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Riera J, Barbeta E, Tormos A, Mellado-Artigas R, Ceccato A, Motos A, Fernández-Barat L, Ferrer R, García-Gasulla D, Peñuelas O, Lorente JÁ, Menéndez R, Roca O, Palomeque A, Ferrando C, Solé-Violán J, Novo M, Boado MV, Tamayo L, Estella Á, Galban C, Trenado J, Huerta A, Loza A, Aguilera L, García Garmendia JL, Barberà C, Gumucio V, Socias L, Franco N, Valdivia LJ, Vidal P, Sagredo V, Ruiz-García ÁL, Martínez Varela I, López J, Pozo JC, Nieto M, Gómez JM, Blandino A, Valledor M, Bustamante-Munguira E, Sánchez-Miralles Á, Peñasco Y, Barberán J, Ubeda A, Amaya-Villar R, Martín MC, Jorge R, Caballero J, Marin J, Añón JM, Suárez Sipmann F, Albaiceta GM, Castellanos-Ortega Á, Adell-Serrano B, Catalán M, Martínez de la Gándara A, Ricart P, Carbajales C, Rodríguez A, Díaz E, de la Torre MC, Gallego E, Cantón-Bulnes L, Carbonell N, González J, de Gonzalo-Calvo D, Barbé F, Torres A. Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic: a matched analysis. Eur Respir J 2023; 61:13993003.01426-2022. [PMID: 36396142 PMCID: PMC9686319 DOI: 10.1183/13993003.01426-2022] [Citation(s) in RCA: 1] [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: 07/22/2022] [Accepted: 10/05/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with coronavirus disease 2019 (COVID-19)-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior noninvasive respiratory support on outcomes. METHODS This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICUs) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of ICU admission. Propensity score matching was used to achieve a balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different time-point (48 h from ICU admission) for early and delayed intubation. RESULTS Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After propensity score matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%; p=0.01), ICU mortality (25.7% versus 36.1%; p=0.007) and 90-day mortality (30.9% versus 40.2%; p=0.02) compared with the early intubation group. Very similar findings were observed when we used a 48-h time-point for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth waves, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (HFNC) (n=294) who were intubated earlier. The subgroup of patients undergoing noninvasive ventilation (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. CONCLUSIONS In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received HFNC.
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Affiliation(s)
- Jordi Riera
- Critical Care Department, Hospital Universitari Vall d'Hebron, SODIR, Vall d'Hebron Institut de Recerca, Barcelona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- These authors contributed equally to this work
| | - Enric Barbeta
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Surgical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- These authors contributed equally to this work
| | - Adrián Tormos
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Ricard Mellado-Artigas
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Surgical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Adrián Ceccato
- Critical Care Center, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
- Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
| | - Anna Motos
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
| | - Laia Fernández-Barat
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
| | - Ricard Ferrer
- Critical Care Department, Hospital Universitari Vall d'Hebron, SODIR, Vall d'Hebron Institut de Recerca, Barcelona, Spain
| | | | - Oscar Peñuelas
- Hospital Universitario de Getafe, Universidad Europea, Madrid, Spain
| | | | - Rosario Menéndez
- Pneumology Department, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain
| | - Oriol Roca
- Critical Care Department, Hospital Universitari Vall d'Hebron, SODIR, Vall d'Hebron Institut de Recerca, Barcelona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea Palomeque
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Respiratory Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carlos Ferrando
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Surgical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Solé-Violán
- Critical Care Department, Hospital Dr Negrín Gran Canaria, Universidad Fernando Pessoa, Las Palmas, Spain
| | - Mariana Novo
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | | | - Luis Tamayo
- Critical Care Department, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Ángel Estella
- Departamento Medicina, Facultad Medicina, Universidad de Cádiz, Hospital Universitario de Jerez, Jerez de la Frontera, Spain
| | - Cristóbal Galban
- Department of Medicine, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Josep Trenado
- Servicio de Medicina Intensiva, Hospital Universitario Mútua de Terrassa, Terrassa, Spain
| | - Arturo Huerta
- Pulmonary and Critical Care Division, Emergency Department, Clínica Sagrada Família, Barcelona, Spain
| | - Ana Loza
- Hospital Virgen de Valme, Sevilla, Spain
| | | | | | | | - Víctor Gumucio
- Department of Intensive Care, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lorenzo Socias
- Intensive Care Unit, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | | | | | - Pablo Vidal
- Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Ángela Leonor Ruiz-García
- Servicio de Microbiología Clínica, Hospital Universitario Príncipe de Asturias, Departamento de Biomedicina y Biotecnología, Universidad de Alcalá de Henares, Madrid, Spain
| | | | - Juan López
- Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - Juan Carlos Pozo
- UGC-Medicina Intensiva, Hospital Universitario Reina Sofia, Instituto Maimonides IMIBIC, Córdoba, Spain
| | - Maite Nieto
- Hospital Universitario de Segovia, Segovia, Spain
| | - José M Gómez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Aaron Blandino
- Servicio de Medicina Intensiva, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - Ángel Sánchez-Miralles
- Servicio de Medicina Intensiva, Hospital Universitario Sant Joan d'Alacant, Alicante, Spain
| | - Yhivian Peñasco
- Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - José Barberán
- Hospital Universitario HM Montepríncipe, Universidad San Pablo-CEU, Madrid, Spain
| | - Alejandro Ubeda
- Servicio de Medicina Intensiva, Hospital Punta de Europa, Algeciras, Spain
| | - Rosario Amaya-Villar
- Intensive Care Clinical Unit, Hospital Universitario Virgen de Rocío, Sevilla, Spain
| | - María Cruz Martín
- Hospital Universitario Torrejón, Universidad Francisco de Vitoria, Madrid, Spain
| | - Ruth Jorge
- Intensive Care Department, Hospital Nuestra Señora de Gracia, Zaragoza, Spain
| | - Jesús Caballero
- Critical Care Department, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain
| | - Judith Marin
- Critical Care Department, Hospital del Mar-IMIM, Barcelona, Spain
| | | | | | - Guillermo M Albaiceta
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Biología Funcional, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Hospital Central de Asturias, Oviedo, Spain
| | | | | | - Mercedes Catalán
- Department of Intensive Care Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Pilar Ricart
- Servei de Medicina Intensiva, Hospital Universitari Germans Trias, Badalona, Spain
| | | | | | - Emili Díaz
- Critical Care Center, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
- Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
| | | | - Elena Gallego
- Unidad de Cuidados Intensivos, Hospital Universitario San Pedro de Alcántara, Cáceres, Spain
| | | | - Nieves Carbonell
- Intensive Care Unit, Hospital Clínico y Universitario de Valencia, Valencia, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, Respiratory Department, Hospital Universitari Aranu de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - David de Gonzalo-Calvo
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Translational Research in Respiratory Medicine, Respiratory Department, Hospital Universitari Aranu de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Ferran Barbé
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Translational Research in Respiratory Medicine, Respiratory Department, Hospital Universitari Aranu de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Antoni Torres
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Respiratory Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
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Adekanmbi O, Alao A, Ibisola B, Odekunle I. A Comparative Analysis of Laboratory Parameters of Hospitalized COVID-19 Patients by Disease Severity and Mortality at a Facility in Ibadan, Nigeria. Niger Med J 2023; 64:243-250. [PMID: 38898975 PMCID: PMC11185805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background COVID-19, which is caused by the SARS-CoV-2 virus, is associated with abnormalities of biochemical parameters. There are indications that some of these biochemical parameters can differ according to the severity of the disease and the outcome of the infection. This study describes and compares laboratory findings among COVID-19 patients hospitalized at a facility in Southwestern Nigeria according to disease severity and mortality. Methodology Records of 223 patients with COVID-19 disease admitted between March 2020 and May 2021 were retrospectively collected. Socio-demographic characteristics, laboratory parameters, and patient outcomes were obtained. Patients were classified according to COVID-19 severity. Laboratory parameters were compared between patients with severe and non-severe disease and between survivors and non-survivors. Results Of the 215 patients with some laboratory data included in the analysis, there were 133 (62%) males, and 56.7% were aged above 60 years. A total of 71.6% had severe COVID-19 and 48.4% died during hospitalization. The severe disease occurred significantly more frequently among non-survivors (P0.01). Higher leukocyte and neutrophil counts, urea levels, D-Dimer, and fasting blood glucose levels occurred significantly more frequently in both severe disease and mortality categories. Additionally, elevated GGT and CRP were significantly more common in those with severe than non-severe disease while lower hemoglobin, hematocrit, albumin, and higher creatinine levels were significantly more common in non-survivors. Conclusion Our study found that certain readily obtainable biochemical parameters occur more frequently with severe disease and/or mortality amongst patients hospitalized with COVID-19 in sub-Saharan Africa and might be useful for prognostication and allocation of resources.
