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Wright KO, Fagbemi T, Omoera V, Johnson T, Aderibigbe AA, Baruwa B, Oludara F, Ogboye O, Imosemi D, Omololu O, Odugbemi B, Adeyemi O, Omosun A, Akinola I, Akinyinka M, Balogun M, Abe J, Sadiku B, Banke-Thomas A, Fabamwo AO. A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method. BMC Pregnancy Childbirth 2024; 24:314. [PMID: 38664731 PMCID: PMC11044405 DOI: 10.1186/s12884-024-06516-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/14/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria. METHODS A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee. RESULTS Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510]. CONCLUSION Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care.
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Affiliation(s)
- Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria.
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria.
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria.
| | - Temiloluwa Fagbemi
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
| | - Victoria Omoera
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Taiwo Johnson
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Adedayo Ayodele Aderibigbe
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Basit Baruwa
- Lagos Bureau of Statistics (LBS), Lagos, Nigeria
| | - Folashade Oludara
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Olusegun Ogboye
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | | | | | - Babatunde Odugbemi
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Oluwatoni Adeyemi
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Adenike Omosun
- Department of Planning, Research and Statistics, Lagos State Health Service Commission, Lagos, Nigeria
| | - Ibironke Akinola
- Department of Paediatrics and Child Health, LASUCOM, Lagos, Nigeria
| | - Modupe Akinyinka
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - John Abe
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | | | - Aduragbemi Banke-Thomas
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Femi-Adebayo T, Adeleke M, Adebayo B, Fadiya T, Popoola B, Ogundimu O, O. Adepoju F, Salawu A, Fisher O, Ogboye O, Zekeng L. Application of the UNAIDS Incidence Patterns Model to Determine the Distribution of New HIV Infection in Lagos State, Nigeria. J Int Assoc Provid AIDS Care 2024; 23:23259582241238653. [PMID: 38509798 PMCID: PMC10956134 DOI: 10.1177/23259582241238653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state. METHODS The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months. RESULTS The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections. CONCLUSION The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.
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Affiliation(s)
- Toriola Femi-Adebayo
- Department of Community Health & Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | | | - Bisola Adebayo
- Department of Community Health & Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
- Department of Community Health & Primary Health Care, Lagos State University College of Medicine, Ojo, Nigeria
| | - Temitope Fadiya
- The Joint United Nations Programme on HIV/AIDS, Ikoyi, Nigeria
| | - Bukola Popoola
- Department of Community Health & Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Opeyemi Ogundimu
- Department of Community Health & Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Funmilade O. Adepoju
- Department of Community Health & Primary Health Care, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Ayotomiwa Salawu
- Department of Public Health, University of Lagos, Lagos, Nigeria
| | | | | | - Leopold Zekeng
- The Joint United Nations Programme on HIV/AIDS, Ikoyi, Nigeria
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Omosun A, Abayomi A, Ogboye O, Lajide D, Oladele D, Popoola A, Banjo AA, Chugani B, Mabadeje B, Abdur-Razaak H, Wellington O, Andu L, Adepase A, Adesina F, Olonire O, Fetuga A, Onasanya O, Awosika F, Folarin-Williams O, Anya SE. Distribution of Cancer and Cancer Screening and Treatment Services in Lagos: A 10-Year Review of Hospital Records. JCO Glob Oncol 2022; 8:e2200107. [PMID: 36265096 PMCID: PMC9812459 DOI: 10.1200/go.22.00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE In Lagos State, Nigeria, the population distribution of cancers is poorly described because studies are conducted at a few tertiary hospitals. Therefore, this study aims to map all health facilities where cancer screening takes place and describe the cases of cancer screened for and treated. METHODS A cross-sectional survey to identify facilities involved in screening and management of cancers was performed followed by extraction of data on individual cases of cancer screened for and treated at these facilities from 2011 to 2020. All health care facilities in the state were visited, and the survey was performed using standardized national tools modified to capture additional information on cancer screening and treatment. Data analysis was performed using STATA version 14 and R version 3.6.3. RESULTS Cervical cancer was the commonest cancer, accounting for 55% of 2,420 cancers screened, followed by breast (41%), prostate (4%), and colorectal cancers (0.2%). Of the 7,682 cancers treated among Lagos residents, the top five were breast (45%), colorectal (8%), cervical (8%), prostate (5%), and ovarian (4%). The female:male ratio of cancer cases was 3:1. The peak age for cancer among females and males was in the 40- to 49-year age group and 60- to 69-year age group, respectively. The Ikorodu local government area had the highest rate of reported cancer per million population. CONCLUSION Cancer screening is poor with a significant gap in screening for breast cancer since it is the commonest cancer in the state. The findings indicate the urgent need for the establishment of organized screening programs for the predominant cancers in the state and the prioritization of cancer research that addresses key policy and program questions.
