Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Implications for the Future

The introduction of effective vaccines in December 2020 marked a significant step forward in the global response to COVID-19. Given concerns with access, acceptability, and hesitancy across Africa, there is a need to describe the current status of vaccine uptake in the continent. An exploratory study was undertaken to investigate these aspects, current challenges, and lessons learnt across Africa to provide future direction. Senior personnel across 14 African countries completed a self-administered questionnaire, with a descriptive analysis of the data. Vaccine roll-out commenced in March 2021 in most countries. COVID-19 vaccination coverage varied from low in Cameroon and Tanzania and up to 39.85% full coverage in Botswana at the end of 2021; that is, all doses advocated by initial protocols versus the total population, with rates increasing to 58.4% in Botswana by the end of June 2022. The greatest increase in people being fully vaccinated was observed in Uganda (20.4% increase), Botswana (18.5% increase), and Zambia (17.9% increase). Most vaccines were obtained through WHO-COVAX agreements. Initially, vaccination was prioritised for healthcare workers (HCWs), the elderly, adults with co-morbidities, and other at-risk groups, with countries now commencing vaccination among children and administering booster doses. Challenges included irregular supply and considerable hesitancy arising from misinformation fuelled by social media activities. Overall, there was fair to reasonable access to vaccination across countries, enhanced by government initiatives. Vaccine hesitancy must be addressed with context-specific interventions, including proactive programmes among HCWs, medical journalists, and the public.

From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria

BACKGROUND

Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response.

DISCUSSION

Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment.

CONCLUSION

Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.

HIV/AIDS-Related Knowledge, Attitudes and Uptake of HIV Testing Services:A Comparative Study of Male and Female Secondary School Students in Lagos, Nigeria

BACKGROUND

Knowledge of HIV/AIDS and use of HIV Testing Services in Nigeria is still far from optimal. Good HIV/AIDS-related knowledge and attitudes are important in prevention. The aim of this study was to assess and compare HIV/AIDS knowledge, attitudes and the uptake of HIV Testing Services between male and female senior secondary school students in Lagos, Nigeria.

METHODS

Using multistage sampling, 543 (50.3% male, 49.7 % female) participants were selected in a comparative cross-sectional study carried out in six senior secondary schools in Alimosho LGA, Lagos. Data was collected using a pre-tested, self-administered questionnaire and analyzed using SPSS- 20, p<0.05 was considered significant.

RESULTS

Participants' level of knowledge of HIV/AIDS was good (86.4% male, 86.3% female), the difference was not statistically significant. The main source of HIV/AIDS information was their teachers (male - 53.6%, female - 49.3%). Attitudes were positive (99.3% males, 98.1% females). However, the uptake of HIV testing was low (27.8% male, 24.1% female). Only 41.8% of males and 34.1% of females knew where HIV Testing Services were offered. The uptake of HIV testing showed a significant association, for the males, with family structure (p=0.034), confiding in their fathers (p=0.039) and religion (p=0.044), and for the females, mothers' level of education (p=0.036), number of siblings (p=0.044) and alcohol use (p=0.006).

CONCLUSION

In both groups, knowledge and attitude were optimal, however. the uptake of HIV testing was low due to poor access. Teaching about HIV/AIDS in schools should be sustained, but to improve the use of HIV Testing Services, stronger families are encouraged, though providing more HIV testing centers, especially Youth Friendly Centers should be considered.