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Abubakar AT, Suleiman K, Ahmad SI, Yahaya SS, Bello UI, Suleiman BA, Haladu SA, Al-Mustapha AI, Abubakar MI. Acceptance of COVID-19 vaccine and associated factors among healthcare workers in Katsina state: a cross-sectional study in Northwest Nigeria. BMJ Open 2023; 13:e063281. [PMID: 38135321 DOI: 10.1136/bmjopen-2022-063281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVES Healthcare workers were prioritised to receive the COVID-19 vaccine in Nigeria. Administration of COVID-19 vaccination in Nigeria was challenging because of a lack of trust in vaccine safety and vaccine effectiveness among healthcare workers, who are expected to provide reliable information about vaccines and vaccine-preventable diseases in the communities. Hence, their acceptance and attitudes towards COVID-19 preventive practices could influence the acceptance of the vaccine by the local population. This cross-sectional study assessed the acceptance of the COVID-19 vaccine among healthcare workers in Katsina State. We predicted the variables that increased the vaccine acceptance using logistic regression analysis. SETTING This hospital-based study was conducted at primary, secondary and tertiary healthcare facilities in Nigeria. PARTICIPANTS A total of 793 healthcare workers were included in this study. Of these, 65.4% (n=519) were male. OUTCOME MEASURES To assess acceptance of COVID-19 vaccine measures, and factors increasing acceptance among healthcare workers. RESULTS Of the healthcare workers, 80% (638) were tested for the SARS-CoV-2, of whom 10.8% (n=65) tested positive. Approximately 97% (n=765) of them believed that the COVID-19 vaccine was safe, and 90% (n=714) received the first dose of the vaccine. Healthcare workers between 30 and 39 years were more likely to accept the vaccine (aOR: 7.06; 95% CI 2.36 to 21.07; p<0.001). Those who had been tested for COVID-19 were more likely (aOR:7.64; 95% CI 3.62 to 16.16; p<0.001) to accept the vaccine. CONCLUSIONS Our findings showed that the age and prior COVID-19 testing were the main factors influencing the acceptance of the COVID-19 vaccine. There was high acceptance of the COVID-19 vaccine among healthcare workers in Katsina State, Nigeria. Future studies should focus on the completion of doses and serological testing for immunity.
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Affiliation(s)
| | - Kabir Suleiman
- Epidemiology, Katsina State Primary Healthcare Agency, Katsina, Nigeria
| | - Suleiman Idris Ahmad
- African Field Epidemiology Network Nigeria, Abuja, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | | | | | | | | | - Ahmad Ibrahim Al-Mustapha
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Musa Imam Abubakar
- REDISSE Project, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
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Osungbade K, Ilesanmi O, Oladokun R, Adekanmbi O, Eze U, Afolabi A, Adetunji A, Kuti K, Ojifinni K, Olopha O, Dada-Adegbola H, Fowotade A, Adebiyi A, Oladipo T, Akinmoladun V, Otegbayo J. RESPONSE TO THE COVID-19 OUTBREAK: LESSONS FROM A TERTIARY HEALTHCARE FACILITY IN SOUTHWEST NIGERIA. Ann Ib Postgrad Med 2023; 21:57-68. [PMID: 38706617 PMCID: PMC11065180] [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: 06/13/2023] [Accepted: 12/30/2023] [Indexed: 05/07/2024] Open
Abstract
Background Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria. Methods A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method. Results Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff. Conclusion The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.
