25
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Iwuagwu AO, Lai DWL, Ndubuisi Ngwu C, Kalu ME. Social Workers' Involvement in Developing and Implementing Social Programs for Older Adults During the COVID-19 Pandemic in Nigeria: A Concept Paper and Suggestions for Action Plans. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022:1-13. [PMID: 36259471 DOI: 10.1080/01634372.2022.2135657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Social workers, especially in the Global North/developed countries such as the United States of America, Australia, Canada, and the United Kingdom, have been actively involved in implementing social programs to improve the psychosocial, health, and wellbeing of older adults during the COVID-19 pandemic. However, this is not the case in the Global South/developing countries like Nigeria, Ghana, etc. This concept paper aims to describe the current state of Nigerian social workers' role in developing and implementing social programs for older adults during the COVID-19 pandemic and to identify action plans for further strengthening their involvement. We systematically reviewed the literature to identify Nigerian social workers' role in developing and implementing social programs for older adults during COVID-19. Our review reflected that social workers are rarely involved in developing and implementing social programs; when involved, their involvement is on a consultation basis, which limits their active involvement in multidisciplinary team of COVID-19 prevention and vaccination ad hoc committees in Nigeria.
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Affiliation(s)
- Anthony Obinna Iwuagwu
- School of Social Sciences, Faculty of Arts, Design & Architecture, University of New South Wales, Sydney, New South Wales, Australia
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
- Emerging Researchers and Professionals in Ageing-African Network, Abuja, Nigeria
| | - Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | | | - Micheal Ebe Kalu
- Emerging Researchers and Professionals in Ageing-African Network, Abuja, Nigeria
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
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26
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Abdullahi A, Oladele D, Owusu M, Kemp SA, Ayorinde J, Salako A, Fink D, Ige F, Ferreira IATM, Meng B, Sylverken AA, Onwuamah C, Boadu KO, Osuolale K, Frimpong JO, Abubakar R, Okuruawe A, Abdullahi HW, Liboro G, Agyemang LD, Ayisi-Boateng NK, Odubela O, Ohihoin G, Ezechi O, Kamasah JS, Ameyaw E, Arthur J, Kyei DB, Owusu DO, Usman O, Mogaji S, Dada A, Agyei G, Ebrahimi S, Gutierrez LC, Aliyu SH, Doffinger R, Audu R, Adegbola R, Mlcochova P, Phillips RO, Solako BL, Gupta RK. SARS-COV-2 antibody responses to AZD1222 vaccination in West Africa. Nat Commun 2022; 13:6131. [PMID: 36253377 PMCID: PMC9574797 DOI: 10.1038/s41467-022-33792-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022] Open
Abstract
Real-world data on vaccine-elicited neutralising antibody responses for two-dose AZD1222 in African populations are limited. We assessed baseline SARS-CoV-2 seroprevalence and levels of protective neutralizing antibodies prior to vaccination rollout using binding antibodies analysis coupled with pseudotyped virus neutralisation assays in two cohorts from West Africa: Nigerian healthcare workers (n = 140) and a Ghanaian community cohort (n = 527) pre and post vaccination. We found 44 and 28% of pre-vaccination participants showed IgG anti-N positivity, increasing to 59 and 39% respectively with anti-receptor binding domain (RBD) IgG-specific antibodies. Previous IgG anti-N positivity significantly increased post two-dose neutralizing antibody titres in both populations. Serological evidence of breakthrough infection was observed in 8/49 (16%). Neutralising antibodies were observed to wane in both populations, especially in anti-N negative participants with an observed waning rate of 20% highlighting the need for a combination of additional markers to characterise previous infection. We conclude that AZD1222 is immunogenic in two independent West African cohorts with high background seroprevalence and incidence of breakthrough infection in 2021. Waning titres post second dose indicates the need for booster dosing after AZD1222 in the African setting despite hybrid immunity from previous infection.
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Affiliation(s)
- Adam Abdullahi
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK.,Department of Medicine, University of Cambridge, Cambridge, UK.,Institute of Human Virology, Abuja, Nigeria
| | - David Oladele
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Michael Owusu
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Steven A Kemp
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK.,Department of Medicine, University of Cambridge, Cambridge, UK
| | - James Ayorinde
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Abideen Salako
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Douglas Fink
- Faculty of Infection and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Department of Infection and Immunity, University College London, London, UK
| | - Fehintola Ige
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Isabella A T M Ferreira
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK.,Department of Medicine, University of Cambridge, Cambridge, UK
| | - Bo Meng
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK.,Department of Medicine, University of Cambridge, Cambridge, UK
| | - Augustina Angelina Sylverken
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Chika Onwuamah
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | | | - Kazeem Osuolale
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | | | - Rufai Abubakar
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Azuka Okuruawe
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | | | - Gideon Liboro
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | | | | | | | - Gregory Ohihoin
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Oliver Ezechi
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | | | - Emmanuel Ameyaw
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Derrick Boakye Kyei
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | | | - Olagoke Usman
- Federal Medical Centre, Ebutte Metta, Lagos, Nigeria
| | - Sunday Mogaji
- Federal Medical Centre, Ebutte Metta, Lagos, Nigeria
| | | | - George Agyei
- Kwadaso Seventh Day Adventist Hospital, Kumasi, Ghana
| | - Soraya Ebrahimi
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Lourdes Ceron Gutierrez
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Sani H Aliyu
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Rainer Doffinger
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Rosemary Audu
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Richard Adegbola
- Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria
| | - Petra Mlcochova
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK. .,Department of Medicine, University of Cambridge, Cambridge, UK.
| | - Richard Odame Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. .,Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.
| | | | - Ravindra K Gupta
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK. .,Department of Medicine, University of Cambridge, Cambridge, UK. .,Africa Health Research Institute, Durban, South Africa.
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27
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Kabantiyok D, Ninyio N, Shittu I, Meseko C, Emeto TI, Adegboye OA. Human Respiratory Infections in Nigeria: Influenza and the Emergence of SARS-CoV-2 Pandemic. Vaccines (Basel) 2022; 10:vaccines10091551. [PMID: 36146628 PMCID: PMC9506385 DOI: 10.3390/vaccines10091551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
The increasing outbreak of zoonotic diseases presents challenging times for nations and calls for a renewed effort to disrupt the chain of events that precede it. Nigeria's response to the 2006 bird flu provided a platform for outbreak response, yet it was not its first experience with Influenza. This study describes the impact of SARS-CoV-2 on Influenza surveillance and, conversely, while the 1918 Influenza pandemic remains the most devastating (500,000 deaths in 18 million population) in Nigeria, the emergence of SARS CoV-2 presented renewed opportunities for the development of vaccines with novel technology, co-infection studies outcome, and challenges globally. Although the public health Intervention and strategies left some positive outcomes for other viruses, Nigeria and Africa's preparation against the next pandemic may involve prioritizing a combination of technology, socioeconomic growth, and active surveillance in the spirit of One Health.
