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Thomas TK, Umeokonkwo CD, Sesay HW, Adewuyi P, Babalola OJ, Wachekwa I, Amo-Addae MP. Maternal mortality review in a major tertiary referral hospital in Liberia, 2018-2021. Heliyon 2024; 10:e28001. [PMID: 38560688 PMCID: PMC10979222 DOI: 10.1016/j.heliyon.2024.e28001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives Anecdotal evidence showed increased maternal deaths at the major tertiary hospital over the past two years (2020-2021). We reviewed the maternal death audit data, identified the main causes of maternal death, and associated risk factors. Findings were shared with policymakers to help reduce maternal mortality. Study design We conducted a secondary data review and descriptive analysis of maternal death at the tertiary hospital located in Monrovia. Method The maternal death data were extracted from patient medical records, including death certificates and maternal audit records. The record of live births was obtained from the delivery register. Data were analyzed using Epi Info version 7.2 Maternal mortality ratio (MMR) was estimated, the leading direct and indirect causes of maternal death were identified, and the factors associated with maternal death were explored using logistic regression at a 5% level of significance. Results There are a total of 233 maternal deaths and 14, 879 live births giving a maternal mortality ratio (MMR) of 1565 per 100,000 live births during the period under review. The median age of the mothers at death was 29 (14-45) years. About 40.3% (94/233) of cases died within <1 day of admission, referrals accounted for 59% (137/233) of the cases. Direct causes of death accounted for 66% (147/223). Hemorrhage [30.6% (45/147)], Eclampsia [(30/147) 20.6%] and Sepsis [(30/147) 20.6%] were the main direct causes of death while cardiovascular-related [18.4% (14/76)] and HIV/AIDS [16% (12/76)] were the leading indirect cause of death. Patients from referred other facilities were 7.9 times more likely to die as compared to non-referral (pOR:7.9, 95%CI: 5.9-10.6, p < 0.001). Conclusion The maternal mortality ratio remained high. Referrals were done late. The Liberia Ministry of Health should equip more secondary-level health facilities and tertiary hospitals to handle maternal emergencies and sensitize the populace and healthcare workers on prompt identification and referral of obstetric emergencies. The MoH also needs to improve the blood transfusion services to help in the management of postpartum hemorrhage.
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Affiliation(s)
- Tete K Thomas
- Liberia Field Epidemiology Training Program, Liberia
- John F. Kennedy Medical Center, Monrovia, Liberia
| | | | - Himiede W Sesay
- Liberia Field Epidemiology Training Program, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Peter Adewuyi
- Liberia Field Epidemiology Training Program, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Obafemi J Babalola
- Liberia Field Epidemiology Training Program, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Ian Wachekwa
- John F. Kennedy Medical Center, Monrovia, Liberia
| | - Maame P Amo-Addae
- Liberia Field Epidemiology Training Program, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
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Dwalu E, Jetoh RW, Shobayo BI, Pewu I, Taweh F, Wilson-Sesay HW, Akpan GE, Shannon F, Joseph BO, Umeokonkwo CD, Adewuyi P, Amo-Addae M, Nagbe TK, Gilayeneh J, MaCauley JA. Trend of Lassa fever cases and factors associated with mortality in Liberia, 2016 - 2021: a secondary data analysis. Pan Afr Med J 2024; 47:22. [PMID: 38558556 PMCID: PMC10979808 DOI: 10.11604/pamj.2024.47.22.42156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 04/04/2024] Open
Abstract