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Affiliation(s)
- Olukemi Adekanmbi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adegboyega Alao
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Babalola Ibisola
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Idowu Odekunle
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
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Joe-Ikechebelu NN, Umeh UM, Eleje GU, Igbodike EP, Ogbuefi EO, Akanwa AO, Echendu ST, Ngene WO, Okpala AN, Okolo OC, Okechukwu CE, Akabuike JC, Agu HO, Okpala VO, Nwazor OC, Nnedum AOU, Esimone CC, Agwaniru HN, Ezeabasili EI, Joe-Ikechebelu BB. Acceptability rate and barriers to COVID-19 vaccination among healthcare workers in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Amaku-Awka, Nigeria. Ther Adv Infect Dis 2023; 10:20499361231174776. [PMID: 37954403 PMCID: PMC10637133 DOI: 10.1177/20499361231174776] [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: 06/24/2022] [Accepted: 04/21/2023] [Indexed: 11/14/2023] Open
Abstract
Background Healthcare workers were at the forefront of the COVID-19 pandemic. The acceptability and uptake of COVID-19 vaccines among healthcare workers was an important strategy in halting the spread of the virus as well as the antecedent implications on global health and the world economy. Objectives This study aims to determine the acceptability rate and barriers to COVID-19 vaccination of frontline healthcare workers in Awka, Nigeria. Design This is an analytical cross-sectional study. Methods An online cross-sectional survey was conducted from February 2022 to April 2022 to obtain the data for this study. One hundred healthcare workers were studied. Acceptability rate and barriers to uptake of COVID-19 vaccination were outcome measures. Results The COVID-19 vaccination rate was 45.0% among healthcare workers in study area of Awka metropolis. Ages 30-39 years had the highest acceptance rate of COVID-19 vaccination, 19 (47.5%; p = 0.262) with a more female preponderance of COVID-19 vaccine acceptance compared to males [26 (41.3%) vs 16 (42.2%), p = 0.721]. The place of residence of respondents (urban vs rural) and their marital status (married vs single) appeared not to influence the acceptance of COVID-19 vaccination [(38 (42.2%) vs 3 (33.3%); p = 0.667; 25 (36.8% vs 17 (54.8%); p = 0.433)]. Years of work experience (<10 years vs >10 years) significantly affected COVID-19 vaccine acceptance [27 (45.8%) vs 12 (52.2%); p = 0.029]. Educational status and monthly income appeared not to influence vaccine uptake (p > 0.05, for both). A significant number of respondents were not sure why they should or should not take the COVID-19 vaccine [49 (92.5%) vs 35 (83.3%); p = 0.001]. Conclusion The COVID-19 vaccination rate is still poor among healthcare workers in Awka metropolis. The majority of respondents do not know why they should or should not take COVID-19 vaccine. We therefore recommend robust awareness campaigns that will explain in clear terms the essence and efficacy of COVID-19 vaccination in order to improve vaccine acceptance.
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Affiliation(s)
- Ngozi Nneka Joe-Ikechebelu
- Department of Community Medicine and Primary Health Care, Chukwuemeka Odumegwu Ojukwu University, Amaku-Awka, Anambra State 420110, Nigeria
| | - Uche Marian Umeh
- Department of Community Medicine and Primary Health Care, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
| | - George Uchenna Eleje
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Emeka Philip Igbodike
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria
- Evercare Hospital, Lagos, Nigeria
| | - Emmanuel Okwudili Ogbuefi
- Department of Parasitology and Entomology, Faculty of Biosciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Angela Oyilieze Akanwa
- Department of Environmental Management, Faculty of Environmental Sciences, Chukwuemeka Odumegwu Ojukwu University, Uli, Nigeria
| | | | | | - Augusta Nkiruka Okpala
- Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | | | | | | | - Helen Obioma Agu
- Department of Food Science and Technology, Nnamdi Azikiwe University, Awka, Nigeria
| | | | - Onyinye Chinenye Nwazor
- Department of Community Medicine and Primary Health Care, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
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Kwaghe VG, Habib ZG, Akor AA, Thairu Y, Bawa A, Adebayo FO, Kwaghe AV, Usman G, Idoko G, Oluseugun A, Ekele BA. Clinical characteristics and outcome of the first 200 patients hospitalized with coronavirus disease-2019 at a treatment center in Abuja, Nigeria: a retrospective study. Pan Afr Med J 2022; 41:118. [PMID: 35465381 PMCID: PMC8994461 DOI: 10.11604/pamj.2022.41.118.26594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/29/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION globally, the ravaging effect of the coronavirus disease-2019 (COVID-19), pandemic is evident on public health and the global economy. We aimed at describing the clinical characteristic and management outcome of COVID-19 patients in Abuja, Nigeria. METHODS we conducted a retrospective study by reviewing the hospital charts of the first 200 COVID-19 patients admitted at the isolation center, University of Abuja Teaching Hospital (UATH), Gwagwalada. Extracted data includes; demographic data, clinical symptoms, underlying comorbidities, and clinical outcomes. The outcome of interest was either discharged or died. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. RESULTS the median age was 45 years (range 2-84 years). Majority of the patients were males (66.5%). The most affected age group was 50-59 years (21%). Children and adolescents were least affected; less than 10 years constituted 2.5% and 10-19 years constituted 4.5%. The commonest symptoms at presentation were fever (94%) and cough (92%). Ninety-four patients (47%) had underlying comorbidities; the commonest was hypertension (36%). Based on disease severity; 126 (63%) had mild disease, 22 (11%) had moderate disease and 52 (26%) had severe disease. The commonest complication was Acute Respiratory Distress Syndrome (ARDS) seen in 29 (14.5%) patients. Out of the 200 cases managed, 189 (94.5%) were discharged in a stable condition while 11 (5.5%) died. Patients with under lying comorbidities had 9.6% death rate while those without comorbidities had 1.9% death rate. CONCLUSION among Nigerian patients', COVID-19 affects males more than females while children and adolescents were least affected. The study highlighted the clinical features of COVID-19 patients. The overall mortality rate is low among Nigerian patients compared to patients in the USA and Europe. This study shows that advanced age, presence of underlying comorbidities and disease severity is associated with the risk of dying from COVID-19.
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Affiliation(s)
- Vivian Gga Kwaghe
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria,,Corresponding author: Vivian Gga Kwaghe, Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.
| | - Zaiyad Garba Habib
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Alexander Agada Akor
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Yunusa Thairu
- Department of Microbiology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Anthony Bawa
- Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Francis Olayemi Adebayo
- Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Ayi Vandi Kwaghe
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja,,Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
| | - Galadima Usman
- Department of Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Godwin Idoko
- Department of Anaesthesia, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Akintola Oluseugun
- Department of Anaesthesia, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - Bissallah Ahmed Ekele
- Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
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Eze UA, Ndoh KI, Ibisola BA, Onwuliri CD, Osiyemi A, Ude N, Chime AA, Ogbor EO, Alao AO, Abdullahi A. Determinants for Acceptance of COVID-19 Vaccine in Nigeria. Cureus 2021; 13:e19801. [PMID: 34963828 PMCID: PMC8695669 DOI: 10.7759/cureus.19801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic heralded an unprecedented race to the development of several vaccine candidates at record speeds never seen in global health. Within nine months, Pfizer-BioNTech’s COVID-19 vaccine was approved by the United States FDA. Unfortunately, while these advances were ongoing, there was a burgeoning epidemic of disinformation about the virus and the vaccines that affected the willingness of people, especially minority groups, to get vaccinated. In Nigeria, this wave of vaccine hesitancy was happening against the backdrop of landmark pharmaceutical litigations such as the 2007 Pfizer trovafloxacin lawsuit in the country. Aim: To assess the determinants of the COVID-19 vaccine's acceptability among Nigerians. Materials and methods: Following ethical approval, a population-based cross-sectional study was conducted from November 2020 to January 2021 using an adapted pretested, self-administered questionnaire originally designed by Amyn Malik and colleagues who conducted a similar study at Yale University School of Public Health. The participants were recruited through simple random sampling using a list of community and corporate sites obtained from Google Maps in the three regional zones of Nigeria (north, east, and west) in diverse occupational and residential settings. Information obtained includes socio-demographics, medical history related to COVID-19, level of knowledge, risk perception, and attitudes toward COVID-19 and the vaccines. Descriptive and inferential statistics were done, and results were summarized into percentages and associations. The level of statistical significance was set at a p-value of <0.05. Using the open EpiR package (Emory), we determined a minimum of 340 participants for a statistical power of 80%. Results: A total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions, of which 189 (53%) were females. The mean age of respondents was 32 years (±11.2 SD). About 75% of the participants had at least a college education. The majority (66.2%) of the participants were willing to accept the approved vaccine. The mean risk perception score for COVID-19 was 5.1 (±2.2 SD) out of 10, while the mean COVID-19 symptom knowledge score was 8.6 (±4.1 SD) out of 19. Variables such as being male, identifying as Christian, Hausa ethnicity, and living in northern Nigeria had a statistically significant relationship with the willingness to get vaccinated. Conclusion: Over 60% of Nigerians are willing to take the COVID-19 vaccines if recommended by health workers. We found male gender, religion, ethnicity, and geographical location to positively influence the willingness of Nigerians to get vaccinated against COVID-19. Health workers should be supported to go beyond the confines of the hospital to educate the general public in schools, marketplaces, churches, and corporate organizations on the efficacy and safety of the approved vaccines.