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Affiliation(s)
- Dennis Kabantiyok
- Laboratory Diagnostic Services Division, National Veterinary Research Institute, PMB 01, Vom 930001, Nigeria
| | - Nathaniel Ninyio
- School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
| | - Ismaila Shittu
- Department of Avian Influenza and Transboundary Animal Diseases, National Veterinary Research Institute, PMB 01, Vom 930010, Nigeria
| | - Clement Meseko
- Department of Avian Influenza and Transboundary Animal Diseases, National Veterinary Research Institute, PMB 01, Vom 930010, Nigeria
| | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, Department, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne, Neglected Tropical Diseases Department, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, Department, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne, Neglected Tropical Diseases Department, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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28
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Ikwuegbuenyi CA, Patil SN, Nie JW, Bankole OB, Mehta AI. Effects of COVID-19 on Neurosurgical Service: Perspective from a Tertiary Medical Center in Nigeria. J Neurosci Rural Pract 2022; 13:398-402. [PMID: 35946013 PMCID: PMC9357510 DOI: 10.1055/s-0042-1744472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background
The outbreak of COVID-19 caused a significant impact on neurosurgical case volume in Nigeria due to the widespread recommendation to minimize elective procedures and redistribute healthcare resources to support COVID-19 patients. This study aims to analyze the effect of COVID-19 in one tertiary care Nigerian hospital on the demographic characteristics, diagnostic classes, and elective/non-elective procedure statuses.
Methods
A retrospective single-center chart review study was conducted to review all patients undergoing a neurosurgical procedure between March to June in 2019 and 2020. Descriptive data on patient age, gender, sex, diagnosis, surgical procedure, elective/non-elective surgery status, and month and year of admission were recorded. Diagnoses were categorized into one of seven types by author review. Pearson's Chi-Square and Fisher's Exact Tests were utilized to test for independence of the categorical variables to the year of patient admission, and a Welch two-sample t-test was used to test for a significant difference in mean age between the two cohorts.
Results
A total of 143 cases were reviewed. There was a 59.8% reduction in overall neurosurgical case volume with an 82% reduction in elective procedures (39 vs. 7, p = 0.017, 95% CI: 1.15 – 8.77) between 2019 and 2020. No significant differences were noted in patient cohorts when comparing demographic characteristics, diagnosis type, or month of admission between the two years.
Conclusion
There was a significant reduction in elective neurosurgical procedures during the early months of COVID-19 in Nigeria. Further studies should consider examining the effects of COVID-19 into 2021.
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Affiliation(s)
| | - Shashank N. Patil
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - James W. Nie
- Department of Neurosurgery, College of Medicine University of Lagos, Lagos, Nigeria
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Olufemi B. Bankole
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Ankit I. Mehta
- Department of Neurosurgery, College of Medicine University of Lagos, Lagos, Nigeria
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States
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29
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Ihekweazu V, Ejibe U, Kaduru C, Disu Y, Oyebanji O, Oguanuo E, Anueyiagu C, Obanor OO, Akande-Alegbe A, Egwuenu A, Ojumu T, Abara AE, Ochu CL. Implementing an emergency risk communication campaign in response to the COVID-19 pandemic in Nigeria: lessons learned. BMJ Glob Health 2022; 7:bmjgh-2022-008846. [PMID: 35675971 PMCID: PMC9184990 DOI: 10.1136/bmjgh-2022-008846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/21/2022] [Indexed: 11/04/2022] Open
Abstract
At the onset of the COVID-19 pandemic, the WHO recommended the prioritisation of risk communication and community engagement as part of response activities in countries. This was related to the increasing spread of misinformation and its associated risks, as well as the need to promote non-pharmaceutical interventions (NPIs) in the absence of an approved vaccine for disease prevention. The Nigeria Centre for Disease Control, the national public health institute with the mandate to prevent and detect infectious disease outbreaks, constituted a multidisciplinary Emergency Operations Centre (EOC), which included NCDC staff and partners to respond to the COVID-19 outbreak. Risk communication, which also comprised crisis communication, was a pillar in the EOC. As the number of cases in Nigeria increased, the increasing spread of misinformation and poor compliance to NPIs inspired the development of the #TakeResponsibility campaign, to encourage individual and collective behavioural change and to foster a shared ownership of the COVID-19 outbreak response. Mass media, social media platforms and community engagement measures were used as part of the campaign. This contributed to the spread of messages using diverse platforms and voices, collaboration with community leaders to contextualise communication materials and empowerment of communication officers at local levels through training, for increased impact. Despite the challenges faced in implementing the campaign, lessons such as the use of data and a participatory approach in developing communications campaigns for disease outbreaks were documented. This paper describes how a unique communication campaign was developed to support the response to the COVID-19 pandemic.
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Affiliation(s)
| | - Ukwori Ejibe
- Tony Blair Institute for Global Change, Abuja, Nigeria
| | - Chijioke Kaduru
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria.,Health Division, Corona Management Systems, Abuja, Nigeria
| | - Yahya Disu
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Oyeronke Oyebanji
- Vaccine Research and Development, Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | - Emeka Oguanuo
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chimezie Anueyiagu
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Abiodun Egwuenu
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tijesu Ojumu
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Abara Erim Abara
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chinwe Lucia Ochu
- Department of Prevention, Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
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Asemota OA, Napier-Raman S, Takeuchi H, Raman S, Asemota EA, Nonye E. Exploring children's knowledge of COVID-19 and stress levels associated with the pandemic in Nigeria: a mixed-method study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001444. [PMID: 36053587 PMCID: PMC9226462 DOI: 10.1136/bmjpo-2022-001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Children have been relatively spared from the direct effects of COVID-19 globally, but there are significant concerns about indirect effects on the most vulnerable children's well-being. Nigeria is the largest African nation, but little is known about children's experience of the COVID-19 pandemic. Our aims were to determine children's knowledge of COVID-19 and their mental health responses to the pandemic. METHODS Children aged 6-17 years living in Calabar, Nigeria, were surveyed using a combination of online data collection assisted by parents and on-site data collection at schools. Parents filled out sociodemographic details, while children answered questions about COVID-19 knowledge and preventive measures. An adapted version of the 'Perceived Stress Scale for Children' was used to assess stress with additional free text space for expression of views and experiences of COVID-19. RESULTS A total of 265 children completed questionnaires, mean age was 12.5 years, 52.1% were girls. All children knew about the virus and over two-thirds (67.8%) had good knowledge of COVID-19 transmission. Children identified television (60.8%), parents (44.2%) and social media (32.8%), as main sources of COVID-19 information. The overall mean stress score among the children was 20.47. Children mentioned the following as stressors: fear of the COVID-19 disease, effect of pandemic restrictions on schooling and social interactions as well as home/family tensions. Parental love and support were overwhelmingly reported as strengths. CONCLUSIONS Nigerian children in this study had good knowledge and understanding of the COVID-19 pandemic and preventive measures to counter the virus. Children had high stress levels and expressed pandemic-related concerns but parental love and support were mitigating factors. Government and child health service providers need to tailor health and support services in response to children's needs and concerns.