Introduction Lassa fever (LF) is endemic in Liberia and is immediately reportable. Suspected cases are confirmed at the National Public Health Reference Laboratory. However, there is limited information on the trend and factors associated with mortality. We described the epidemiological characteristics of LF cases and determined factors associated with mortality in Liberia from 2016 to 2021. Methods we reviewed 867 case-based LF surveillance data from 2016 to 2021 obtained from the National Public Health Institute of Liberia (NPHIL). The cases that met the suspected LF case definition were tested with RT-PCR. Using Epi Info 7.2.5.0. We conducted univariate, bivariate, and multivariate and analysis. We calculated frequencies, proportions. Positivity rate, case fatality rate, and factors associated with LF mortality using chi-square statistics and logistics regression at 5% level of significance. Results eighty-five percent (737/867) of the suspected cases were tested and 26.0% (192/737) were confirmed LF positive. The median age of confirmed LF cases was 21(IQR: 12-34) years. Age 10-19 years accounted for 24.5% (47/192) and females 54.2% (104/192). Bong 33.9% (65/192), Grand Bassa 31.8% (61/192), and Nimba counties, 21.9% (42/192) accounted for most of the cases. The median duration from symptom onset to hospital admission was 6 (IQR: 3-9) days. A majority, 66% (126/192) of the cases were reported during the dry season (October-March) and annual incidence was highest at 12 cases per 1,000,000 population in 2019 and 2020. The overall case fatality rate was 44.8%. Non-endemic counties, Margibi, 77.8% and Montserrado, 66.7% accounted for the highest case fatality rate (CFR), while 2018, 66.7% and 2021, 60.0% recorded the highest CFR during the period. Age ≥30 years (aOR=2.1,95% CI: 1.08-4.11, p=0.027) and residing in Grand Bassa County (aOR=0.3, 95% CI: 0.13-0.73, p=0.007) were associated with LF mortality. Conclusion Lassa fever was endemic in three of the fifteen counties of Liberia, case fatality rate remained generally high and widely varied. The high fatality of LF has been reported to the NPHIL and is currently being further investigated. There is a need to continuously train healthcare workers, especially in non-endemic counties to improve the LF treatment outcome.
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Affiliation(s)
- Emmanuel Dwalu
- National Public Health Institute of Liberia, Monrovia, Liberia
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
| | - Ralph Weah Jetoh
- National Public Health Institute of Liberia, Monrovia, Liberia
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
| | | | - Irene Pewu
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Fahn Taweh
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Himiede Wede Wilson-Sesay
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Godwin Etim Akpan
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Fulton Shannon
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
| | - Babalola Obafemi Joseph
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Chukwuma David Umeokonkwo
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Peter Adewuyi
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Maame Amo-Addae
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
- African Field Epidemiology Network, Monrovia, Liberia
| | - Thomas Knue Nagbe
- National Public Health Institute of Liberia, Monrovia, Liberia
- Liberia Field Epidemiology Training Program, Monrovia, Liberia
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Bastani P, Jammeh A, Lamar F, Malenfant JH, Adewuyi P, Cavanaugh AM, Calloway K, Crisp C, Fofana N, Hallett TC, Jallow A, Muoneke U, Nyassi M, Thomas J, Troeschel A, Yard E, Yeh M, Bittaye M. Acute Kidney Injury Among Children Likely Associated with Diethylene Glycol-Contaminated Medications - The Gambia, June-September 2022. MMWR Morb Mortal Wkly Rep 2023; 72:217-222. [PMID: 36862590 PMCID: PMC9997663 DOI: 10.15585/mmwr.mm7209a1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
On July 26, 2022, a pediatric nephrologist alerted The Gambia's Ministry of Health (MoH) to a cluster of cases of acute kidney injury (AKI) among young children at the country's sole teaching hospital, and on August 23, 2022, MoH requested assistance from CDC. CDC epidemiologists arrived in The Gambia, a West African country, on September 16 to assist MoH in characterizing the illness, describing the epidemiology, and identifying potential causal factors and their sources. Investigators reviewed medical records and interviewed caregivers to characterize patients' symptoms and identify exposures. The preliminary investigation suggested that various contaminated syrup-based children's medications contributed to the AKI outbreak. During the investigation, MoH recalled implicated medications from a single international manufacturer. Continued efforts to strengthen pharmaceutical quality control and event-based public health surveillance are needed to help prevent future medication-related outbreaks.