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Affiliation(s)
- Ugochukwu A Eze
- Department of Ophthalmology, Federal Medical Centre, Asaba, NGA.,Department of Public Health, University of Suffolk, Ipswich, GBR.,Health Economics Program, Department of Economics, Kaduna State University, Kaduna, NGA
| | - Kingsley I Ndoh
- Department of Global Health, University of Washington, Seattle, USA
| | | | - Chinemerem D Onwuliri
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Adenekan Osiyemi
- Department of Family Medicine, University College Hospital, Ibadan, NGA
| | - Nnamdi Ude
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Amalachukwu A Chime
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Eric O Ogbor
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, NGA
| | - Adegboyega O Alao
- Department of Family Medicine, University College Hospital, Ibadan, NGA
| | - Ashiru Abdullahi
- Department of Ophthalmology, Federal Medical Centre, Katsina, NGA
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Onaolapo A, Onaolapo O. COVID-19, the Brain, and the Future: Is Infection by the Novel Coronavirus a Harbinger of Neurodegeneration? CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2021; 21:818-829. [PMID: 34951374 DOI: 10.2174/1871527321666211222162811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/07/2021] [Accepted: 10/28/2021] [Indexed: 12/12/2022]
Abstract
The possible impact of viral infections on the development or pathogenesis of neurodegenerative disorders remains largely unknown. However, there have been reports associating the influenza virus pandemic and long-term infection with the Japanese encephalitis virus with the development of post-encephalitic Parkinsonism or von Economo encephalitis. In the last one year plus, there has been a worldwide pandemic arising from infection with the novel coronavirus or severe acute respiratory syndrome coronavirus (SARS-CoV)-2 which causes a severe acute respiratory syndrome that has become associated with central nervous system symptoms or complications. Its possible central nervous system involvement is in line with emerging scientific evidence which shows that the human respiratory coronaviruses can enter the brain, infect neural cells, persist in the brain, and cause activation of myelin-reactive T cells. Currently, there is a dearth of scientific information on the acute or possible long-term impact of infection with SARS-CoV-2 on the development of dementias and/or neurodegenerative diseases. This is not unrelated to the fact that the virus is 'new', and its effects on humans are still being studied. This narrative review examines extant literature for the impact of corona virus infections on the brain; as it considers the possibility that coronavirus disease 2019 (COVID-19) could increase the risk for the development of neurodegenerative diseases or hasten their progression.
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Affiliation(s)
- Adejoke Onaolapo
- Behavioural Neuroscience Unit, Neurobiology Subdivision Department of Anatomy, Ladoke Akintola University of Technology, Ogbomosho, Oyo State. Nigeria
| | - Olakunle Onaolapo
- Behavioural Neuroscience Unit, Neuropharmacology Subdivision, Department of Pharmacology, Ladoke Akintola University of Technology, Ogbomosho, Oyo State. Nigeria
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Lasisi GT, Duro-Emanuel AO, Akintomide TE, Ologunja JO, Amah OE. Cardiac manifestation of corona virus disease 2019: a preliminary report. Cardiovasc J Afr 2021; 32:297-300. [PMID: 33506856 PMCID: PMC8756045 DOI: 10.5830/cvja-2020-061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/04/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Corona virus disease 2019 (COVID-19) is a multi-systemic illness that can present with cardiac complications. This report describes the preliminary findings of cardiac manifestations seen in patients managed in three centres in Lagos, Nigeria. METHODS Ten patients, part of an ongoing study of patients admitted in three centres in Lagos, Nigeria, with COVID-19 diagnosed with reverse transcriptase polymerase chain reaction (RT-PCR) or serology were retrospectively studied for cardiac manifestations. RESULTS The mean (SD) age was 52.5 ± 18.79 years (with a minimum of 17 years and maximum of 79 years). Six patients were female and four were male. Hypertension was seen in 70%, diabetes in 50% and obesity in 60% of patients. All had elevated inflammatory markers. Only four patients had bilateral pneumonia. The rest had only cardiac manifestations. Six patients presented with de novo heart failure and one had decompensated heart failure. A set of three patients had individually fulminant myocarditis, probable pulmonary embolism and stress cardiomyopathy, respectively. CONCLUSIONS This study shows that co-morbidities are common in patients with COVID-19 and cardiac complications. The array of cardiac complications is large, with the commonest being heart failure.
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Affiliation(s)
- G T Lasisi
- Department of Medicine, General Hospital Ifako-Ijaiye, Lagos, Nigeria.
| | - A O Duro-Emanuel
- Department of Medicine, General Hospital Ifako-Ijaiye, Lagos, Nigeria
| | - T E Akintomide
- Department of Radiology, General Hospital Ifako-Ijaiye, Lagos, Nigeria
| | - J O Ologunja
- TAAL Specialist Hospital, Wemabod Estate, Ikeja Lagos, Nigeria
| | - O E Amah
- 661 Nigerian Air Force Hospital, Ikeja Lagos, Nigeria
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Akerele IO, Oreh AC, Kawu MB, Ahmadu A, Okechukwu JN, Mbo DN, John DJ, Habib F, Ashikeni MA. Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34797115 PMCID: PMC8603147 DOI: 10.4102/phcfm.v13i1.2940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes. AIM This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja. SETTING The study was conducted in Abuja, the Federal Capital Territory, Nigeria. METHODS This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation. RESULTS Patients' median age was 39.3 years (interquartile range [IQR]: 26-52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5-19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%. CONCLUSION Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.
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Affiliation(s)
- Isaac O Akerele
- Department of Family Medicine, Asokoro District Hospital COVID-19 Isolation and Treatment Centre, Federal Capital Territory Administration, Abuja.
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Elimian KO, Aderinola O, Gibson J, Myles P, Ochu CL, King C, Okwor T, Gaudenzi G, Olayinka A, Zaiyad HG, Ohonsi C, Ebhodaghe B, Dan-Nwafor C, Nwachukwu W, Abdus-Salam IA, Akande OW, Falodun O, Arinze C, Ezeokafor C, Jafiya A, Ojimba A, Aremu JT, Joseph E, Bowale A, Mutiu B, Saka B, Jinadu A, Hamza K, Ibeh C, Bello S, Asuzu M, Mba N, Oladejo J, Ilori E, Alfvén T, Igumbor E, Ihekweazu C. Assessing the capacity of symptom scores to predict COVID-19 positivity in Nigeria: a national derivation and validation cohort study. BMJ Open 2021; 11:e049699. [PMID: 34479936 PMCID: PMC8421116 DOI: 10.1136/bmjopen-2021-049699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study aimed to develop and validate a symptom prediction tool for COVID-19 test positivity in Nigeria. DESIGN Predictive modelling study. SETTING All Nigeria States and the Federal Capital Territory. PARTICIPANTS A cohort of 43 221 individuals within the national COVID-19 surveillance dataset from 27 February to 27 August 2020. Complete dataset was randomly split into two equal halves: derivation and validation datasets. Using the derivation dataset (n=21 477), backward multivariable logistic regression approach was used to identify symptoms positively associated with COVID-19 positivity (by real-time PCR) in children (≤17 years), adults (18-64 years) and elderly (≥65 years) patients separately. OUTCOME MEASURES Weighted statistical and clinical scores based on beta regression coefficients and clinicians' judgements, respectively. Using the validation dataset (n=21 744), area under the receiver operating characteristic curve (AUROC) values were used to assess the predictive capacity of individual symptoms, unweighted score and the two weighted scores. RESULTS Overall, 27.6% of children (4415/15 988), 34.6% of adults (9154/26 441) and 40.0% of elderly (317/792) that had been tested were positive for COVID-19. Best individual symptom predictor of COVID-19 positivity was loss of smell in children (AUROC 0.56, 95% CI 0.55 to 0.56), either fever or cough in adults (AUROC 0.57, 95% CI 0.56 to 0.58) and difficulty in breathing in the elderly (AUROC 0.53, 95% CI 0.48 to 0.58) patients. In children, adults and the elderly patients, all scoring approaches showed similar predictive performance. CONCLUSIONS The predictive capacity of various symptom scores for COVID-19 positivity was poor overall. However, the findings could serve as an advocacy tool for more investments in resources for capacity strengthening of molecular testing for COVID-19 in Nigeria.
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Affiliation(s)
- Kelly Osezele Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Jack Gibson
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Puja Myles
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | | | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tochi Okwor
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Giulia Gaudenzi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | | | - Oluwatosin Wuraola Akande
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | | | | | | | | | | - Emmanuel Joseph
- Kaduna State Infectious Disease Control Center Community Medicine, Kaduna, Nigeria
| | | | | | - Babatunde Saka
- Lagos State Government Ministry of Health, Ikeja, Nigeria
| | | | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Christian Ibeh
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Shaibu Bello
- Department of Medical Education, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Michael Asuzu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Bellville, South Africa
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Iroungou BA, Mangouka LG, Bivigou-Mboumba B, Moussavou-Boundzanga P, Obame-Nkoghe J, Nzigou Boucka F, Mouinga-Ondeme A, Aghokeng AF, Tchoua R, Pineau P, Nzenze JR. Demographic and Clinical Characteristics Associated With Severity, Clinical Outcomes, and Mortality of COVID-19 Infection in Gabon. JAMA Netw Open 2021; 4:e2124190. [PMID: 34519768 PMCID: PMC8441589 DOI: 10.1001/jamanetworkopen.2021.24190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Since the emergence of COVID-19 in central China, sub-Saharan African countries, with the exception of South Africa, have been relatively spared during the COVID-19 pandemic. Consequently, few descriptive studies from this region are available. OBJECTIVE To describe the clinical characteristics and outcomes of patients with COVID-19 infection in Gabon, from March to June 2020. DESIGN, SETTING, AND PARTICIPANTS A single-center, cross-sectional study of 837 patients with COVID-19 was conducted from March to June 2020 in the Armed Forces Hospital in Libreville, Gabon. MAIN OUTCOMES AND MEASURES Demographic and clinical characteristics and imaging findings of hospitalized patients with COVID-19. RESULTS Of the 837 patients enrolled, 572 (68.3%) were men, and 264 (31.5%) were women (male to female ratio, 2:1); the median (interquartile range [IQR]) age was 35 (30-45) years (mean [SD] age, 38.0 [12.2] years. The mortality rate associated with COVID-19 was low (1.4%). Of these 837 patients, 524 (62.6%) were categorized as having no symptoms, 282 (33.7%) as having mild symptoms, and 31 (3.7%) as having severe symptoms. Patients with severe symptoms were older (mean [SD] age, 46.1 [14.7] years) than patients with mild symptoms (mean [SD] age, 41.3 [12.5] years) and those with no symptoms (mean [SD] age, 35.7 [11.3] years) (Kruskal-Wallis χ22 = 53.5; P < .001). History of diabetes was the principal risk factor associated with both severe symptoms in 5 of 31 patients (16.1%) and mild symptoms in 11 of 282 (3.9%) compared with no symptoms in 5 of 524 (0.9%) (Pearson χ22 = 30.9; P < .001). Patients with severe symptoms and a fatal outcome were older (mean [SD] age, 53.4 [15.1] years) than survivors (mean [SD] age, 41.5 [12.9] years) (t20.83 = 2.2; P = .03). CONCLUSIONS AND RELEVANCE In this single-center, cross-sectional study in Libreville, Gabon, the mortality rate associated with COVID-19 infection from March to June 2020 was low, and patients who died of COVID-19 infection were younger on average than reported elsewhere, possibly reflecting a smaller elderly population in Gabon.