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Affiliation(s)
- K Osungbade
- Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Disease Surveillance Unit, University College Hospital, Ibadan, Nigeria
| | - O Ilesanmi
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - R Oladokun
- Department of Paediatrics, University College Hospital, Ibadan, Oyo State, Nigeria
- College of Medicine, University of Ibadan, Oyo State, Nigeria
| | - O Adekanmbi
- College of Medicine, University of Ibadan, Oyo State, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - U Eze
- Department of Pathology, University College Hospital, Ibadan, Nigeria
| | - A Afolabi
- Technical and Strategic Research Directorate, MSI Nigeria Reproductive Choices, Abuja, Nigeria
| | - A Adetunji
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - K Kuti
- Infectious Disease Institute, College of Medicine, University of Ibadan, Nigeria
- Staff Medical Services Department, University College Hospital, Ibadan, Nigeria
| | - K Ojifinni
- Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria
| | - O Olopha
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - H Dada-Adegbola
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - A Fowotade
- Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - A Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - T Oladipo
- Office of the Commissioner for Health, Oyo State Ministry of Health, Ibadan, Nigeria
| | - V Akinmoladun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | - J Otegbayo
- College of Medicine, University of Ibadan, Oyo State, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
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Osaigbovo II, Ogboghodo EO, Obarisiagbon OE, Obaseki DE. An assessment of COVID-19 vaccine knowledge and acceptability among healthcare workers in a Nigerian tertiary hospital. Ghana Med J 2023; 57:284-292. [PMID: 38957845 PMCID: PMC11215228 DOI: 10.4314/gmj.v57i4.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Objectives To assess the knowledge and acceptability of COVID-19 vaccines among HCWs. Design A descriptive cross-sectional study was conducted in March 2021 among eligible HCWs using a self-administered questionnaire. Setting The study was conducted in a southern Nigerian tertiary hospital. Participants All HCWs not on annual or study leave were eligible to participate. The number of HCWs in each occupational category was determined by proportional allocation. HCWs were selected by stratified sampling technique. Main outcome measures Knowledge of COVID-19 vaccines was assessed using 25 questions. The minimum and maximum scores were 0 and 25, respectively. Scores were converted to percentages. Scores of 50% and above were rated as good knowledge. Participants were also asked if they were willing to receive the vaccine. Results The mean age of 512 participating HCWs was 33.4±7.8 with an M:F ratio of 1:1.1. Overall, 399 (76.6%) had good knowledge. Occupation and exposure to COVID-19 were predictors of knowledge. Three hundred and twenty-eight respondents (63.0%) were willing to take the vaccine. Predictors of willingness to accept vaccination were age, sex, number of years in employment and knowledge about the vaccines (p< 0.05). Conclusions Most HCWs had good knowledge and were disposed to accepting the COVID-19 vaccine. Educational interventions are necessary to improve HCWs knowledge as they may provide vaccine-related information to the general public. Funding None declared.
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Affiliation(s)
- Iriagbonse I Osaigbovo
- Department of Medical Microbiology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Esohe O Ogboghodo
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Otaniyenuwa E Obarisiagbon
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
| | - Darlington E Obaseki
- Office of the Chief Medical Director/ Department of Anatomic Pathology, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State
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Lee EH, Rashid A, Lawal I, Adekanye U, Adamu Y, Godfrey C, Agaba PA, Okeji N, Desai P. Protecting healthcare workers and patients during the COVID-19 pandemic: a comparison of baseline and follow-up infection prevention and control needs in Nigerian military healthcare facilities delivering HIV services. BMC Health Serv Res 2023; 23:1254. [PMID: 37964245 PMCID: PMC10647028 DOI: 10.1186/s12913-023-10289-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/07/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities. METHODS We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: 'IPC program structure, funding and leadership engagement'; 'IPC policies, guidelines and standard operating procedures (SOPs)'; 'infrastructure'; 'triage and screening'; 'training, knowledge and practice'; 'personal protective equipment (PPE) materials, availability and adequacy'; 'biosafety and waste management'; and 'monitoring and remediation' prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation. RESULTS IPC readiness remained high at both baseline and follow-up assessments for 'IPC guidelines, policies, and SOPs' (96.7%). The components 'infrastructure' and 'monitoring and remediation', which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in 'IPC program structure, funding and leadership engagement', 'training, knowledge and practice', and 'biosafety and waste management'. 'PPE materials availability and adequacy' improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for 'triage and screening' did not change from baseline to follow-up (73%). CONCLUSION Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