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Affiliation(s)
| | - Sharanya Napier-Raman
- School of Medical and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Shanti Raman
- Community Paediatrics, Southwest Sydney Local Health District, sydney, New South Wales, Australia
| | | | - Ezeh Nonye
- Department of Paediatrics, New Cross Hospital, Wolverhampton, UK.,Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
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Ameye SA, Ojo TO, Adetunji TA, Awoleye MO. Is there an association between COVID-19 mortality and Human development index? The case study of Nigeria and some selected countries. BMC Res Notes 2022; 15:186. [PMID: 35597995 PMCID: PMC9123789 DOI: 10.1186/s13104-022-06070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/05/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives We assessed Case Fatality Rate (CFR) of COVID-19 as an indicator to situate the performance of Nigeria relative to other selected countries. We obtained case fatality rates of different countries from data sets available from open-sources. The CFRs were calculated as the rate of deaths compared with total cases. The values were compared with Nigeria’s COVID-19 CFR. Other relevant statistical comparisons were also conducted. Results The worst performing countries with regards to CFR in descending order were Yemen (19.5%), Peru (9.0%) Mexico (7.6%), Sudan (7.4%) and Ecuador (6.3%) while the best performing nations were Bhutan (0.11%), Burundi (0.19%), Iceland (0.20%), Laos (0.21%) and Qatar (0.25%). The CFR of Nigeria was 1.39% which falls below the 50th percentile. Other comparison done showed significant difference in the CFR values between countries similar to Nigeria and countries that are dissimilar when HDI is used. (Mann–Whitney U test 126.0, p = 0.01). The trend of the CFR in Nigeria showed a steady decline and flattening of the CFR curve which does not seem to be affected by the spikes in the daily declared cases.
Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06070-8.
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Affiliation(s)
- Sanyaolu Alani Ameye
- Department of Otorhinolaryngology, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | | | - Tajudin Adesegun Adetunji
- Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
| | - Michael Olusesan Awoleye
- African Institute for Science Policy and Innovation, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ayemoba O, Adekanye U, Iroezindu M, Onoh I, Lawal I, Suleiman A, Joshua S, Ogundeji A, Adamu Y, Ugandem-Okonkwo D, Owolabi F, Atang M, Nwagbara G, Musa Y, Odeyemi S, Amosu A, Okoye I, Ahmed Y, Nalazai J, Elayo Z, Adelanwa T, Monday T, Bloom E, Benyeogor E, Chittenden L, Okeji N. The Nigerian Military Public Health Response to COVID-19: A 14-Month Appraisal. Health Secur 2022; 20:203-211. [PMID: 35613403 PMCID: PMC10818039 DOI: 10.1089/hs.2021.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/05/2022] [Accepted: 02/17/2022] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic has caused significant morbidity and mortality since its emergence in December 2019. In Nigeria, the government inaugurated the Presidential Task Force on COVID-19 to coordinate resources while the Nigeria Centre for Disease Control led the public health response. The Nigeria Ministry of Defence Health Implementation Programme (MODHIP), in partnership with the US Army Medical Research Directorate - Africa/Nigeria, responded immediately to the pandemic by establishing a public health emergency operations center to coordinate the military response in support of national efforts. MODHIP has 5 functional units and 6 pillars that coordinate testing, surveillance, case management, risk communication, logistics, research, and infection prevention and control. It developed an incident action plan and each pillar had its own terms of reference to guide specific response activities while preventing duplication of efforts within the military and the Nigeria Centre for Disease Control. In addition, awareness and sensitization sessions were conducted on preventive practices for COVID-19 and infrastructure was provided for hand hygiene and screening at all military facilities. Military laboratories were configured for SARS-CoV-2 testing while selected military health facilities were equipped and designated as COVID-19 treatment centers. Research proposals aimed at better understanding the disease and controlling it were also developed. The traditional combat role of the military was redirected to complement this public health emergency response. In this article, we highlight gaps, opportunities, and lessons to improve military participation in public health emergency response in the future. More funding and multisectoral collaboration with civilian institutions are key to strengthening military public health emergency preparedness and response capabilities.
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Affiliation(s)
- Ojor Ayemoba
- Ojor Ayemoba, MBChB, FMCPath, is Clinical Research Advisor and Consultant Haematologist, Clinical Research, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Usman Adekanye
- Usman Adekanye, MPH, is an Assistant Clinical Research Officer and Programme Veterinarian and Field Epidemiologist, Clinical Research, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Michael Iroezindu
- Michael Iroezindu, FWACP, MPH, is Director of Research and Consultant Infectious Disease Physician, Clinical Research Center, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Ikenna Onoh
- Ikenna Onoh, FWACP, MSc, is a Research Fellow, Consultant Community Physician, and Field Epidemiologist, Health Emergency Preparedness and Response, Nigerian Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Ismail Lawal
- Ismail Lawal, MPH, MBA, is Care and Treatment Lead and a Public Health Physician, Clinical Care and Treatment, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Aminu Suleiman
- Aminu Suleiman, PhD, MPH, is Laboratory Team Lead and Chief Medical Laboratory Scientist, Clinical Laboratory Services, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Samuel Joshua
- Samuel Joshua is Programme Lab Officer and Principal Laboratory Scientist, Clinical Laboratory Services, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Amos Ogundeji
- Amos Ogundeji, MPH, PhD, is Lab TB-HIV Lead and Associate Director, Clinical Laboratory Services, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Yakubu Adamu
- Yakubu Adamu, FMCPH, is Deputy Director and a Public Health Physician, Public Health Programs and Policy, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Dooshima Ugandem-Okonkwo
- Dooshima Ugandem-Okonkwo, MSc, is Health Counselling Lead and Prevention Manager, Preventive Health Services, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Funmilayo Owolabi
- Funmilayo Owolabi is a Prevention Officer and Public Health Nurse, Preventive Health Services, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Mary Atang
- Mary Atang, MSc, is a Training Officer and Public Health Nurse, Training, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Goodluck Nwagbara
- Goodluck Nwagbara, MSc, is Director and Chief Lab Scientist, Defence Reference Laboratory, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Yaya Musa
- Yaya Musa, MSc, is Acting/Ag Director and Chief Lab Scientist, Defence Reference Laboratory, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Sunday Odeyemi
- Sunday Odeyemi, MSc, is Associate Laboratory Director and Medical Laboratory Scientist, Defence Reference Laboratory, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Abiodun Amosu