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Affiliation(s)
- Berthe Amélie Iroungou
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | | | - Berthold Bivigou-Mboumba
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Pamela Moussavou-Boundzanga
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Judicaël Obame-Nkoghe
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
- Unité Écologie des Systèmes Vectoriels, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | | | - Augustin Mouinga-Ondeme
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Avelin Fobang Aghokeng
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Unité Mixite de Recherche, Institut de Recherche pour Developpement 224, Centre National de la Recherche Scientifique 5290, Maladies infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle, Université de Montpellier, Montpellier, France
| | - Romain Tchoua
- Service de Réanimation, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
| | - Pascal Pineau
- Unité “Organisation Nucléaire et Oncogenèse,” INSERM U993, Institut Pasteur, Paris, France
| | - Jean Raymond Nzenze
- Service de Médecine Interne, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
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Abayomi A, Osibogun A, Kanma-Okafor O, Idris J, Bowale A, Wright O, Adebayo B, Balogun M, Ogboye S, Adeseun R, Abdus-Salam I, Mutiu B, Saka B, Lajide D, Yenyi S, Agbolagorite R, Onasanya O, Erinosho E, Obasanya J, Adejumo O, Adesola S, Oshodi Y, Akase IE, Ogunbiyi S, Omosun A, Erinoso F, Abdur-Razzaq H, Osa N, Akinroye K. Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: a retrospective cohort study. Glob Health Res Policy 2021; 6:26. [PMID: 34325747 PMCID: PMC8319704 DOI: 10.1186/s41256-021-00210-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 06/20/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described. METHODS In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 62,020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher's exact tests were used in determining associations between variables. Kaplan-Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant. RESULTS A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P < 0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR = 2.41, P = 0.001, 95%CI = 1.4-4.0, death: HR = 2.30, P = 0.001, 95%CI = 1.2-4.6, for those with hypertension only} {severe/critical illness: HR = 3.76, P = 0.001, 95%CI = 2.1-6.4, death: crude HR = 6.63, P = 0.001, 95%CI = 3.4-1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. CONCLUSION The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.
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Affiliation(s)
- Akin Abayomi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Akin Osibogun
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria.
- Lagos State Primary Health Care Board, Lagos, Nigeria.
| | | | - Jide Idris
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Ololade Wright
- Lagos State University College of Medicine, Lagos, Nigeria
| | - Bisola Adebayo
- Lagos State University College of Medicine, Lagos, Nigeria
| | | | - Segun Ogboye
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Remi Adeseun
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Ismael Abdus-Salam
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | | | - Dayo Lajide
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Sam Yenyi
- World Health Organization, Nigeria Office, Abuja, Nigeria
| | - Rotimi Agbolagorite
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | | | | | | | | | - Yewande Oshodi
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | | | | | - Adenike Omosun
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Femi Erinoso
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Hussein Abdur-Razzaq
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Nike Osa
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
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12
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Okoh M, Onyia N, Okoh DS, Abah AA, Otakhoigbogie U, Adedapo HA, Oyetola EO, Agho ET, Owotade FJ. Awareness of COVID-19 and the Dental Implications of its Oral Manifestations among Dental Health Practitioners in Nigeria. Niger Med J 2021; 62:194-201. [PMID: 38694212 PMCID: PMC11058442 DOI: 10.60787/nmj-62-4-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Abstract
Background There are many aspects of COVID-19 that are related to dental practice. Hence, this study aimed to assess the level of awareness of COVID-19 concerning its symptoms, transmission and prevention and the dental implications of its oral manifestations among dentists in Nigeria. Methodology This is a cross-sectional study that sampled dentists who work in Nigeria regardless of their place of work with an online questionnaire using Google forms to collect the data. The questionnaire was anonymous to maintain the privacy and confidentiality of all information collected in the study. The survey was a structured questionnaire divided into three sections: Dentists' demographics, knowledge of the disease and dental implications of COVID-19. Results This study included 206 dentists practising in Nigeria, with 126 (61.2%) males and 80 (38.8%) females. A total of 191 (92.7%) dentists perceived COVID-19 as highly contagious and deadly. Almost all the participants (n=205, 99.5%) were knowledgeable about the mode of transmission of the disease through respiratory droplets. A total of 204 (99.0%) affirmed that dental practitioners were at risk of becoming infected with COVID-19. About 84.5% reported that salivary glands can serve as a potential reservoir for COVID-19. Conclusion The awareness of COVID-19 concerning the mode of transmission, symptoms and prevention among the dental professionals was encouraging. This would lead to enhanced infection control in dental settings. The majority of the participants reported that saliva can be used as a promising non-invasive specimen for diagnosis, monitoring and infection control in patients with COVID-19.
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Affiliation(s)
- Mercy Okoh
- Department of Oral and Maxillofacial Pathology and Medicine, School of Dentistry, University of Benin, Nigeria
| | - Nonso Onyia
- Department Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | | | - Aderonke Adebowun Abah
- Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Uwaila Otakhoigbogie
- Department of Oral Pathology and Oral Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Happy Adeyinka Adedapo
- Department of Oral Pathology and Oral Medicine, University College Hospital, Ibadan, Nigeria
| | - Elijah Olufemi Oyetola
- Department of Oral Pathology and Oral Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Foluso John Owotade
- Department of Oral Pathology and Oral Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
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Fadipe B, Oshodi YO, Umeh C, Aikomo K, Ajirotutu OF, Kajero J, Fashanu C, Adeoye AA, Coker AO, Sokunbi M, Nyamali VO, Ajomale T, Gbadebo A, Oni A, Keshinro AO, Ngozi Ejiegbu TA, Bowale A, Akase IE, Mutiu B, Adebayo B, Abdus-Salam I, Bode C, Osibogun A. Psychosocial health effects of Covid-19 infection on persons in treatment centers in Lagos, Nigeria. Brain Behav Immun Health 2021; 16:100284. [PMID: 34151305 PMCID: PMC8205258 DOI: 10.1016/j.bbih.2021.100284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Prior research has highlighted the psychosocial impact of infectious diseases on individuals and the community at large. However, little is known about the psychosocial implications of COVID-19. This study set out to determine the rate as well as correlates of anxiety and depressive symptoms among persons managed as in-patients for COVID-19 in Lagos, Nigeria. Materials and methods We conducted an online survey between April to June ending 2020 using a consecutive sampling technique of persons positive for COVID-19 and who were managed as in-patients across five (5) treatment centres in Lagos, Nigeria. The survey collected information on demographic as well as clinical data including suicidality. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Results There were one hundred and sixty participants in total. The mean age of respondents was 36.4 (±9.7) years with a higher proportion (56.9%) being males. With regards to diagnosis, 28.1% and 27.5% of the respondents were categorised as probable cases of depression and anxiety respectively, while 3.8% respondents reported suicidal ideation. Majority of the respondents (61.9%) reported the fear of infecting their loved ones. The variables that showed association with psychiatric morbidity were a past history of an emotional concern, employment status, guilt about infecting others and boredom. Conclusion This study revealed a high burden of psychological/psychiatric morbidity among persons treated for COVID-19, particularly persons who have had prior emotional concerns. The findings from this study reiterate the need to pay attention to the mental health of people during disease outbreaks and to incorporate psychosocial interventions as part of the management package.
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Affiliation(s)
- Babatunde Fadipe
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Yewande O Oshodi
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Charles Umeh
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Kehinde Aikomo
- Dept of Medical Social Work, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | | | | | | | | | - Ayodele Olurotimi Coker
- Department of Psychiatry, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria
| | | | | | - Tolu Ajomale
- Lagos State Ministry of Health, Ikeja, Lagos, Nigeria
| | | | - Adedapo Oni
- Dept of Psychiatry, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | | | | | | | - Iorhen E Akase
- Infectious Disease Unit, Department of Medicine, Lagos University Teaching Hospital (LUTH), Nigeria
| | - Bamidele Mutiu
- Lagos State Biobank, Mainland Hospital, Yaba, Lagos, Nigeria
| | - Bisola Adebayo
- Department of Community Health and Primary Care, Lagos State University, College of Medicine, Ikeja, Lagos, Nigeria
| | | | - Chris Bode
- Department of Surgery, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria
| | - Akin Osibogun
- Department of Community Health and Primary Care, College of Medicine University of Lagos, 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] [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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15
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Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, Wright O, Adeseun R, Mutiu B, Saka B, Osa N, Lajide D, Abdus-Salam I, Osikomaiya B, Onasanya O, Adebayo B, Oshodi Y, Adesola S, Adejumo O, Erinoso O, Abdur-Razzaq H, Bowale A, Akinroye K. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One 2021; 16:e0248281. [PMID: 33720975 PMCID: PMC7959379 DOI: 10.1371/journal.pone.0248281] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. METHODS This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. RESULTS Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33-55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22-4.01), diabetes (OR: 3.69, 95% CI: 1.99-6.85), renal disease (OR: 12.53, 95%CI: 1.97-79.56), cancer (OR: 14.12, 95% CI: 2.03-98.19) and HIV (OR: 1.77-84.15]. CONCLUSION Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.