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Affiliation(s)
- Elizabeth H Lee
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Ayesha Rashid
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Ismail Lawal
- US Army Medical Research Directorate - Africa/Nigeria, Walter Reed Army Institute of Research, Abuja, Nigeria
| | - Usman Adekanye
- Nigerian Ministry of Defence - Health Implementation Programme, Abuja, Nigeria
| | - Yakubu Adamu
- US Army Medical Research Directorate - Africa/Nigeria, Walter Reed Army Institute of Research, Abuja, Nigeria
| | - Catherine Godfrey
- Office of the Global AIDS Coordinator, Department of State, US President's Emergency Plan for AIDS Relief, Washington, DC, USA
| | - Patricia A Agaba
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Nathan Okeji
- Nigerian Ministry of Defence - Health Implementation Programme, Abuja, Nigeria
| | - Priyanka Desai
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
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Risk Factors for COVID-19 Infection among Healthcare Workers in North-East Nigeria. Healthcare (Basel) 2022; 10:healthcare10101919. [PMID: 36292365 PMCID: PMC9601610 DOI: 10.3390/healthcare10101919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
Healthcare workers (HCWs) face an unprecedented higher risk of COVID-19 infection due to their work and exposure. In this study, we aim to examine the associated risk factors for COVID-19 infection among HCWs in North-East Nigeria. We used data collected retrospectively among a cohort of clinical and non-clinical HCWs in six healthcare facilities in Adamawa State, Nigeria. We estimated the marginal probability of COVID-19 infection among HWCs using alternating logistic regression via the generalized estimating equations (GEE) approach. Among the 318 HCWs, 178 (55.97%) were males, mean (±SD) age was 36.81 (±8.98), 237 (74.76%) were clinical, and 80 (25.24) were non-clinical staff. The overall prevalence of COVID-19 was 16.67% among HCWs. After adjusting for other variables in the model, our results showed that clinical staff had a 5-fold higher risk of COVID-19 infection than non-clinical staff (aOR = 5.07, 95% CI: 1.32–19.52). Moreover, significant exposure risk factors for COVID-19 infection for HCWs increase with age, time spent attending to patients, caring for COVID-19 patients, and having worked with COVID-19 samples, while the risk decreases with the use of an N95 mask. Our findings suggested that the burden of COVID-19 infection is higher for clinical staff than non-clinical staff, and increasing age contributed to the increased risk.
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Umeozuru CM, Usman AB, Olorukooba AA, Abdullahi IN, John DJ, Lawal LA, Uwazie CC, Balogun MS. Performance of COVID-19 case-based surveillance system in FCT, Nigeria, March 2020 –January 2021. PLoS One 2022; 17:e0264839. [PMID: 35421123 PMCID: PMC9009682 DOI: 10.1371/journal.pone.0264839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The emergence of novel SARS-CoV-2 has caused a pandemic of Coronavirus Disease 19 (COVID-19) which has spread exponentially worldwide. A robust surveillance system is essential for correct estimation of the disease burden and containment of the pandemic. We evaluated the performance of COVID-19 case-based surveillance system in FCT, Nigeria and assessed its key attributes. Methods We used a cross-sectional study design, comprising a survey, key informant interview, record review and secondary data analysis. A self-administered, semi-structured questionnaire was administered to key stakeholders to assess the attributes and process of operation of the surveillance system using CDC’s Updated Guidelines for Evaluation of Public Health Surveillance System 2001. Data collected alongside surveillance data from March 2020 to January 2021 were analyzed and summarized using descriptive statistics. Results Out of 69,338 suspected cases, 12,595 tested positive with RT-PCR with a positive predictive value (PPV) of 18%. Healthcare workers were identified as high-risk group with a prevalence of 23.5%. About 82% respondents perceived the system to be simple, 85.5% posited that the system was flexible and easily accommodates changes, 71.4% reported that the system was acceptable and expressed willingness to continue participation. Representativeness of the system was 93%, stability 40%, data quality 56.2% and timeliness 45.5%, estimated result turnaround time (TAT) was suboptimal. Conclusion The system was found to be useful, simple, flexible, sensitive, acceptable, with good representativeness but the stability, data quality and timeliness was poor. The system meets initial surveillance objectives but rapid expansion of sample collection and testing sites, improvement of TAT, sustainable funding, improvement of electronic database, continuous provision of logistics, supplies and additional trainings are needed to address identified weaknesses, optimize the system performance and meet increasing need of case detection in the wake of rapidly spreading pandemic. More risk-group persons should be tested to improve surveillance effectiveness.