- Abiodun Amosu, MA, is Chief Medical Records Officer and Strategic Information Lead, Strategic Information, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Ifeanyi Okoye
- Ifeanyi Okoye, MInfSc, is Strategic Information Lead and a Public Health Physician, Strategic Information, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Yusuf Ahmed
- Yusuf Ahmed, MPH, is Prevention Team Lead and a Public Health Physician, Preventive Health Services, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Joshua Nalazai
- Joshua Nalazai, FPCPharm, is a Programme Pharmacist and Logistics Officer, Procurement and Logistics, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Zubairu Elayo
- Zubairu Elayo, MBA, is a Programme Logistician and Deputy Director, Procurement and Logistics, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Taiwo Adelanwa
- Taiwo Adelanwa, PGD, is Deputy Director and a Public Health Nurse, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Thomas Monday
- Thomas Monday, MBA, PGD, is Assistant Director, Finance and Accounts, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Eddie Bloom
- Eddie Bloom, MSc, MA, is Director, Administration and Operations, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Emmanuel Benyeogor
- Emmanuel Benyeogor, MSc, is an Epidemiologist and Subnational PHEOC Coordination Assistant, Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Laura Chittenden
- Laura Chittenden, PhD, is Country Director, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
| | - Nathan Okeji
- Nathan Okeji, MBBS, FWACS, is Director General and Consultant Obstetrician/Gynaecologist, Ministry of Defence Health Implementation Programme, United States Army Medical Research Directorate – Africa/Nigeria, Abuja, Nigeria
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Examining Psychosocial Factors and Community Mitigation Practices to Limit the Spread of COVID-19: Evidence from Nigeria. Healthcare (Basel) 2022; 10:healthcare10030585. [PMID: 35327062 PMCID: PMC8949232 DOI: 10.3390/healthcare10030585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
We examine the psychosocial factors influencing community adoption of non-pharmaceutical interventions (NPI) to limit the spread of COVID-19. Using data from 990 respondents in communities across Nigeria, we examine the correlation of health behaviors and socioeconomic indicators. We conduct logistic regression to estimate the relationship between mask wearing as a health-seeking NPI with demographic and socioeconomic variables. We estimate separate models in the sensitivity robustness checks with other NPIs and control for differences across sex, age, education, number in household, and the presence of a student in the respondent’s household. A crucial finding is that health-seeking NPI behaviors are statistically significantly affected in different ways by the menu of socioeconomic indicators. The control for age, sex, education, and household size indicates that there is intersectionality of how these factors influence specific mitigation practices. We find that women are more likely to engage in mask wearing, hand washing, and use of hand sanitizers and tissues than men, and the provision of palliatives and access to family supplies significantly enhances community mitigation. Palliatives and access to family supplies enhance most health-seeking behaviors. The implication for pandemic mitigation policy is that minimizing incidence rates requires having responsive initiatives such as information updates on pandemic progression.
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Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, Adetifa IMO, Colbourn T, Ogunlesi AO, Onwujekwe O, Owoaje ET, Okeke IN, Adeyemo A, Aliyu G, Aliyu MH, Aliyu SH, Ameh EA, Archibong B, Ezeh A, Gadanya MA, Ihekweazu C, Ihekweazu V, Iliyasu Z, Kwaku Chiroma A, Mabayoje DA, Nasir Sambo M, Obaro S, Yinka-Ogunleye A, Okonofua F, Oni T, Onyimadu O, Pate MA, Salako BL, Shuaib F, Tsiga-Ahmed F, Zanna FH. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet 2022; 399:1155-1200. [PMID: 35303470 PMCID: PMC8943278 DOI: 10.1016/s0140-6736(21)02488-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023]
Affiliation(s)
| | | | - Blake Angell
- UCL Institute for Global Health, London, UK; The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Olutobi Sanuade
- UCL Institute for Global Health, London, UK; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Aishatu Lawal Adamu
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Ifedayo M O Adetifa
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Paediatrics and Child Health, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | | | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Eme T Owoaje
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - Gambo Aliyu
- National Agency for the Control of AIDS, Abuja, Nigeria
| | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sani Hussaini Aliyu
- Infectious Disease and Microbiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emmanuel A Ameh
- Division of Paediatric Surgery, National Hospital, Abuja, Nigeria
| | - Belinda Archibong
- Department of Economics, Barnard College, Columbia University, New York, NY, USA
| | - Alex Ezeh
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Muktar A Gadanya
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | | | | | - Zubairu Iliyasu
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | - Aminatu Kwaku Chiroma
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
| | - Diana A Mabayoje
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Stephen Obaro
- Department of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA; International Foundation Against Infectious Diseases in Nigeria, Abuja, Nigeria
| | | | - Friday Okonofua
- Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria; University of Medical Sciences, Ondo City, Nigeria
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK; Research Initiative for Cities Health and Equity, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Olu Onyimadu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Muhammad Ali Pate
- Health, Nutrition and Population (HNP) Global Practice and Global Financing Facility for Women, Children and Adolescents, World Bank, Washington DC, WA, USA; Harvard T Chan School of Public Health, Boston, MA, USA
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fatimah Tsiga-Ahmed
- Department of Community Medicine, Bayero University, Nigeria; Aminu Kano Teaching Hospital Kano, Nigeria
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Iyaniwura SA, Rabiu M, David JF, Kong JD. The basic reproduction number of COVID-19 across Africa. PLoS One 2022; 17:e0264455. [PMID: 35213645 PMCID: PMC8880647 DOI: 10.1371/journal.pone.0264455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/10/2022] [Indexed: 12/15/2022] Open
Abstract
The pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) took the world by surprise. Following the first outbreak of COVID-19 in December 2019, several models have been developed to study and understand its transmission dynamics. Although the spread of COVID-19 is being slowed down by vaccination and other interventions, there is still a need to have a clear understanding of the evolution of the pandemic across countries, states and communities. To this end, there is a need to have a clearer picture of the initial spread of the disease in different regions. In this project, we used a simple SEIR model and a Bayesian inference framework to estimate the basic reproduction number of COVID-19 across Africa. Our estimates vary between 1.98 (Sudan) and 9.66 (Mauritius), with a median of 3.67 (90% CrI: 3.31-4.12). The estimates provided in this paper will help to inform COVID-19 modeling in the respective countries/regions.