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Affiliation(s)
- Adenike Omosun
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria,Health Service Commission, Lagos Island, Lagos State, Nigeria,Adenike Omosun, MBBS, MPH, FMCPH, Health Service Commission, 1, Ganui Smith Street, Lagos Island, 100221, Lagos State, Nigeria; e-mail:
| | - Akin Abayomi
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | | | - Dayo Lajide
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - David Oladele
- Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Abiodun Popoola
- Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | | | - Bindiya Chugani
- Lakeshore Cancer Centre, Victoria Island, Lagos State, Nigeria
| | | | | | | | - Lateefah Andu
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Abiola Adepase
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Funke Adesina
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
| | - Olorunfemi Olonire
- Health Facility Monitoring and Accreditation Agency, Ikeja, Lagos State, Nigeria
| | - Adedoyin Fetuga
- Health Service Commission, Lagos Island, Lagos State, Nigeria
| | | | - Flora Awosika
- Lagos State Ministry of Health, Ikeja, Lagos State, Nigeria
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Ogun SA, Erinoso O, Aina OO, Ojo OI, Adejumo O, Adeniran A, Bowale A, Olaniyi CA, Adedoyin BM, Mutiu B, Saka B, Oshinaike O, Arabambi W, Adejumo F, Shuaib O, Salmon AO, Abdur-Razzaq H, Njokanma OF, Ojini O, Ogboye O, Lajide O, Wright KO, Osibogun A, Abayomi A. Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study. West Afr J Med 2022; 39:83-89. [PMID: 35167198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.
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Affiliation(s)
- S A Ogun
- Neurology Unit, Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - O Erinoso
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - O O Aina
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - O I Ojo
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - O Adejumo
- Mainland Hospital, Yaba, Lagos, Nigeria
| | - A Adeniran
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - A Bowale
- Mainland Hospital, Yaba, Lagos, Nigeria
| | - C A Olaniyi
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - B M Adedoyin
- National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria
| | - B Mutiu
- Lagos State Biobank, Nigeria
| | - B Saka
- Lagos State Biobank, Nigeria
| | - O Oshinaike
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - W Arabambi
- Neurology Unit, Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - F Adejumo
- Mainland Hospital, Yaba, Lagos, Nigeria
| | - O Shuaib
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - A O Salmon
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | | | - O F Njokanma
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - O Ojini
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - O Ogboye
- Lagos State Ministry of Health, Lagos, Nigeria
| | - O Lajide
- Lagos State Ministry of Health, Lagos, Nigeria
| | - K O Wright
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - A Osibogun
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - A Abayomi
- Lagos State Ministry of Health, Lagos, Nigeria
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Osikomaiya B, Erinoso O, Wright KO, Odusola AO, Thomas B, Adeyemi O, Bowale A, Adejumo O, Falana A, Abdus-Salam I, Ogboye O, Osibogun A, Abayomi A. 'Long COVID': persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria. BMC Infect Dis 2021; 21:304. [PMID: 33765941 PMCID: PMC7993075 DOI: 10.1186/s12879-020-05716-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coronavirus disease once thought to be a respiratory infection is now recognised as a multi-system disease affecting the respiratory, cardiovascular, gastrointestinal, neurological, immune, and hematopoietic systems. An emerging body of evidence suggests the persistence of COVID-19 symptoms of varying patterns among some survivors. This study aimed to describe persistent symptoms in COVID-19 survivors and investigate possible risk factors for these persistent symptoms. METHODS The study used a retrospective study design. The study population comprised of discharged COVID-19 patients. Demographic information, days since discharge, comorbidities, and persistent COVID-19 like symptoms were assessed in patients attending the COVID-19 outpatient clinic in Lagos State. Statistical analysis was done using STATA 15.0 software (StataCorp Texas) with significance placed at p-value < 0.05. RESULTS A total of 274 patients were enrolled in the study. A majority were within the age group > 35 to ≤49 years (38.3%), and male (66.1%). More than one-third (40.9%) had persistent COVID-19 symptoms after discharge, and 19.7% had more than three persistent COVID-like symptoms. The most persistent COVID-like symptoms experienced were easy fatigability (12.8%), headaches (12.8%), and chest pain (9.8%). Symptomatic COVID-19 disease with moderate severity compared to mild severity was a predictor of persistent COVID-like symptoms after discharge (p < 0.05). CONCLUSION Findings from this study suggests that patients who recovered from COVID-19 disease may still experience COVID-19 like symptoms, particularly fatigue and headaches. Therefore, careful monitoring should be in place after discharge to help mitigate the effects of these symptoms and improve the quality of life of COVID-19 survivors.