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Akpan GE, Bawo L, Amo-Addae M, Kennedy J, Wesseh CS, Whesseh F, Adewuyi P, Sanvee-Blebo L, Babalola J, Sesay HWW, Yeabah TO, Jackson D, Shannon F, Umeokonkwo CD, Nyenswah AW, Macauley J, Jallah W. COVID-19 reinfection in Liberia: Implication for improving disease surveillance. PLoS One 2022; 17:e0265768. [PMID: 35324956 PMCID: PMC8947140 DOI: 10.1371/journal.pone.0265768] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
COVID-19 remains a serious disruption to human health, social, and economic existence. Reinfection with the virus intensifies fears and raises more questions among countries, with few documented reports. This study investigated cases of COVID-19 reinfection using patients’ laboratory test results between March 2020 and July 2021 in Liberia. Data obtained from Liberia’s Ministry of Health COVID-19 surveillance was analyzed in Excel 365 and ArcGIS Pro 2.8.2. Results showed that with a median interval of 200 days (Range: 99–415), 13 out of 5,459 cases were identified and characterized as reinfection in three counties during the country’s third wave of the outbreak. Eighty-six percent of the COVID-19 reinfection cases occurred in Montserrado County within high clusters, which accounted for over 80% of the randomly distributed cases in Liberia. More cases of reinfection occurred among international travelers within populations with high community transmissions. This study suggests the need for continued public education and surveillance to encourage longer-term COVID-19 preventive practices even after recovery.
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Affiliation(s)
- Godwin E. Akpan
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
- * E-mail:
| | - Luke Bawo
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Maame Amo-Addae
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Jallah Kennedy
- Office of the Executive Director, Roads To Health (Roads to Rural and Vulnerable Population Health), Galloway, New Jersey, United States of America
| | - C. Sanford Wesseh
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Faith Whesseh
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Peter Adewuyi
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Lily Sanvee-Blebo
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Joseph Babalola
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Himiede W. W. Sesay
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
| | - Trokon O. Yeabah
- Division of Infectious Disease and Epidemiology, National Public Health Institute of Liberia, Monrovia, Liberia
| | - Dikena Jackson
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Fulton Shannon
- Department of Planning, Research and Development, Ministry of Health, Monrovia, Liberia
| | - Chukwuma David Umeokonkwo
- Division of Field Epidemiology Training Program, African Field Epidemiology Network, Monrovia, Liberia
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Abraham W. Nyenswah
- Division of Infectious Disease and Epidemiology, National Public Health Institute of Liberia, Monrovia, Liberia
| | - Jane Macauley
- Office of the Director General, National Public Health Institute of Liberia, Monrovia, Liberia
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Welle SC, Ajumobi O, Dairo M, Balogun M, Adewuyi P, Adedokun B, Nguku P, Gidado S, Ajayi I. Preference for Artemisinin-based combination therapy among healthcare providers, Lokoja, North-Central Nigeria. Glob Health Res Policy 2019; 4:1. [PMID: 30680328 PMCID: PMC6339351 DOI: 10.1186/s41256-018-0092-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
Background In Nigeria, Artemisinin-based Combination Therapy (ACT) is the recommended first line antimalarial medicine for uncomplicated malaria. However, health care providers still continue the use of less efficacious medicines such as Sulphadoxine-pyrimethamine and chloroquine. We therefore determined preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, North-Central Nigeria as well as assessed healthcare providers' knowledge of malaria case management. Methods We conducted a cross-sectional study among physicians, nurses, pharmacists, community health officers (CHOs), community health extension workers (CHEWs) and, patent and proprietary medicine vendors (PPMVs). Interviewer-administered questionnaires were administered to collect data on respondents' characteristics, previously received malaria case management training and knowledge of malaria treatment. Knowledge scores ≥3 were categorised as good, maximum obtainable being 5. Results Of the 404 respondents, 214 (53.0%) were males. Overall, 219 (54.2%) respondents who received malaria case management training included PPMVs: 79 (65.8%), CHEWs: 25 (64.1%), CHOs: 5 (55.6%), nurses: 72 (48.7%), physicians: 35 (47.3%) and pharmacists: 3 (23.1%). Overall, 202 (50.0%) providers including physicians: 69 (93.2%), CHO: 8 (88.9%), CHEWs: 33 (84.6%), pharmacists: 8 (61.5%), nurses: 64 (43.2%) and PPMVs: 20 (16.5%), had good knowledge of malaria treatment guidelines. Overall, preference for ACT among healthcare providers was 39.6%. Physicians: 50 (67.6%), pharmacists: 7 (59.3%) CHOs: 5 (55.6%), CHEWS: 16 (41.0%), nurses: 56 (37.8%) and PPMV: 24 (19.8%) had PFA. Receiving malaria case management training (adjusted odds ratio [aOR]) = 2.3; CI = 1.4 - 3.7) and having good knowledge of malaria treatment (aOR = 4.0; CI = 2.4 - 6.7) were associated with PFA. Conclusions Overall preference for ACT use was low among health care providers in this study. Preference for ACTs and proportion of health workers with good knowledge of malaria case management were even lower among PPMVs who had highest proportion of those who received malaria case management training. We recommend evaluation of current training quality, enhanced targeted training, follow-up supportive supervision of PPMVs and behavior change communication on ACT use.