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Affiliation(s)
- Akin Osibogun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Akin Abayomi
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Lagos State Ministry of Health, Lagos, Nigeria
| | - Jide Idris
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Yetunde Kuyinu
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Remi Adeseun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bamidele Mutiu
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Nike Osa
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Dayo Lajide
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Ismael Abdus-Salam
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bodunrin Osikomaiya
- Lagos State Blood Transfusion Service, Lagos State Ministry of Health, Lagos, Nigeria
| | | | - Bisola Adebayo
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Yewande Oshodi
- Department of Psychiatry, College of Medicine University of Lagos, Lagos, Nigeria
| | | | | | - Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Nigeria
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16
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Olusola-Makinde OO, Makinde OS. COVID-19 incidence and mortality in Nigeria: gender based analysis. PeerJ 2021; 9:e10613. [PMID: 33614262 PMCID: PMC7883696 DOI: 10.7717/peerj.10613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) has been surging globally. Risk strata in medical attention are of dynamic significance for apposite assessment and supply distribution. Presently, no known cultured contrivance is available to fill this gap of this pandemic. The aim of this study is to develop a predictive model based on vector autoregressive moving average (VARMA) model of various orders for gender based daily COVID-19 incidence in Nigeria. This study also aims to proffer empirical evidence that compares incidence between male and female for COVID-19 risk factors. METHODS Wilcoxon signed-rank test is employed to investigate the significance of the difference in the gender distributions of the daily incidence. A VARMA model of various orders is formulated for the gender based daily COVID-19 incidence in Nigeria. The optimal VARMA model is identified using Bayesian information criterion. Also, a predictive model based on univariate autoregressive moving average model is formulated for the daily death cases in Nigeria. Fold change is estimated based on crude case-fatality risk to investigate whether there is massive underreporting and under-testing of COVID-19 cases in Nigeria. RESULTS Daily incidence is higher in males on most days from 11 April 2020 to 12 September 2020. Result of Wilcoxon signed-rank test shows that incidence among male is significantly higher than female (p-value < 2.22 × 10-16). White neural network test shows that daily female incidence is not linear in mean (p-value = 0.00058746) while daily male incidence is linear in mean (p-value = 0.4257). McLeod-Li test shows that there is autoregressive conditional heteroscedasticity in the female incidence (Maximum p-value = 1.4277 × 10-5) and male incidence (Maximum p-value = 9.0816 × 10-14) at 5% level of significance. Ljung-Box test (Tsay, 2014) shows that the daily incidence cases are not random (p-value=0.0000). The optimal VARMA model for male and female daily incidence is VARMA (0,1). The optimal model for the Nigeria's daily COVID-19 death cases is identified to be ARIMA (0,1,1). There is no evidence of massive underreporting and under-testing of COVID-19 cases in Nigeria. CONCLUSIONS Comparison of the observed incidence with fitted data by gender shows that the optimal VARMA and ARIMA models fit the data well. Findings highlight the significant roles of gender on daily COVID-19 incidence in Nigeria.
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Affiliation(s)
| | - Olusola S. Makinde
- Department of Statistics, Federal University of Technology, Akure, Akure, Ondo, Nigeria
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17
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Olumade TJ, Uzairue LI. Clinical characteristics of 4499 COVID-19 patients in Africa: A meta-analysis. J Med Virol 2021; 93:3055-3061. [PMID: 33543800 PMCID: PMC8013423 DOI: 10.1002/jmv.26848] [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: 10/30/2020] [Revised: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus disease‐2019 (COVID‐19) pandemic that started in December 2019 has affected over 95 million people and killed over 2 million people as of January 19, 2021. While more studies are published to help us understand the virus, there is a dearth of studies on the clinical characteristics and associated outcomes of the severe acute respiratory syndrome coronavirus 2 on the African continent. We evaluated evidence from previous studies in Africa available in six databases between January 1 and October 6, 2020. Meta‐analysis was then performed using Open‐Meta Analyst and Jamovi software. A total of seven studies, including 4499 COVID‐19 patients, were included. The result of the meta‐analysis showed that 68.8% of infected patients were male. Common symptoms presented (with their incidences) were fever (42.8%), cough (33.3%), headache (11.3%), and breathing problems (16.8%). Other minor occurring symptoms included diarrhea (7.5%) and rhinorrhea (9.4%). Fatality rate was 5.6%. There was no publication bias in the study. This study presents the first description and analysis of the clinical characteristics of COVID‐19 patients in Africa. The most common symptoms are fever, cough, and breathing problems.
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Affiliation(s)
- Testimony Jesupamilerin Olumade
- Department of Biological Sciences, Redeemer's University, Ede, Osun, Nigeria.,African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun, Nigeria
| | - Leonard Ighodalo Uzairue
- Department of Microbiology, College of Biosciences, Federal University of Agriculture, Abeokuta, Ogun, Nigeria.,Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, Federal University, Oye-Ekiti, Ekiti, Nigeria
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18
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Jibrin YB, Okwong OK, Maigari IM, Dunga JA, Ballah AM, Umar MS, Mohammed A, Hassan ZI. Clinical and laboratory characteristics of COVID-19 among adult patients admitted to the isolation centre at Abubakar Tafawa Balewa Teaching Hospital Bauchi, Northeast Nigeria. Pan Afr Med J 2021; 37:27. [PMID: 33456651 DOI: 10.11604/pamj.supp.2020.37.27.26162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 10/01/2020] [Indexed: 01/18/2023] Open
Abstract
Introduction as the epidemiological trend of COVID-19 infection continue to evolve with increasing prevalence and incidence globally, management of cases in low-resource health care settings require basic detailed clinical and laboratory characteristics. This study retrospectively described the clinical and laboratory characteristics of confirmed COVID-19 cases admitted into the isolation centre of ATBUTH, Bauchi. Methods clinical and laboratory data of 84 confirmed COVID-19 cases admitted into the isolation centre of ATBUTH, Bauchi according to NCDC guidelines were used. Diagnosis was based on nasal and nasopharyngeal swab positive result of reverse transcriptase-polymerase chain reaction (RT-PCR) result. Data extracted includes demographic, clinical presentations and laboratory characteristics. Results the 84 COVID-19 patients comprised of 72% (59) males and 28% (25) females with mean age of 41.0±10.5 years, majority of the patients were within age-group 21-40 years. Forty-one percent presented with mild to moderate symptoms, 3.6% (3) presented with severe symptoms while 58.3% (49) were asymptomatic with mean body temperature of 36.60C ± Sá. The common clinical manifestations were fever 23.4% (19) and cough 20.7% (17). About 29.3% of the patients had comorbidities, 17.1% (14) were hypertensive while 12.2% of the diabetic. Thirty percent (10) of the patients with DM required intensive care unit (ICU) admission with 10% mortality. Biochemical parameters were within normal range for all the patients. However, haematological parameters showed increased neutrophil (10, 43.5%) and lymphocyte count (19 (59.4%). Conclusion the study findings revealed high number of asymptomatic cases, similarity in clinical manifestation and relatively normal laboratory characteristics. More experience with increase in number of patients may provide additional information. Interrupting community transmission will require early detection and contact trace of asymptomatic cases.
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Affiliation(s)
- Yusuf Bara Jibrin
- Department of Internal Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Okon Kenneth Okwong
- Department of Medical Microbiology, Federal Medical Centre, Makurdi, Nigeria
| | - Ibrahim Mahmood Maigari
- Department of Internal Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Jacob Amos Dunga
- Department of Internal Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | | | - Mustapha Sabo Umar
- Department of Internal Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Alkali Mohammed
- Department of Internal Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Zuwaira Ibrahim Hassan
- Department of Community Medicine, Aabubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
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19
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Mukhtar NB, Abdullahi A, Abba MA, Mohammed J. Views and experiences of discharged COVID-19 patients in Kano, Nigeria: a qualitative study. Pan Afr Med J 2021; 37:38. [PMID: 33456662 DOI: 10.11604/pamj.supp.2020.37.38.26609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction COVID-19 has spread globally, thereby contributing to substantial hospitalisation rates and morbidity. However, little or no information is available on the experiences of patients with COVID-19 in an African-setting. The study aimed to explore the experiences of patients with COVID-19. Methods semi-structured interviews were conducted via telephone with eleven individuals who were managed and discharged due to COVID-19. A descriptive phenomenological approach to qualitative research was employed and participants were mainly asked about their experiences before, during and after hospitalisation for COVID-19. Data were analysed using thematic analysis. Results patients' viewpoints were suggestive of community and secondary transmission of COIVD-19 in the study area. A few participants experienced severe symptoms. Most participants tend to resign their condition to fate; while some displayed unfounded conspiracy theories. Nevertheless, precautionary measures to prevent infection were largely observed. COVID-19 also negatively affected activities of daily living of the participants. Furthermore, the participants were generally satisfied with quality of care provided. However, areas of patients' education, isolation centre set-up and caregiver-patient interaction needed further improvements. Lastly, experience of fear and stigma during post-hospitalisation were common. Conclusion COVID-19 impacted negatively on the lives of the studied population. However, their experience during hospitalisation was generally positive.