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Affiliation(s)
- Chikodi Modesta Umeozuru
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
- * E-mail:
| | | | | | - Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Doris Japhet John
- Department of Public Health, Federal Capital Territory Administration, Abuja, Nigeria
| | - Lukman Ademola Lawal
- Department of Public Health, Federal Capital Territory Administration, Abuja, Nigeria
| | - Charles Chukwudi Uwazie
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
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Self medication practices and its determinants in health care professionals during the coronavirus disease-2019 pandemic: cross-sectional study. Int J Clin Pharm 2022; 44:507-516. [PMID: 35022953 PMCID: PMC8754192 DOI: 10.1007/s11096-021-01374-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/23/2021] [Indexed: 12/12/2022]
Abstract
Background The exposure of health care professionals (HCP) to patients with coronavirus disease-2019 (COVID-19) in the course of performing their professional duties may expose them to contracting the virus. This may likely increase their tendency to self-medicate for prevention or treatment of perceived infection. Aim This study determined the prevalence of COVID-19 related self-medication and its determinants among HCPs in three tertiary hospitals in Southern Nigeria. Method This was a cross-sectional study that enrolled 669 adult HCPs from three tertiary hospitals in three Southern Nigerian States using a non-probability convenience sampling method. A structured self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM SPSS version 22. Results The mean age of the respondents was 35.6 ± 8.7 years. Two hundred and forty-three respondents (36.3%) reported having practiced COVID-19 related self-medication. The commonly used medications were ivermectin, azithromycin, vitamin C, chloroquine and zinc. Factors associated with self-medication were older age (p = < 0.0001), being pharmacist (p = 0.03), higher income (p = < 0.0001), previous COVID-19 testing (p < 0.001). Predictors of self medication were > 44 years (Adjusted Odd Ratio[AOR]:2.77,95% Confidence Interval [CI]: 1.62–4.75, p = < 0.0001), previous COVID-19 testing (AOR = 2.68, 95% CI: 1.82–3.94, p = < 0.0001). Conclusion About one-third of HCPs practiced COVID-19 related self-medication. HCPs that are often assumed to be health literate may not necessarily practice safe health behavior. Regular health education of the HCPs on implications of self-medications is highly recommended. There should also be formulation and effective implementation of policies that regulate purchase of medications.