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Affiliation(s)
- Sarafa A. Iyaniwura
- Department of Mathematics and Institute of Applied Mathematics, University of British Columbia, Vancouver, BC, Canada
- * E-mail:
| | - Musa Rabiu
- School of Mathematics, Statistics & Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | - Jummy F. David
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
| | - Jude D. Kong
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), York University, Toronto, Ontario, Canada
- Laboratory for Applied and Industrial Mathematics (LIAM), York University, Toronto, Ontario, Canada
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Jacobs ED, Okeke MI. A critical evaluation of Nigeria's response to the first wave of COVID-19. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:44. [PMID: 35228791 PMCID: PMC8867460 DOI: 10.1186/s42269-022-00729-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The first wave of the Coronavirus Disease 2019 (COVID-19) pandemic began when the first index case was reported in Nigeria on the 27th of February 2020, and since then, more than 68,000 cases of the disease were confirmed, with 1173 deaths as of November 30, 2020. MAIN BODY Daily situation reports from the Nigeria Centre for Disease Control spanning February 27-November 30, 2020, were fully considered in this review. Further literature search was performed using PubMed and Google Scholar databases for articles related to response measures adopted by Nigeria. The instantaneous reproduction number (R) was then estimated as a metric to investigate the non-pharmaceutical intervention measures. Nigeria responded to COVID-19 pandemic by implementing anti-COVID-19 mitigation strategies in travel restrictions, social distancing, source control, contact tracing, self-isolation, and quarantine, as well as in clinical interventions. Our epidemiological model estimated the R-value of more than 1.0 in Nigeria and in each of all the 36 states and the Federal Capital Territory. CONCLUSION Nigeria implemented containment and mitigation measures in response to the first wave of COVID-19 and these measures may have contributed to the mild COVID-19 outcome in Nigeria compared to the global trend. However, inadequate PCR testing capacity, lack or suboptimal utilization of epidemic metrics like the virus reproduction number (R) to inform decision making, and premature easing of lockdown measures among others were major challenges to the effective implementation of the COVID-19 response measures.
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Affiliation(s)
| | - Malachy Ifeanyi Okeke
- Department of Natural and Environmental Sciences, Biomedical Science Concentration, American University of Nigeria, 98 Lamido Zubairu Way, PMB 2250, Yola, Adamawa State Nigeria
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Joy Okwor T, Gatua J, Umeokonkwo CD, Abah S, Ike IF, Ogunniyi A, Ipadeola O, Attah T, Assad H, Dooga J, Olayinka A, Abubakar J, Oladejo J, Aderinola O, Eneh C, Ilori E, Ibekwe P, Ochu C, Ihekweazu C. An assessment of infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic (February–May 2020). J Infect Prev 2022; 23:101-107. [PMID: 35502165 PMCID: PMC8872810 DOI: 10.1177/17571774211060418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/31/2021] [Indexed: 12/15/2022] Open
Abstract
Background Infection prevention and control (IPC) activities play a large role in preventing the
transmission of SARS-CoV-2 in healthcare settings. This study describes the state of IPC
preparedness within health facilities in Nigeria during the early phase of coronavirus
disease (COVID-19) pandemic. Methods We carried out a cross sectional study of health facilities across Nigeria using a
COVID-19 IPC checklist adapted from the U.S Centers for Disease Control and Prevention.
The IPC aspects assessed were the existence of IPC committee and teams with terms of
reference and workplans, IPC training, availability of personal protective equipment and
having systems in place for screening, isolation and notification of COVID-19 patients.
Existence of the assessed aspects was regarded as preparedness in that aspect. Results In total, 461 health facilities comprising, 350 (75.9%) private and 111 (24.1%) public
health facilities participated. Only 19 (4.1%) health facilities were COVID-19 treatment
centres with 68% of these being public health facilities. Public health facilities were
better prepared in the areas of IPC programme with 69.7% of them having an IPC focal
point versus 32.3% of private facilities. More public facilities (59.6%) had an IPC
workplan versus 26.8% of private facilities. Neither the public nor the private
facilities were adequately prepared for triaging, screening, and notifying suspected
cases, as well as having trained staff and equipment to implement triaging. Conclusions The results highlight the need for government, organisations and policymakers to
establish conducive IPC structures to reduce the risk of COVID-19 transmission in
healthcare settings.
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Affiliation(s)
| | - Josephine Gatua
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Overseas Development Institute, Abuja, Nigeria
| | - Chukwuma David Umeokonkwo
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Stephen Abah
- Department of Community Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | | | | | | | | | - Hassan Assad
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Jerome Dooga
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Chibuzo Eneh
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Chinwe Ochu
- Nigeria Centre for Disease Control, Abuja, Nigeria
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Folayan MO, Ibigbami O, ElTantawi M, Abeldaño GF, Ara E, Ayanore MA, Ellakany P, Gaffar B, Al-Khanati NM, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Osamika BE, Popoola BO, Quadri MFA, Roque M, Shamala A, Al-Tammemi AB, Yousaf MA, Virtanen JI, Zuñiga RAA, Okeibunor JC, Nguyen AL. Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study. BMC Psychiatry 2022; 22:48. [PMID: 35062920 PMCID: PMC8777174 DOI: 10.1186/s12888-021-03617-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria. .,Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, 22005, Nigeria.
| | - Olanrewaju Ibigbami
- grid.10824.3f0000 0001 2183 9444Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Maha ElTantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,School of Medicine, University of Sierra Sur, Oaxaca, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412997.00000 0001 2294 5433Government College for Women, Maulana Azad Road, Srinagar, J&K India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449729.50000 0004 7707 5975Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411975.f0000 0004 0607 035XDepartment of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.416197.c0000 0001 0247 1197Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Jazan University, Jazan, Saudi Arabia ,grid.5012.60000 0001 0481 6099Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Abeedah Tu-Allah Khan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XSchool of Biological Sciences, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.449469.20000 0004 0516 1006Regent’s University London, London, United Kingdom
| | - Ntombifuthi P. Nzimande
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9008.10000 0001 1016 9625Department of Economic and Social Geography, University of Szeged, Szeged, Hungary
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.259956.40000 0001 2195 6763Department of Psychology, Miami University Oxford, Ohio, USA
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.9582.60000 0004 1794 5983Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.411831.e0000 0004 0398 1027Department of Preventive Dental Sciences, Division of Dental Public Health, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mark Roque
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.412892.40000 0004 1754 9358Department of Maternity & Childhood Nursing, College of Nursing, Taibah University, Madinah, Kingdom of Saudi Arabia
| | - Anas Shamala
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.444917.b0000 0001 2182 316XDepartment of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Ala’a B. Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.7122.60000 0001 1088 8582Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary ,grid.7122.60000 0001 1088 8582Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.11173.350000 0001 0670 519XInstitute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590 Pakistan
| | - Jorma I. Virtanen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.1374.10000 0001 2097 1371Faculty of Medicine, University of Turku, Turku, Finland
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.463718.f0000 0004 0639 2906Research Development and Innovations, Assistant Regional Director Cluster, WHO Regional Office for Africa, Brazzaville, Congo
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria ,grid.42505.360000 0001 2156 6853Department of Family Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA USA
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Akande OW, Elimian KO, Igumbor E, Dunkwu L, Kaduru C, Olopha OO, Ohanu DO, Nwozor L, Agogo E, Aruna O, Balogun MS, Aderinola O, Ahumibe A, Arinze C, Badaru SO, Nwachukwu W, Dada AO, Erameh C, Hamza K, Mohammed TB, Ndodo N, Obiekea C, Ofoegbunam C, Ogunbode O, Ohonsi C, Tobin EA, Yashe R, Adekaiyaoja A, Asuzu MC, Audu RA, Bello MB, Bello SO, Deeni YY, Disu Y, Joseph G, Ezeokafor C, Habib ZG, Ibeh C, Ike IF, Iwara E, Luka-Lawal RK, Namara G, Okwor T, Olajide L, Ilesanmi OO, Omonigho S, Oyiri F, Takpa K, Ugbogulu NU, Ibekwe P, Oladejo J, Ilori E, Ochu CL, Ihekweazu C. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021. BMJ Glob Health 2021; 6:bmjgh-2021-007076. [PMID: 34794956 PMCID: PMC8602923 DOI: 10.1136/bmjgh-2021-007076] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.