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Affiliation(s)
- Naziru Bashir Mukhtar
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Auwal Abdullahi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Movant, Wilrijk, Belgium
| | - Muhammad Aliyu Abba
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jibril Mohammed
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria
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20
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Alasia D, Owhonda G, Maduka O, Nwadiuto I, Arugu G, Tobin-West C, Azi E, Oris-Onyiri V, Urang IJ, Abikor V, Olofinuka AM, Adebiyi O, Somiari A, Avundaa H, Alali A. Clinical and epidemiological characteristics of 646 hospitalised SARS-Cov-2 positive patients in Rivers State Nigeria: a prospective observational study. Pan Afr Med J 2021; 38:25. [PMID: 33777293 PMCID: PMC7955600 DOI: 10.11604/pamj.2021.38.25.26755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/08/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION the knowledge of epidemiologic and clinical variables in patients with SARS- CoV-2 infection provides evidence and lessons that are useful for the pandemic response, with consideration of National and sub-National variations. The objective of this study was to characterize and describe the clinical and epidemiologic features of all the hospitalised patients with COVID-19 in Rivers State Nigeria, from March to August 2020. METHODS a prospective descriptive multi-center study of patients with positive SARS-CoV-2 RT PCR, who were hospitalised for treatment and self-isolation in four treatment centers in Rivers state, Nigeria. RESULTS the mean age of all the patients was 39.21 ± 12.31 years, with a range of 2 to 77 years. The majority of patients were in the 31 to 40-year (33.0%), 41 to 50-year (23.1%) and 18-to 30-year (22.0%) age groups. The patient population included 474 (73.4%) males and 172 (26.6%) females, with 93 (14.4%) healthcare workers. A history of contact and travel was established in 38.5% and at least one comorbid disease condition was present in 32.8% of patients. Patients with severe disease were 61 (9.45%), while the overall case fatality rate was 2%. The leading comorbid disease conditions were Hypertension in 23.8% and diabetes in 7.7% of patients. Fever (26.0%), dry Cough (17.6%), dyspnoea (12.7%), anosmia (12.7%) and headache (9.9%) were the most common symptoms. The presence of comorbidity and increasing age predicted death from COVID-19. CONCLUSION the clinical and epidemiologic characteristics of this cohort of hospitalised patients show significant similarities with existing trends from previously reported studies, with contextual peculiarities.
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Affiliation(s)
- Datonye Alasia
- Department of Internal Medicine, University of Port Harcourt, Rivers State, Nigeria
| | - Golden Owhonda
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | - Omosivie Maduka
- Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State, Nigeria
| | - Ifeoma Nwadiuto
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | - Godswill Arugu
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | - Charles Tobin-West
- Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State, Nigeria
| | - Esther Azi
- Department of Community Medicine, Rivers State University Port-Harcourt, Nigeria, Rivers State, Nigeria
| | - Victor Oris-Onyiri
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | - Inwon Joseph Urang
- Department of Community Health, Rivers State Primary Health Care Management Board, Rivers State, Nigeria
| | - Victor Abikor
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | | | - Obelebra Adebiyi
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Rivers State, Nigeria
| | - Abiye Somiari
- Department of Community Medicine, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
| | - Hope Avundaa
- Department of Community Medicine, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
| | - Aloni Alali
- Department of Community Medicine, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
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21
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Abayomi A, Odukoya O, Osibogun A, Wright O, Adebayo B, Balogun M, Abdus-Salam I, Bowale A, Mutiu B, Saka B, Adejumo M, Yenyi S, Agbolagorite R, Onasanya O, Erinosho E, Obasanya J, Adejumo O, Adesola S, Oshodi Y, Akase IE, Ogunbiyi S, Lajide D, Erinoso F, Abdur-Razzaq H. Presenting Symptoms and Predictors of Poor Outcomes Among 2,184 Patients with COVID-19 in Lagos State, Nigeria. Int J Infect Dis 2021; 102:226-232. [PMID: 33075534 PMCID: PMC7566672 DOI: 10.1016/j.ijid.2020.10.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Lagos state remains the epicentre of COVID-19 in Nigeria. We describe the symptoms and signs of the first 2,184 PCR-confirmed COVID-19 patients admitted at COVID-19 treatment centers in Lagos State. We also assessed the relationship between patients' presenting symptoms, sociodemographic and clinical characteristics and COVID-19 deaths.. METHODS Medical records of PCR-confirmed COVID-19 patients were extracted and analyzed for their symptoms, symptom severity, presence of comorbidities and outcome. RESULTS The ages of the patients ranged from 4 days to 98 years with a mean of 43.0(16.0) years. Of the patients who presented with symptoms, cough (19.3%) was the most common presenting symptom. This was followed by fever (13.7%) and difficulty in breathing, (10.9%). The most significant clinical predictor of death was the severity of symptoms and signs at presentation. Difficulty in breathing was the most significant symptom predictor of COVID-19 death (OR:19.26 95% CI 10.95-33.88). The case fatality rate was 4.3%. CONCLUSION Primary care physicians and COVID-19 frontline workers should maintain a high index of suspicion and prioritize the care of patients presenting with these symptoms. Community members should be educated on such predictors and ensure that patients with these symptoms seek care early to reduce the risk of deaths associated with COVID-19.
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Affiliation(s)
| | | | - Akin Osibogun
- College of Medicine University of Lagos; Lagos State Primary Health Care Board; Lagos University Teaching Hospital.
| | | | | | | | | | | | | | | | | | - Sam Yenyi
- World Health Organization, Nigeria Office
| | | | | | | | | | | | | | - Yewande Oshodi
- College of Medicine University of Lagos; Lagos University Teaching Hospital
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22
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Abubakar AR, Sani IH, Godman B, Kumar S, Islam S, Jahan I, Haque M. Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications. Infect Drug Resist 2020; 13:4673-4695. [PMID: 33402839 PMCID: PMC7778508 DOI: 10.2147/idr.s289037] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
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Affiliation(s)
- Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria
| | - Ibrahim Haruna Sani
- Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, Kano, Nigeria
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar382422, India
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka1342, Bangladesh
| | - Iffat Jahan
- Department of Physiology, Eastern Medical College, Cumilla, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
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23
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Otuonye NM, Olumade TJ, Ojetunde MM, Holdbrooke SA, Ayoola JB, Nyam IY, Iwalokun B, Onwuamah C, Uwandu M, Abayomi A, Osibogun A, Bowale A, Osikomaiya B, Thomas B, Mutiu B, Odunukwe NN. Clinical and Demographic Characteristics of COVID-19 patients in Lagos, Nigeria: A Descriptive Study. J Natl Med Assoc 2020; 113:301-306. [PMID: 33358220 PMCID: PMC7759120 DOI: 10.1016/j.jnma.2020.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/06/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022]
Abstract
Introduction COVID-19 is an emerging, rapidly evolving global situation, infecting over 25 million people and causing more than 850,000 deaths. Several signs and symptoms have been described to be characteristic of the disease. However, there is a dearth of report on the description of the clinical characteristics of the disease in patients from Nigeria. This study was designed to provide a description of the clinical and demographic characteristics of COVID-19 patients in Nigeria. Methods This study is a case series that includes patients that are evaluated between May and August 2020, and diagnosed with COVID-19. Patient health records were reviewed and evaluated to describe the clinical characteristics on presentation. Results A total of 154 COVID-19 patients were included in this study, with a mean age (S.D.) of 46.16 (13.701). Most of the patients survived (mortality rate of 2.6%), and were symptomatic (89.6%). There were more males (74.7%) than females, and the most common symptoms were fever, breathing difficulty, dry cough and malaise. Co-morbidities were also present in almost half of the study participants (49.4%). Conclusion This study presents the most extensive description, to date, on the clinical and demographic characteristics of COVID-19 patients in Nigeria. Males are more likely than females to be infected with COVID-19 and the most occurring symptoms are fever, breathing difficulty, malaise, dry cough and chest pain. Old age and the presence of co-morbidities may also be associated with developing the severe disease.
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Affiliation(s)
| | - Testimony Jesupamilerin Olumade
- Department of Biological Sciences, Redeemer's University, Ede, Osun state; African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun state
| | | | | | | | - Itse Yusuf Nyam
- Central Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Bamidele Iwalokun
- Molecular Biological and Biotechnology Department, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Chika Onwuamah
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Mabel Uwandu
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Akinola Abayomi
- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria
| | - Akin Osibogun
- College of Medicine University of Lagos, Nigeria; Lagos State Primary Health Care Board, Lagos, Nigeria
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Ejeh FE, Saidu AS, Owoicho S, Maurice NA, Jauro S, Madukaji L, Okon KO. Knowledge, attitude, and practice among healthcare workers towards COVID-19 outbreak in Nigeria. Heliyon 2020; 6:e05557. [PMID: 33230488 PMCID: PMC7673666 DOI: 10.1016/j.heliyon.2020.e05557] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/23/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is a global pandemic. Healthcare workers' (HCWs) role in patient management is predisposing and can serve as means of hospitals and community transmission. This study evaluated HCWs' knowledge, attitude, and practice towards COVID-19 in Nigeria. METHODS we carried out a cross-sectional survey among HCWs during the COVID-19 outbreak in Nigeria from March to June 2020. The study assessed 346 HCWs for Knowledge, attitude, and practice by using an online (Google form) self-administered questionnaire, based on a convinience sampling technique Data were retrieved and analyzed using descriptive statistics. Chi-Square and one-way ANOVA were used to measure association and difference among demographic variables. The relationship between knowledge, attitude, and practice was measured using Spearman's rho correlation test. RESULTS the mean knowledge score of the HCWs was 7.1 on a scale of 0-8. The correct overall rate of the knowledge questionnaire was 88.75%. Knowledge was gained mainly from television (35.0%) and social media (35.0%). The mean attitude score on a scale of 0-6 was 5.31 ± 0.39. Most (92.5%) participants were confident that Nigerian medical scientists would win the war against COVID-19. The majority (92.2%) of the respondents thought that SARS-CoV-2 was not a biological weapon. About 1 out of 5 respondents held that faith healing or prayer is the only cure for COVID-19. A vast majority of the HCWs were taking precautionary measures such as avoiding crowded places (94.2%), washing of hands (96.0%), and the use of personal protective equipment (91.6%) against SARS-CoV-2 infection. Nevertheless, only 3 out of 5 HCWs used a face mask when leaving home. There was a significant (p = 0.046) positive correlation (0.584) between knowledge and attitude. CONCLUSION our results showed that HCWs in Nigeria had excellent knowledge and possessed a positive attitude and good practice towards COVID-19. However; there were areas where poor knowledge, negative attitudes and unacceptable practices were observed. We recommend continuous public health education of HCWs on SARS-COV-2 infection control and prevention.