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Affiliation(s)
- Sylvanus C Welle
- 1Division of Health Promotion, Department of Family Health, Federal Ministry of Health, Abuja, Nigeria.,Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,3African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Magbagbeola Dairo
- 4Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Muhammad Balogun
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,3African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Peter Adewuyi
- Liberia Field Epidemiology Training Programme, Monrovia, Liberia
| | - Babatunde Adedokun
- 4Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,3African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - Saheed Gidado
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,3African Field Epidemiology Network, Nigeria Country Office, Abuja, Nigeria
| | - IkeOluwapo Ajayi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.,4Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
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6
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Usman SA, Shehu A, Ajumobi O, Gidado S, Dalhatu I, Balogun M, Riyad M, Saude I, Adewuyi P, Nsubuga P. Predictors of non-adherence to antiretroviral therapy among HIV patients in secondary health care facilities in Kano State- Nigeria: a case-control study. Pan Afr Med J 2019; 32:3. [PMID: 30984325 PMCID: PMC6445334 DOI: 10.11604/pamj.supp.2019.32.1.13746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 05/09/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Treatment success requires both a sustainable supply of Antiretroviral Therapy (ART) to clinics and lifelong adherence to treatment by patients. Poor adherence to medication may lead to treatment failure as a result of developing HIV resistance strains. Based on WHO 2014 guideline, over 26 million people will be additionally enrolled globally. Optimal treatment requires identification of patients with suboptimal adherence for targeted intervention. The aim of the study was to determine the predictors of non-adherence to ART. Methods An unmatched 1:2 case-control study with 68 cases using simple random sampling. A case was defined as an ART patient who failed to achieve increase in CD4 count of 100cell/mm3 in one year. Controls are those with adequate immunological response. Questionnaires were administered for socio-demographic and adherence-related information. Bivariate and multivariable logistic regression was done using Epi Info at 95% Confidence Interval (CI) and precision of 5%. Results A total of 204 patients were enrolled, mean age of cases was 36 (Standard Deviation Sd=8.8), n=68 and controls 37 (Sd=9.8), n=136. Of enrollees, 69.6% (142) were females. Mean duration on ART was 4.9 years for cases and 4.5 years for controls (standard deviation = ± 2.2 years). The commonest reason for missing drugs was forgetfulness (58% cases). On multivariate analysis, having formal education (Adjusted Odds Ratio [aOR] = 3.03, 95% CI = 1.5-6.0) and income above minimum wage, (aOR = 2.38, 95% CI = 1.06-4.76) were independently associated with non-adherence. The commonest reason for missing drugs was forgetfulness (58% cases). Conclusion In conclusion, educated people and those with higher income were more likely to be non-adherent and should be the focus of adherence counseling. Some form of reminders like use of telephone should be adopted to address forgetfulness.