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Affiliation(s)
- Oluwatosin Wuraola Akande
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria .,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Kelly Osezele Elimian
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Lauryn Dunkwu
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Chijioke Kaduru
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,IQVIA, Abuja, Nigeria
| | - Olubunmi Omowunmi Olopha
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Dabri Olohije Ohanu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Lilian Nwozor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Emmanuel Agogo
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Resolve to Save Lives, Abuja, Federal Capital Territory, Nigeria
| | - Olusola Aruna
- International Health Regulations (IHR) Strengthening Project, Global Operations, UK Health Security Agency, London, UK
| | | | - Olaolu Aderinola
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Anthony Ahumibe
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinedu Arinze
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Sikiru Olanrewaju Badaru
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - William Nwachukwu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | | | - Cyril Erameh
- Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Tarik Benjamin Mohammed
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Nnaemeka Ndodo
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Celestina Obiekea
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinenye Ofoegbunam
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oladipo Ogunbode
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Cornelius Ohonsi
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | | | - Rimamdeyati Yashe
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Afolabi Adekaiyaoja
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Michael C Asuzu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Rosemary Ajuma Audu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Muhammad Bashir Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Center for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Shaibu Oricha Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Pharmacology & Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Yusuf Yahaya Deeni
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology & Biotechnology, Federal University Dutse, Dutse, Jigawa State, Nigeria.,Centre for Environmental and Public Health Research and Development, Kano, Kano State, Nigeria
| | - Yahya Disu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Gbenga Joseph
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chidiebere Ezeokafor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria
| | - Zaiyad Garba Habib
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,University of Abuja Teaching Hospital, Gwagwalada, Abuja, Federal Capital Territory, Nigeria
| | - Christian Ibeh
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Emem Iwara
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Maryland Global Initiatives Corporation, Abuja, Federal Capital Territory, Nigeria
| | - Rejoice Kudirat Luka-Lawal
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Geoffrey Namara
- World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Tochi Okwor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Lois Olajide
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oluwafunke Olufemi Ilesanmi
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Solomon Omonigho
- Department of Microbiology, University of Benin, Benin, Edo State, Nigeria
| | - Ferdinand Oyiri
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Koubagnine Takpa
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Joint United Nations Programme on AIDS (UNAIDS), Abuja, Federal Capital Territory, Nigeria
| | - Nkem Usha Ugbogulu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Priscilla Ibekwe
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - John Oladejo
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Elsie Ilori
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinwe Lucia Ochu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Chikwe Ihekweazu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
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Kendall EA, Arinaminpathy N, Sacks JA, Manabe YC, Dittrich S, Schumacher SG, Dowdy DW. Antigen-based Rapid Diagnostic Testing or Alternatives for Diagnosis of Symptomatic COVID-19: A Simulation-based Net Benefit Analysis. Epidemiology 2021; 32:811-819. [PMID: 34292212 PMCID: PMC8478097 DOI: 10.1097/ede.0000000000001400] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND SARS-CoV-2 antigen-detection rapid diagnostic tests can diagnose COVID-19 rapidly and at low cost, but lower sensitivity compared with reverse-transcriptase polymerase chain reaction (PCR) has limited clinical adoption. METHODS We compared antigen testing, PCR testing, and clinical judgment alone for diagnosing symptomatic COVID-19 in an outpatient setting (10% COVID-19 prevalence among the patients tested, 3-day PCR turnaround) and a hospital setting (40% prevalence, 24-hour PCR turnaround). We simulated transmission from cases and contacts, and relationships between time, viral burden, transmission, and case detection. We compared diagnostic approaches using a measure of net benefit that incorporated both clinical and public health benefits and harms of the intervention. RESULTS In the outpatient setting, we estimated that using antigen testing instead of PCR to test 200 individuals could be equivalent to preventing all symptomatic transmission from one person with COVID-19 (one "transmission-equivalent"). In a hospital, net benefit analysis favored PCR and testing 25 patients with PCR instead of antigen testing achieved one transmission-equivalent of benefit. In both settings, antigen testing was preferable to PCR if PCR turnaround time exceeded 2 days. Both tests provided greater net benefit than management based on clinical judgment alone unless intervention carried minimal harm and was provided equally regardless of diagnostic approach. CONCLUSIONS For diagnosis of symptomatic COVID-19, we estimated that the speed of diagnosis with antigen testing is likely to outweigh its lower accuracy compared with PCR, wherever PCR turnaround time is 2 days or longer. This advantage may be even greater if antigen tests are also less expensive.
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Affiliation(s)
- Emily A. Kendall
- From the Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nimalan Arinaminpathy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jilian A. Sacks
- MRC Centre for Global Infectious Disease Analysis, Imperial College, London, United Kingdom
| | - Yukari C. Manabe
- From the Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sabine Dittrich
- MRC Centre for Global Infectious Disease Analysis, Imperial College, London, United Kingdom
| | - Samuel G. Schumacher
- MRC Centre for Global Infectious Disease Analysis, Imperial College, London, United Kingdom
| | - David W. Dowdy
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
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Abstract
In sub-Saharan Africa, most households in rural communities keep smallholder poultry, and are exposed to harsh socio-economic conditions caused by COVID-19 pandemic due to the vulnerability of their production systems to crisis. This study assessed the impact of COVID-19 on 525 smallholder poultry farmers in five states of Nigeria. The study was conducted 15 months after the onset of the pandemic in Nigeria using structured questionnaires focused on socio-demography, income, production systems, markets, and food security. Average household size increased from 6.9 before COVID-19, to 8.3 during COVID-19, representing a 20.3% increase in population growth. Over half (52.6%) of this increase was due to childbirths. Average monthly income before and during the pandemic was reduced from NGN 22,565 (USD 62.70) to NGN15,617 (USD 38.10), respectively. During the pandemic, there was a 28.4% increase in the number of farmers living below the international poverty line of USD 1.90 per day. In addition, reliance on chickens for food and income was significantly (p < 0.05) impacted by gender, location, household size, and monthly income. These results show that the COVID-19 pandemic had a significant effect on the livelihoods and food security of farmers, and the findings are essential in developing appropriate post-COVID-19 interventions for smallholder poultry production in Nigeria.