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Ogboghodo EO, Osaigbovo II, Obaseki DE, Iduitua MTN, Asamah D, Oduware E, Okwara BU. Implementation of a COVID-19 screening tool in a southern Nigerian tertiary health facility. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000578. [PMID: 36962763 PMCID: PMC10021546 DOI: 10.1371/journal.pgph.0000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
Screening for coronavirus disease 2019 (COVID-19) in emergency rooms of health facilities during outbreaks prevents nosocomial transmission. However, effective tools adapted for use in African countries are lacking. This study appraised an indigenous screening and triage tool for COVID-19 deployed at the medical emergency room of a Nigerian tertiary facility and determined the predictors of a positive molecular diagnostic test for COVID-19. A cross-sectional study of all patients seen between May and July 2020 at the Accident and Emergency of the University of Benin Teaching Hospital was conducted. Patients with any one of the inputs- presence of COVID-19 symptoms, history of international travel, age 60 years and above, presence of comorbidities and oxygen saturation < 94%- were stratified as high-risk and subjected to molecular testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Data was obtained from the screening record book patterned after a modified screening tool for COVID-19, deidentified and entered into IBM-SPSS version 25.0. Binary logistic regression was conducted to determine significant predictors of a positive SARS-CoV-2 test. The level of significance was set at p < 0.05. In total, 1,624 patients were screened. Mean age (standard deviation) was 53.9±18.0 years and 651 (40.1%) were 60 years and above. One or more symptoms of COVID-19 were present in 586 (36.1%) patients. Overall, 1,116 (68.7%) patients were designated high risk and tested for SARS-CoV-2, of which 359 (32.2%) were positive. Additional inputs, besides symptoms, increased COVID-19 detection by 108%. Predictors of a positive test were elderly age [AOR = 1.545 (1.127-2.116)], co-morbidity [AOR = 1.811 (1.296-2.530)] and oxygen saturation [AOR = 3.427 (2.595-4.528)]. This protocol using additional inputs such as oxygen saturation improved upon symptoms-based screening for COVID-19. Models incorporating identified predictors will be invaluable in resource limited settings.
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Affiliation(s)
- Esohe O Ogboghodo
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Iriagbonse I Osaigbovo
- Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Darlington E Obaseki
- Chief Medical Director's Office, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Micah T N Iduitua
- Accident and Emergency Department, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Doris Asamah
- Department of Nursing Services, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Emmanuel Oduware
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Benson U Okwara
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
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Adebisi YA, Rabe A, Lucero-Prisno III DE. COVID-19 surveillance systems in African countries. Health Promot Perspect 2021; 11:382-392. [PMID: 35079582 PMCID: PMC8767077 DOI: 10.34172/hpp.2021.49] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/08/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d'Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed. Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others. Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.
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Affiliation(s)
- Yusuff Adebayo Adebisi
- Global Health Focus Africa, Nigeria
- African Young Leaders for Global Health, Abuja, Nigeria
- Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Adrian Rabe
- Global Health Focus Africa, Nigeria
- Faculty of Medicine, School of Public Health, Imperial College London, UK
| | - Don Eliseo Lucero-Prisno III
- Global Health Focus Africa, Nigeria
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
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Akande OW, Elimian KO, Igumbor E, Dunkwu L, Kaduru C, Olopha OO, Ohanu DO, Nwozor L, Agogo E, Aruna O, Balogun MS, Aderinola O, Ahumibe A, Arinze C, Badaru SO, Nwachukwu W, Dada AO, Erameh C, Hamza K, Mohammed TB, Ndodo N, Obiekea C, Ofoegbunam C, Ogunbode O, Ohonsi C, Tobin EA, Yashe R, Adekaiyaoja A, Asuzu MC, Audu RA, Bello MB, Bello SO, Deeni YY, Disu Y, Joseph G, Ezeokafor C, Habib ZG, Ibeh C, Ike IF, Iwara E, Luka-Lawal RK, Namara G, Okwor T, Olajide L, Ilesanmi OO, Omonigho S, Oyiri F, Takpa K, Ugbogulu NU, Ibekwe P, Oladejo J, Ilori E, Ochu CL, Ihekweazu C. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021. BMJ Glob Health 2021; 6:bmjgh-2021-007076. [PMID: 34794956 PMCID: PMC8602923 DOI: 10.1136/bmjgh-2021-007076] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.