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Affiliation(s)
- Francis Enenche Ejeh
- Department of Veterinary Microbiology, Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Nigeria
| | - Adamu Saleh Saidu
- Department of Veterinary Public Health & Preventive Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Nigeria
| | - Samuel Owoicho
- Nigerian Field Epidemiology and Laboratory Training Program, Nigeria
| | - Nanven Abraham Maurice
- Department of Diagnostic and Extension, Nigerian Veterinary Research Institute, Vom, Nigeria
| | - Solomon Jauro
- Department of Veterinary Microbiology, Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Nigeria
| | | | - Kenneth O. Okon
- Department of Medical Microbiology, Federal Medical Centre, Makurdi, Nigeria
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25
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Ibrahim OR, Suleiman BM, Abdullahi SB, Oloyede T, Sanda A, Gbadamosi MS, Yusuf BO, Iliyasu RY, Ibrahim LM, Danladi Dawud A, Bashir SS, Okonta NE, Umar WF, Tekobo AG, Abubakar MS, Aminu BT, Ibrahim SO, Olaosebikan R, Mokuolu OA. Epidemiology of COVID-19 and Predictors of Outcome in Nigeria: A Single-Center Study. Am J Trop Med Hyg 2020; 103:2376-2381. [PMID: 33124545 PMCID: PMC7695094 DOI: 10.4269/ajtmh.20-0759] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
There is a paucity of information regarding the epidemiology and outcome of COVID-19 from low/middle-income countries, including from Nigeria. This single-center study described the clinical features, laboratory findings, and predictors of in-hospital mortality of COVID-19 patients. Patients admitted between April 10, 2020 and June 10, 2020 were included. Forty-five patients with a mean age of 43 (16) years, predominantly male (87%), presented with fever (38%), cough (29%), or dyspnea (24%). In-hospital mortality was 16%. The independent predictors of mortality were hypoxemia (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.3–5.1) and creatinine > 1.5 mg/dL (aOR: 4.3; 95% CI: 1.9–9.8).
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Affiliation(s)
| | | | | | - Taofeek Oloyede
- Department of Internal Medicine, Federal Medical Center, Katsina, Nigeria
| | - Abdallah Sanda
- Department of Medical Microbiology, Federal Medical Center, Katsina, Nigeria
| | | | | | | | | | - Adamu Danladi Dawud
- Department of Disease Control and Immunization, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Sulaiman Saidu Bashir
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Amadu Bello University, Zaria, Nigeria
| | | | | | | | | | - Bashir Taiye Aminu
- Department of Internal Medicine, Federal Medical Center, Katsina, Nigeria
| | | | - Rasaq Olaosebikan
- Department of Pharmacology and Experimental Pharmacology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Olugbenga Ayodeji Mokuolu
- Department of Pediatrics, University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria
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26
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Oleribe O, Ezechi O, Osita-Oleribe P, Olawepo O, Musa AZ, Omoluabi A, Fertleman M, Salako BL, Taylor-Robinson SD. Public perception of COVID-19 management and response in Nigeria: a cross-sectional survey. BMJ Open 2020; 10:e041936. [PMID: 33055123 PMCID: PMC7559048 DOI: 10.1136/bmjopen-2020-041936] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/24/2020] [Accepted: 09/28/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES A study designed to assess the public perception of the response of government and its institutions to the COVID-19 pandemic in Nigeria. SETTING Self-selecting participants throughout Nigeria completed a self-administered questionnaire through an online cross-sectional survey. PARTICIPANTS 495. RESULTS The majority of respondents were married (76.6%), were males (61.8%), had tertiary level education (91.0%), were public servants (36.8%), Christians (82.6%), and resident either in the Federal Capital Territory (Abuja) (49.1%) or in the South-East Region of Nigeria (36.6%). Over 95% of the respondents had heard of COVID-19 (98.8%) and knew it is a viral disease (95.4%). The government and its institutions response to the pandemic were rated as poor, with the largest rating as poor for Federal President's Office (57.5%). Communication (50.0%) and prevention messages (43.7%) received the highest perception good rating. Female respondents and those less than 40 years generally rated the governmental responses as poor. CONCLUSIONS/RECOMMENDATIONS It is recommended that as a public-private partnership approached was efficiently used to more effectively disseminate public health communication and prevention messages, the Nigerian Government should expand this collaboration to improve the quality of services provided in other areas of COVID-19 outbreak management.
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Affiliation(s)
- Obinna Oleribe
- International Office, Royal College of Physicians, London, UK
- Chief Executive Office, Excellence and Friends Management Care Centre (EFMC), Abuja, Nigeria
| | - Oliver Ezechi
- Director of Research, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | - Olatayo Olawepo
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, United States
| | - Adesola Z Musa
- Director of Research, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | - Michael Fertleman
- Cutrale Preoperative & Ageing Group, Imperial College London, London, UK
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27
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Tinto B, Salinas S, Dicko A, Kagone TS, Traore I, de Rekeneire N, Bicaba BW, Hien H, Meda N, van de Perre P, Kania D, Simonin Y. Spreading of SARS-CoV-2 in West Africa and assessment of risk factors. Epidemiol Infect 2020; 148:e213. [PMID: 32921332 PMCID: PMC7506176 DOI: 10.1017/s0950268820002149] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/21/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
Although the African continent is, for the moment, less impacted than the rest of the world, it still faces the risk of a spread of COVID-19. In this study, we have conducted a systematic review of the information available in the literature in order to provide an overview of the epidemiological and clinical features of COVID-19 pandemic in West Africa and of the impact of risk factors such as comorbidities, climatic conditions and demography on the pandemic. Burkina Faso is used as a case study to better describe the situation in West Africa. The epidemiological situation of COVID-19 in West Africa is marked by a continuous increase in the numbers of confirmed cases. This geographic area had on 29 July 2020, 131 049 confirmed cases by polymerase chain reaction, 88 305 recoveries and 2102 deaths. Several factors may influence the SARS-CoV-2 circulation in Africa: (i) comorbidities: diabetes mellitus and high blood pressure could lead to an increase in the number of severe cases of SARS-CoV-2; (ii) climatic factors: the high temperatures could be a factor contributing to slow the spread of the virus and (iii) demography: the West Africa population is very young and this could be a factor limiting the occurrence of severe forms of SARS-CoV-2 infection. Although the spread of the SARS-CoV-2 epidemic in West Africa is relatively slow compared to European countries, vigilance must remain. Difficulties in access to diagnostic tests, lack of hospital equipment, but also the large number of people working in the informal sector (such as trading, businesses, transport and restoration) makes it difficult to apply preventive measures, namely physical distancing and containment.
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Affiliation(s)
- B. Tinto
- Laboratoire National de Référence des Fièvres Hémorragiques Virales, Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - S. Salinas
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, INSERM, EFS, Montpellier, France
| | - A. Dicko
- Laboratoire Central de Référence, INSP, Ouagadougou, Burkina Faso
| | - T. S. Kagone
- Laboratoire National de Référence des Fièvres Hémorragiques Virales, Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - I. Traore
- Laboratoire National de Référence des Fièvres Hémorragiques Virales, Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - N. de Rekeneire
- Centre Muraz, INSP, Bobo-Dioulasso, Burkina Faso
- Expertise France, Paris, France
| | - B. W. Bicaba
- Centre des Opérations de Réponse aux Urgences Sanitaires (CORUS), INSP, Ouagadougou, Burkina Faso
| | - H. Hien
- INSP, Ouagadougou, Burkina Faso
| | - N. Meda
- UFR/SDS, Université Ouaga I Professeur Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - P. van de Perre
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, INSERM, EFS, Montpellier, France
| | - D. Kania
- Laboratoire National de Référence des Fièvres Hémorragiques Virales, Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Y. Simonin
- Pathogenesis and Control of Chronic Infections, Université de Montpellier, INSERM, EFS, Montpellier, France
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28
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Elimian KO, Ochu CL, Ilori E, Oladejo J, Igumbor E, Steinhardt L, Wagai J, Arinze C, Ukponu W, Obiekea C, Aderinola O, Crawford E, Olayinka A, Dan-Nwafor C, Okwor T, Disu Y, Yinka-Ogunleye A, Kanu NE, Olawepo OA, Aruna O, Michael CA, Dunkwu L, Ipadeola O, Naidoo D, Umeokonkwo CD, Matthias A, Okunromade O, Badaru S, Jinadu A, Ogunbode O, Egwuenu A, Jafiya A, Dalhat M, Saleh F, Ebhodaghe GB, Ahumibe A, Yashe RU, Atteh R, Nwachukwu WE, Ezeokafor C, Olaleye D, Habib Z, Abdus-Salam I, Pembi E, John D, Okhuarobo UJ, Assad H, Gandi Y, Muhammad B, Nwagwogu C, Nwadiuto I, Sulaiman K, Iwuji I, Okeji A, Thliza S, Fagbemi S, Usman R, Mohammed AA, Adeola-Musa O, Ishaka M, Aketemo U, Kamaldeen K, Obagha CE, Akinyode AO, Nguku P, Mba N, Ihekweazu C. Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February-6 June 2020. Epidemiol Infect 2020; 148:e208. [PMID: 32912370 PMCID: PMC7506173 DOI: 10.1017/s095026882000206x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/18/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31-40 years (25.5%) and 61-70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.