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Folayan MO, Ibigbami OI, Oloniniyi IO, Oginni O, Aloba O. Associations between psychological wellbeing, depression, general anxiety, perceived social support, tooth brushing frequency and oral ulcers among adults resident in Nigeria during the first wave of the COVID-19 pandemic. BMC Oral Health 2021; 21:520. [PMID: 34645423 PMCID: PMC8510883 DOI: 10.1186/s12903-021-01871-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 10/01/2021] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION The aims of this study were to determine the associations between psychological wellbeing, and the frequency of tooth brushing and presence of oral ulcers during the COVID-19 pandemic; and to identify the mediating roles of psychological distress (general anxiety and depression) and perceived social support in the paths of observed associations. METHODS This cross-sectional study recruited 996 adults in Nigeria between June and August 2020. Data collected through an online survey included outcome variables (decreased frequency of tooth brushing and presence of oral ulcers), explanatory variable (psychological wellbeing), mediators (general anxiety symptoms, depression symptoms and perceived social support) and confounders (age, sex at birth, educational and employment status). Multivariate logistic regression was used to determine the risk indicators for the outcome variables. A path analysis was conducted to identify the indirect effect of mediators on the association between the outcome and explanatory variables. RESULTS Of the 966 respondents, 96 (9.9%) reported decreased tooth-brushing frequency and 129 (13.4%) had oral ulcers during the pandemic. The odds of decreased tooth-brushing during the pandemic decreased as the psychological wellbeing increased (AOR: 0.87; 95% CI: 0.83-0.91; p < 0.001) and as generalized anxiety symptoms increased (AOR: 0.92; 95% CI: 0.86-0.98; p = 0.009). The odds of having an oral ulcer was higher as the generalized anxiety symptoms increased (AOR: 1.15; 95% CI: 01.08-1.21; p < 0.001). Only generalized anxiety (indirect effect: 0.02; 95% CI: 0.01-0.04; P = 0.014) significantly mediated the relationship between wellbeing and tooth-brushing accounting for approximately 12% of the total effect of wellbeing on decreased toothbrushing. Generalized anxiety (indirect effect 0.05; 95% CI: - 0.07-0.03; P < 0.001) also significantly mediated the relationship between wellbeing and presence of oral ulcer accounting for 70% of the total effect of wellbeing on presence of oral ulcer. Depressive symptoms and perceived social support did not significantly mediate the associations between psychological wellbeing, decreased frequency of tooth brushing and the presence of oral ulcers. CONCLUSION Patients who come into the dental clinic with poor oral hygiene or oral ulcers during the COVID-19 pandemic may benefit from screening for generalized anxiety and psychological wellbeing to identify those who will benefit from interventions for mental health challenges.
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Affiliation(s)
| | | | | | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olutayo Aloba
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
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43
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Adejumo OA, Ogunniyan T, Adesola S, Gordon I, Oluwadun OB, Oladokun OD, Abdulsalam IA, Falana AA, Anderson OS, Anumah A, Dawodu OT, Owuna HJ, Osoba EG, Disu AOA, Adetola AV, Oloniniyi NB, Fadoju PK, Ogunsanya AO, Osundaro OA, Bowale A. Clinical presentation of COVID-19-positive and -negative patients in Lagos Nigeria: A comparative study. Niger Postgrad Med J 2021; 28:75-80. [PMID: 34494591 DOI: 10.4103/npmj.npmj_547_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background A lot has been documented about the pathophysiology and clinical presentation of coronavirus disease 2019 (COVID-19). We compared the clinical features of real-time reverse transcriptase polymerase-chain-reaction (RT-PCR) confirmed COVID-19 positive and negative patients admitted in Lagos State. Methods Medical records of all patients admitted in 15 isolation centres across Lagos state between 27th February 2020 and 30th September 2020, were abstracted and reviewed. We compared the clinical features, co-morbidities and clinical outcomes of COVID-19 positive and negative patients. Results A total of 3157 records of patients admitted in 15 isolation centres in Lagos State were reviewed of which 302 (9.6%) tested negative to RT-PCR COVID-19. There was no gender difference between COVID-19 positive and negative patients (P = 0.687). The average age of the negative patients was higher (46.8 ± 18.3 years) than positive patients (41.9 ± 15.5 years) (P < 0.001). A higher proportion of the COVID-19 negative patients had co-morbidity (38.1% vs. 27.8%), were symptomatic (67.5% vs. 44.6%) and higher mortality (21.9% vs. 6.6%) than positive patients (P < 0.001). The percentages with hypertension (26.2% vs. 21.0%, P = 0.038), diabetes (17.2% vs. 9.4%, P < 0.001), cardiovascular disease (2.3% vs. 0.9%, P < 0.029) and cancer (2.3% vs. 0.5%, P < 0.002) were more among patients without COVID-19. More patients without COVID-19 presented with fever (36.1% vs. 18.8%), cough (33.7% vs. 23.1%) and breathlessness (40.8% vs. 16.1%) than the positive patients (P < 0.001). Conclusion Anosmia and dysgeusia were strongly associated with COVID-19. Clinical decision-making should only be used to prioritise testing and isolation of patients suspected to have COVID-19, especially in settings with limited access to diagnostic kits.
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Affiliation(s)
| | | | | | - Igbodo Gordon
- Nigeria Centre for Disease Control, Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
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44
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Adebisi YA, Rabe A, Lucero-Prisno Iii DE. Risk communication and community engagement strategies for COVID-19 in 13 African countries. Health Promot Perspect 2021; 11:137-147. [PMID: 34195037 PMCID: PMC8233683 DOI: 10.34172/hpp.2021.18] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) outbreak is a major threat facing health systems globally and African countries are not an exception. Stakeholders, governments, and national authorities have mounted responses to contain the pandemic. This study aimed to catalogue the risk communication and community engagement (RCCE) strategies as well as the challenges facing RCCE in 13 African countries. Methods: We conducted a narrative review of evidence to answer the aim of the study. The search was conducted in March 2021 and evidence published between December 2019 and February 2021 were included. Data reported in this article were obtained from reports, literature in peer-reviewed journals, grey literature and other data sources in 13 African countries. The 13 countries include Ethiopia, Ghana, Kenya, Algeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia. The authors also snowball further data to gather information for this review. Results: Most of the priority African countries have RCCE strategies to contain the transmission and spread of the coronavirus. Our findings revealed RCCE strategies in the 13 African countries focused on training and capacity building, risk communication systems, internal and partners’ coordination, community engagement, public communication, contending uncertainty, addressing misperceptions and managing misinformation. However, the RCCE response activities were not without challenges, which included distrust in government, cultural, social, and religious resistance, and inertia among others. Conclusion: With the similar RCCE approaches and interventions seen across the countries, it is clear that countries are learning from each other and from global health organizations to develop COVID-19 RCCE programs. It is important for African countries to address the challenges facing RCCE in order to effectively contain the pandemic and to prepare for future public health emergencies.