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Affiliation(s)
- Oluwatosin Wuraola Akande
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria .,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Kelly Osezele Elimian
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Lauryn Dunkwu
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Chijioke Kaduru
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,IQVIA, Abuja, Nigeria
| | - Olubunmi Omowunmi Olopha
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Dabri Olohije Ohanu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Lilian Nwozor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Emmanuel Agogo
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Resolve to Save Lives, Abuja, Federal Capital Territory, Nigeria
| | - Olusola Aruna
- International Health Regulations (IHR) Strengthening Project, Global Operations, UK Health Security Agency, London, UK
| | | | - Olaolu Aderinola
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Anthony Ahumibe
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinedu Arinze
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Sikiru Olanrewaju Badaru
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - William Nwachukwu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | | | - Cyril Erameh
- Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Tarik Benjamin Mohammed
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Nnaemeka Ndodo
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Celestina Obiekea
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinenye Ofoegbunam
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oladipo Ogunbode
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Cornelius Ohonsi
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | | | - Rimamdeyati Yashe
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Afolabi Adekaiyaoja
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Michael C Asuzu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Rosemary Ajuma Audu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Muhammad Bashir Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Center for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Shaibu Oricha Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Pharmacology & Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Yusuf Yahaya Deeni
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology & Biotechnology, Federal University Dutse, Dutse, Jigawa State, Nigeria.,Centre for Environmental and Public Health Research and Development, Kano, Kano State, Nigeria
| | - Yahya Disu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Gbenga Joseph
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chidiebere Ezeokafor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria
| | - Zaiyad Garba Habib
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,University of Abuja Teaching Hospital, Gwagwalada, Abuja, Federal Capital Territory, Nigeria
| | - Christian Ibeh
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Emem Iwara
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Maryland Global Initiatives Corporation, Abuja, Federal Capital Territory, Nigeria
| | - Rejoice Kudirat Luka-Lawal
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Geoffrey Namara
- World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Tochi Okwor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Lois Olajide
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oluwafunke Olufemi Ilesanmi
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Solomon Omonigho
- Department of Microbiology, University of Benin, Benin, Edo State, Nigeria
| | - Ferdinand Oyiri
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Koubagnine Takpa
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Joint United Nations Programme on AIDS (UNAIDS), Abuja, Federal Capital Territory, Nigeria
| | - Nkem Usha Ugbogulu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Priscilla Ibekwe
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - John Oladejo
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Elsie Ilori
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinwe Lucia Ochu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Chikwe Ihekweazu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
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11
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Aborode AT, Hasan MM, Jain S, Okereke M, Adedeji OJ, Karra-Aly A, Fasawe AS. Impact of poor disease surveillance system on COVID-19 response in africa: Time to rethink and rebuilt. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100841. [PMID: 34368503 PMCID: PMC8330137 DOI: 10.1016/j.cegh.2021.100841] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 02/08/2023] Open
Abstract
Infectious disease outbreaks have long posed a public health threat, especially in Africa, where the incidence of infectious outbreaks has risen exponentially. Although, Africa has witnessed several outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic-prone diseases, little attention has been given towards strengthening the health surveillance systems. However, the recent COVID-19 pandemic has uncovered the region's already due to inefficient and ineffective health surveillance systems. However, the impact posed by the COVID-19 pandemic on health systems in the region has been catastrophic, it has also stressed the importance of rethinking and focusing on lessons learned during the COVID-19 pandemic. In this paper, we examine how Africa's poor disease surveillance systems affected the responses and strategies aimed at COVID-19 containment. To ensure early disease outbreak identification and prompt public health interventions in Africa, the current disease surveillance and response mechanisms must be strengthened.
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Affiliation(s)
- Abdullahi Tunde Aborode
- Healthy Africans Platform, Research and Development, Ibadan, Nigeria.,West African Institute of Public Health, Abuja, Nigeria
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, 1902, Bangladesh.,Division of Infectious Diseases, The Red-Green Research Centre, BICCB, Dhaka, 1215, Bangladesh
| | | | - Melody Okereke
- Faculty of Pharmaceutical Sciences, University of Ilorin, Kwara State, Nigeria
| | | | - Ayah Karra-Aly
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Ayoola S Fasawe
- Department of Cellular Biology and Genetics, Illinois State University, USA
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