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Affiliation(s)
- K. O. Elimian
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Microbiology, Faculty of Life Sciences, University of Benin, Edo State, Nigeria
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
| | - C. L. Ochu
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
| | - E. Ilori
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - J. Oladejo
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - E. Igumbor
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - L. Steinhardt
- Centers for Disease Control and Prevention, U.S. Embassy Abuja, Abuja, Nigeria
| | - J. Wagai
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - C. Arinze
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - W. Ukponu
- Georgetown University, Abuja, Nigeria
| | - C. Obiekea
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - O. Aderinola
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - E. Crawford
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Olayinka
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
- World Health Organization, Abuja, Nigeria
- Ahmadu Bello University, Zaria, Nigeria
| | - C. Dan-Nwafor
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - T. Okwor
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Y. Disu
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Yinka-Ogunleye
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - N. E. Kanu
- African Field Epidemiology Network, Abuja, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | | | - O. Aruna
- Public Health England's International Health Regulations Strengthening Project, Abuja, Nigeria
| | | | - L. Dunkwu
- Tony Blair Institute for Global Change, Abuja, Nigeria
| | - O. Ipadeola
- Centers for Disease Control and Prevention, U.S. Embassy Abuja, Abuja, Nigeria
- University of Ilorin, Ilorin, Nigeria
| | - D. Naidoo
- World Health Organization, Abuja, Nigeria
| | - C. D. Umeokonkwo
- African Field Epidemiology Network, Abuja, Nigeria
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - A. Matthias
- Centers for Disease Control and Prevention, U.S. Embassy Abuja, Abuja, Nigeria
| | - O. Okunromade
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - S. Badaru
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Jinadu
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - O. Ogunbode
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Egwuenu
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Jafiya
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - M. Dalhat
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
- Resolve to Save Lives, Abuja, Nigeria
| | - F. Saleh
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - G. B. Ebhodaghe
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - A. Ahumibe
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - R. U. Yashe
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - R. Atteh
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - W. E. Nwachukwu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - C. Ezeokafor
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
- National Agency for the Control of AIDS, Abuja, Nigeria
| | - D. Olaleye
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Z. Habib
- Nigeria COVID-19 Research Consortium, Abuja, Nigeria
- University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - E. Pembi
- Ministry of Health and Human Services, Adamawa State, Nigeria
| | - D. John
- Department of Public Health, Health and Human Services Secretariat, FCT, Abuja, Nigeria
| | | | - H. Assad
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Nigeria
- Ministry of Health, Kebbi State, Nigeria
| | - Y. Gandi
- Department of Disease Control and Immunisation, Bauchi State Ministry of Health, Bauchi, Nigeria
| | - B. Muhammad
- Department of Public Health, Kano State Ministry of Health, Kano State, Nigeria
| | - C. Nwagwogu
- Department of Public Health, Abia State Ministry of Health, Abia State, Nigeria
| | - I. Nwadiuto
- Department of Public Health, Rivers State Ministry of Health, Rivers State, Nigeria
| | - K. Sulaiman
- Department of Epidemiology and Disease Control, Katsina State Ministry of Health, Katsina, Nigeria
| | - I. Iwuji
- Epidemiology Unit, Department of Public Health, Ministry of Health, Bayelsa State, Nigeria
| | - A. Okeji
- Epidemiology Unit, Department of Public Health, Ministry of Health, Imo State, Nigeria
| | - S. Thliza
- Epidemiology Unit, Department of Public Health, Ministry of Health, Borno State, Nigeria
| | - S. Fagbemi
- Department of Epidemiology and Disease Control, Ministry of Health, Ondo State, Nigeria
| | - R. Usman
- Department of Public Health, Zamfara State Ministry of Health, Zamfara State, Nigeria
| | - A. A. Mohammed
- Department of Public Health Services, Ministry of Health, Sokoto State, Nigeria
| | - O. Adeola-Musa
- Department of Public Health, Ministry of Health, Osun State, Nigeria
| | - M. Ishaka
- Department of Public Health, Yobe State Primary Healthcare Management Board, Yobe State, Nigeria
| | - U. Aketemo
- Department of Public Health, Taraba State Ministry of Health, Taraba State, Nigeria
| | - K. Kamaldeen
- Department of Public Health, Kwara State Ministry of Health, Kwara State, Nigeria
| | - C. E. Obagha
- Anambra State Ministry of Health, Anambra State, Nigeria
| | - A. O. Akinyode
- Directorate of Public Health, Oyo State Ministry of Health, Oyo State, Nigeria
| | - P. Nguku
- African Field Epidemiology Network, Abuja, Nigeria
| | - N. Mba
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - C. Ihekweazu
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Nigeria
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29
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Ajiboye OK, Katibi OS, Ayeni O, Osuoji C, Agbaje OA. Chest imaging findings in COVID-19 patients: a case series from Nigeria. Pan Afr Med J 2020; 37:39. [PMID: 33209166 PMCID: PMC7648470 DOI: 10.11604/pamj.2020.37.39.25006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/26/2020] [Indexed: 11/11/2022] Open
Abstract
COVID-19 is a global pandemic ravaging the whole world with large numbers of reported cases globally. It is a highly-contagious novel infectious disease that causes inflammation in the respiratory system. Chest imaging is a useful adjunct for diagnosis, documenting the extent of disease as well as observation of changes and is thus, strongly recommended in suspected COVID-19 cases, for initial evaluation, differential diagnoses and follow-up. Description of typical imaging findings abound worldwide with a dearth of similar publications in sub-Saharan Africa. This series documents the chest imaging findings from a single facility of four cases between the ages of 38 and 60 who all tested positive for COVID-19 with real-time, reverse transcriptase polymerase chain reaction of the nasopharyngeal swabs.
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Affiliation(s)
| | - Oludolapo Sherifat Katibi
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ohiole Ayeni
- Emergency Department, Cedarcrest Hospitals, Abuja, Nigeria
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30
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Olusola A, Olusola B, Onafeso O, Ajiola F, Adelabu S. Early geography of the coronavirus disease outbreak in Nigeria. GEOJOURNAL 2020; 87:733-747. [PMID: 32836703 PMCID: PMC7425795 DOI: 10.1007/s10708-020-10278-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
An understanding of the COVID-19 spread is growing around the world, yet little is known of Africa. This paper explores the time-space geographies of COVID-19 infection focusing on Africa and Nigeria especially. We appraise the global-to-local situation of confirmed cases, deaths and recoveries as well as measures engaged in response to the pandemic. Findings reveal that South Africa accounts for 40% of the total confirmed cases in Africa, followed by Egypt (18%), Nigeria (6.8%), Ghana (4.6%) and Algeria (3.6). Our study shows a significant relationship between population density and COVID-19 cases in Nigeria (R2 = 0.76; y = 2.43x - 268.7). This expression suggests that high population densities catalyze the spread of COVID-19. While Nigeria has only recorded about 25,964 cases as at the time of writing, the country is struggling to match pressures from rising cases as a result of existing disparities in health care systems.
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Affiliation(s)
- Adeyemi Olusola
- Department of Geography, University of the Free State, Bloemfontein, South Africa
| | - Babatunde Olusola
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olumide Onafeso
- Department of Geography, Olabisi Onabanjo University, Ago-Iwoye, Ogun State Nigeria
| | - Felix Ajiola
- Department of History and Strategic Studies, University of Lagos, Lagos, Nigeria
| | - Samuel Adelabu
- Department of Geography, University of the Free State, Bloemfontein, South Africa
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31
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Ijarotimi OA, Ubom AE, Olofinbiyi BA, Kuye-Kuku T, Orji EO, Ikimalo JI. COVID-19 and obstetric practice: A critical review of the Nigerian situation. Int J Gynaecol Obstet 2020; 151:17-22. [PMID: 32698245 PMCID: PMC9087677 DOI: 10.1002/ijgo.13325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022]
Abstract
Objective To review what is known about COVID‐19 and highlight gaps in the context of Nigerian obstetric practice. Research data on COVID‐19 are understandably sparse in Africa. Nigeria, like most African countries, is battling a disease she is poorly equipped to fight. Methods The current available literature on COVID‐19 was reviewed in relation to obstetric practice in the Nigerian context, gaps were identified, and recommendations were made to improve the handling of the COVID‐19 pandemic in Nigerian obstetric practice. Results In and out of hospital, both the obstetrician and the obstetric patient are constantly being put at risk of exposure to the coronavirus because testing and preventive measures are either ineffective or non‐existent. Conclusion The pandemic has exposed the gross inadequacies in Nigeria’s healthcare system and is therefore a wake‐up call to the need for a complete overhaul of infrastructure and services. The government will do well to increase the budget allocation for health from the current paltry 4.14% to the recommended 15% of the total budget. The Nigerian obstetrician stands a high risk of exposure due to inadequate preventive measures, and testing and diagnostic challenges. The Nigerian obstetrician stands a high risk of exposure due to inadequate preventive measures, and testing and diagnostic challenges.
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Affiliation(s)
- Omotade A Ijarotimi
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.,Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Akaninyene E Ubom
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Babatunde A Olofinbiyi
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, Ekiti State University/Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
| | - Taiwo Kuye-Kuku
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Lagos State University/Teaching Hospital, Lagos State, Lagos, Nigeria
| | - Ernest O Orji
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.,Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - John I Ikimalo
- Department of Obstetrics and Gynaecology, University of Port Harcourt/Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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