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Affiliation(s)
| | - Olufemi Erinoso
- Lagos State University Teaching Hospital, Lagos, Lagos State, Nigeria.
| | | | | | | | | | | | | | | | | | | | - Akin Osibogun
- College of Medicine, University of Lagos, Lagos, Nigeria
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Erinoso OA, Wright KO, Anya S, Bowale A, Adejumo O, Adesola S, Osikomaiya B, Mutiu B, Saka B, Falana A, Ola-Ayinde D, Akase EI, Owuna H, Abdur-Razzaq H, Lajide D, Ezechi O, Ogboye O, Osibogun A, Abayomi A. Clinical characteristics, predictors of symptomatic coronavirus disease 2019 and duration of hospitalisation in a cohort of 632 Patients in Lagos State, Nigeria. Niger Postgrad Med J 2020; 27:285-292. [PMID: 33154280 DOI: 10.4103/npmj.npmj_272_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still evolving. This study describes the clinical characteristics and investigates factors that predict symptomatic presentation and duration of hospitalisation in a cohort of coronavirus disease 2019 (COVID-19) patients managed in Lagos, Nigeria. METHODOLOGY This was a retrospective assessment of patients hospitalised with COVID-19 disease in six dedicated facilities in Lagos, Nigeria, between April 1st and May 31st 2020. Participants were individuals with laboratory-confirmed SARS-CoV-2 infection. The outcome measures were presence of symptoms and duration of hospitalisation. Demographic and comorbidity data were also obtained. Statistical analysis was done using STATA 15.0 software, with P < 0.05 being considered statistically significant. RESULTS A total of 632 cases were analysed. The median age was 40 years (IQR: 30.5-49); male patients accounted for 60.1%. About 63% of patients were asymptomatic at presentation. Among the symptomatic, the most common symptoms were cough (47.4%) and fever (39.7%). The most common comorbidities were hypertension (16.8%) and diabetes (5.2%). The median duration of hospitalisation was 10 days (IQR: 8-14). Comorbidities increased the odds of presenting with symptoms 1.6-fold (P = 0.025) for one comorbidity and 3.2-fold (P = 0.005) for ≥2 comorbidities. Individuals aged ≥50 years were twice as likely to be hospitalised for more than 14 days compared to individuals aged <50 years (P = 0.016). CONCLUSION Most individuals had no symptoms with comorbidities increasing the likelihood of symptoms. Older age was associated with longer duration of hospitalisation. Age and comorbidities should be used for COVID-19 triaging for efficient resource allocation.
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Affiliation(s)
- Olufemi A Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Lagos State, Lagos, Nigeria
| | - Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital, Lagos State, Lagos, Nigeria
| | - Samuel Anya
- Research Unit, Directorate of Health Planning Research and Statistics Lagos State Ministry of Health, Lagos State, Lagos, Nigeria
| | - Abimbola Bowale
- Infectious Disease Unit, Mainland Hospital, Lagos State, Lagos, Nigeria
| | - Olusola Adejumo
- Research Unit, Directorate of Health Planning Research and Statistics Lagos State Ministry of Health, Lagos State, Lagos, Nigeria
| | - Sunday Adesola
- Infectious Disease Unit, Mainland Hospital, Lagos State, Lagos, Nigeria
| | | | - Bamidele Mutiu
- Lagos State Bio-Security Laboratory, Mainland Hospital Yaba, Lagos State, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Bio-Security Laboratory, Mainland Hospital Yaba, Lagos State, Lagos, Nigeria
| | - Ayodeji Falana
- Infectious Disease Unit, Mainland Hospital, Lagos State, Lagos, Nigeria
| | - Disu Ola-Ayinde
- Infectious Disease Unit, Mainland Hospital, Lagos State, Lagos, Nigeria
| | - Ephraim I Akase
- Department of Medicine, Infectious Disease Unit, Lagos University Teaching Hospital, Lagos State, Lagos, Nigeria
| | - Henry Owuna
- Infectious Disease Unit, Mainland Hospital, Lagos State, Lagos, Nigeria
| | - Hussein Abdur-Razzaq
- Research Unit, Directorate of Health Planning Research and Statistics Lagos State Ministry of Health, Lagos State, Lagos, Nigeria
| | - Dayo Lajide
- Research Unit, Directorate of Health Planning Research and Statistics Lagos State Ministry of Health, Lagos State, Lagos, Nigeria
| | - Oliver Ezechi
- Directorate of Research, Institute of Medical Research, Lagos State, Lagos, Nigeria
| | | | - Akin Osibogun
- Department of Community and Primary Health, College of Medicine, University of Lagos, Lagos, Nigeria
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