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Affiliation(s)
- Yusuff Adebayo Adebisi
- Global Health Focus, London, United Kingdom.,African Young Leaders for Global Health, Abuja, Nigeria.,Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Adrian Rabe
- Global Health Focus, London, United Kingdom.,Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Don Eliseo Lucero-Prisno Iii
- Global Health Focus, London, United Kingdom.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Abstract
COVID-19 pandemic has affected the world, including developing countries in various aspects. This pandemic might have severe consequences in terms of population health, especially in places where the health system is already weak. Using the health facility-level data over time, we evaluated the impact of COVID-19 lockdown on the vaccination service delivery in Nigeria. The lockdown was announced on March 30, 2020 and was effective until May 4, 2020. Compared to the quantity of vaccinations administered in March 2020, the quantity was significantly reduced during April 2020. The quantity was further reduced during May 2020. However, from June onwards, the quantity of vaccination administered has recovered. We observed that, although the lockdown reduced the quantity of vaccination administered significantly, it quickly recovered soon after the lockdown was relaxed.
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Affiliation(s)
- Ryoko Sato
- Center for Health Decision Science, Harvard T.H Chan School of Public Health, Boston, MA, USA
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46
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Qureshi S. Pandemics within the pandemic: confronting socio-economic inequities in a datafied world. INFORMATION TECHNOLOGY FOR DEVELOPMENT 2021. [DOI: 10.1080/02681102.2021.1911020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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47
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Abubakar I, Dalglish SL, Ihekweazu CA, Bolu O, Aliyu SH. Lessons from co-production of evidence and policy in Nigeria's COVID-19 response. BMJ Glob Health 2021; 6:e004793. [PMID: 33741561 PMCID: PMC7985933 DOI: 10.1136/bmjgh-2020-004793] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 01/08/2023] Open
Abstract
In February 2020, Nigeria faced a potentially catastrophic COVID-19 outbreak due to multiple introductions, high population density in urban slums, prevalence of other infectious diseases and poor health infrastructure. As in other countries, Nigerian policymakers had to make rapid and consequential decisions with limited understanding of transmission dynamics and the efficacy of available control measures. We present an account of the Nigerian COVID-19 response based on co-production of evidence between political decision-makers, health policymakers and academics from Nigerian and foreign institutions, an approach that allowed a multidisciplinary group to collaborate on issues arising in real time. Key aspects of the process were the central role of policymakers in determining priority areas and the coordination of multiple, sometime conflicting inputs from stakeholders to write briefing papers and inform effective national decision making. However, the co-production approach met with some challenges, including limited transparency, bureaucratic obstacles and an overly epidemiological focus on numbers of cases and deaths, arguably to the detriment of addressing social and economic effects of response measures. Larger systemic obstacles included a complex multitiered health system, fragmented decision-making structures and limited funding for implementation. Going forward, Nigeria should strengthen the integration of the national response within existing health decision bodies and implement strategies to mitigate the social and economic impact, particularly on the poorest Nigerians. The co-production of evidence examining the broader public health impact, with synthesis by multidisciplinary teams, is essential to meeting the social and public health challenges posed by the COVID-19 pandemic in Nigeria and other countries.
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Affiliation(s)
- Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Sarah L Dalglish
- Institute for Global Health, University College London, London, UK
| | - Chikwe A Ihekweazu
- Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Omotayo Bolu
- U.S. Centers for Disease Control and Prevention, Nigeria Country Office, Abuja, Nigeria
| | - Sani H Aliyu
- Nigerian Presidential Taskforce on COVID-19, Abuja, Nigeria
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48
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Nachega JB, Atteh R, Ihekweazu C, Sam-Agudu NA, Adejumo P, Nsanzimana S, Rwagasore E, Condo J, Paleker M, Mahomed H, Suleman F, Ario AR, Kiguli-Malwadde E, Omaswa FG, Sewankambo NK, Viboud C, Reid MJA, Zumla A, Kilmarx PH. Contact Tracing and the COVID-19 Response in Africa: Best Practices, Key Challenges, and Lessons Learned from Nigeria, Rwanda, South Africa, and Uganda. Am J Trop Med Hyg 2021; 104:1179-1187. [PMID: 33571138 PMCID: PMC8045625 DOI: 10.4269/ajtmh.21-0033] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/25/2021] [Indexed: 01/05/2023] Open
Abstract
Most African countries have recorded relatively lower COVID-19 burdens than Western countries. This has been attributed to early and strong political commitment and robust implementation of public health measures, such as nationwide lockdowns, travel restrictions, face mask wearing, testing, contact tracing, and isolation, along with community education and engagement. Other factors include the younger population age strata and hypothesized but yet-to-be confirmed partially protective cross-immunity from parasitic diseases and/or other circulating coronaviruses. However, the true burden may also be underestimated due to operational and resource issues for COVID-19 case identification and reporting. In this perspective article, we discuss selected best practices and challenges with COVID-19 contact tracing in Nigeria, Rwanda, South Africa, and Uganda. Best practices from these country case studies include sustained, multi-platform public communications; leveraging of technology innovations; applied public health expertise; deployment of community health workers; and robust community engagement. Challenges include an overwhelming workload of contact tracing and case detection for healthcare workers, misinformation and stigma, and poorly sustained adherence to isolation and quarantine. Important lessons learned include the need for decentralization of contact tracing to the lowest geographic levels of surveillance, rigorous use of data and technology to improve decision-making, and sustainment of both community sensitization and political commitment. Further research is needed to understand the role and importance of contact tracing in controlling community transmission dynamics in African countries, including among children. Also, implementation science will be critically needed to evaluate innovative, accessible, and cost-effective digital solutions to accommodate the contact tracing workload.
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Affiliation(s)
- Jean B Nachega
- 1Department of Medicine and Center for Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.,2Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,4Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Rhoda Atteh
- 5Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chikwe Ihekweazu
- 6Office of the Director-General, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Nadia A Sam-Agudu
- 7International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.,8Department of Pediatrics, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland.,9Department of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Prisca Adejumo
- 10Department of Nursing, University of Ibadan, Ibadan, Nigeria
| | | | - Edson Rwagasore
- 11Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda
| | - Jeanine Condo
- 12University of Rwanda, School of Public Health, Kigali, Rwanda.,13School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Masudah Paleker
- 14South African Department of Health, Western Cape Province, Cape Town, South Africa.,15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa
| | - Hassan Mahomed
- 14South African Department of Health, Western Cape Province, Cape Town, South Africa.,15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa
| | - Fatima Suleman
- 16Discipline of Pharmaceutical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Alex Riolexus Ario
- 17Uganda National Institute of Public Health, Ministry of Health, Kampala, Uganda
| | | | - Francis G Omaswa
- 18African Centre for Global Health and Social Transformation, Kampala, Uganda
| | - Nelson K Sewankambo
- 19Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Cecile Viboud
- 20Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Michael J A Reid
- 21University of California San Francisco, San Francisco, California
| | - Alimuddin Zumla
- 22Division of Infection and Immunity, University College London, London, United Kingdom.,23NIHR Biomedical Research Centre, University College London Hospitals, London, United Kingdom
| | - Peter H Kilmarx
- 20Fogarty International Center, National Institutes of Health, Bethesda, Maryland
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