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Affiliation(s)
| | | | - Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Program, Nigeria
| | - Saheed Gidado
- Nigeria Field Epidemiology and Laboratory Training Program, Nigeria
| | | | - Muhammad Balogun
- Nigeria Field Epidemiology and Laboratory Training Program, Nigeria
| | | | - Ibrahim Saude
- Nigeria Field Epidemiology and Laboratory Training Program, Nigeria
| | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training Program, Nigeria
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7
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Musa EO, Adedire E, Adeoye O, Adewuyi P, Waziri N, Nguku P, Nanjuya M, Adebayo B, Fatiregun A, Enya B, Ohuabunwo C, Sabitu K, Shuaib F, Okoh A, Oguntimehin O, Onyekwere N, Nasidi A, Olayinka A. Epidemiological profile of the Ebola virus disease outbreak in Nigeria, July-September 2014. Pan Afr Med J 2015; 21:331. [PMID: 26587177 PMCID: PMC4633745 DOI: 10.11604/pamj.2015.21.331.5834] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/14/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION In July 2014, Nigeria experienced an outbreak of Ebola virus disease following the introduction of the disease by an ill Liberian Traveler. The Government of Nigeria with the support of Technical and Development Partners responded quickly and effectively to contain the outbreak. The epidemiological profile of the outbreak that majorly affected two States in the country in terms of person, place and time characteristics of the cases identified is hereby described. METHODS Using field investigation technique, all confirmed and probable cases were identified, line-listed and analysed using Microsoft Excel 2007 by persons, time and place. RESULTS A total of 20 confirmed and probable cases; 16 in Lagos (including the index case from Liberia) and 4 in Port Harcourt were identified. The mean age was 39.5 ± 12.4 years with over 40% within the age group 30-39 years. The most frequent exposure type was direct physical contact in 70% of all cases and 73% among health care workers. The total case-fatality was 40%; higher among healthcare workers (46%) compared with non-healthcare workers (22%). The epidemic curve initially shows a typical common source outbreak, followed by a propagated pattern. CONCLUSION Investigation revealed the size and spread of the outbreak and provided information on the characteristics of persons, time and place. Enhanced surveillance measures, including contact tracing and follow- up proved very useful in early case detection and containment of the outbreak.
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Affiliation(s)
| | | | - Olawunmi Adeoye
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | | | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Miriam Nanjuya
- World Health Organization, Department of Communicable Diseases, Kampala District, Uganda
| | - Bisola Adebayo
- Department of Community Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Akinola Fatiregun
- World Health Organisation, Field Office, State Ministry of Health, Akure, Ondo State, Nigeria
| | - Bassey Enya
- World Health Organization, Country Office, Abuja, Nigeria
| | - Chima Ohuabunwo
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
| | - Kabiru Sabitu
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja ; Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Alex Okoh
- Federal Ministry of Health, Abuja, Nigeria
| | | | | | | | - Adebola Olayinka
- Nigeria Field Epidemiology and Laboratory Training programme, Abuja
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8
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Tom-Aba D, Olaleye A, Olayinka AT, Nguku P, Waziri N, Adewuyi P, Adeoye O, Oladele S, Adeseye A, Oguntimehin O, Shuaib F. Innovative Technological Approach to Ebola Virus Disease Outbreak Response in Nigeria Using the Open Data Kit and Form Hub Technology. PLoS One 2015; 10:e0131000. [PMID: 26115402 PMCID: PMC4482726 DOI: 10.1371/journal.pone.0131000] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The recent outbreak of Ebola Virus Disease (EVD) in West Africa has ravaged many lives. Effective containment of this outbreak relies on prompt and effective coordination and communication across various interventions; early detection and response being critical to successful control. The use of information and communications technology (ICT) in active surveillance has proved to be effective but its use in Ebola outbreak response has been limited. Due to the need for timeliness in reporting and communication for early discovery of new EVD cases and promptness in response; it became imperative to empower the response team members with technologies and solutions which would enable smooth and rapid data flow. The Open Data Kit and Form Hub technology were used in combination with the Dashboard technology and ArcGIS mapping for follow up of contacts, identification of cases, case investigation and management and also for strategic planning during the response. A remarkable improvement was recorded in the reporting of daily follow-up of contacts after the deployment of the integrated real time technology. The turnaround time between identification of symptomatic contacts and evacuation to the isolation facility and also for receipt of laboratory results was reduced and informed decisions could be taken by all concerned. Accountability in contact tracing was ensured by the use of a GPS enabled device. The use of innovative technologies in the response of the EVD outbreak in Nigeria contributed significantly to the prompt control of the outbreak and containment of the disease by providing a valuable platform for early warning and guiding early actions.
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Affiliation(s)
- Daniel Tom-Aba
- African Field Epidemiology Network, Abuja Office, Abuja, Nigeria
| | | | - Adebola Tolulope Olayinka
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
- Ahmadu Bello University, Zaria, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Ndadilnasiya Waziri
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Olawunmi Adeoye
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
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9
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Oladimeji AM, Gidado S, Nguku P, Nwangwu IG, Patil ND, Oladosu F, Roberts AA, Waziri NE, Shuaib F, Oguntimehin O, Musa E, Nasidi A, Adewuyi P, Olayinka A, Odubanjo O, Poggensee G. Ebola virus disease - gaps in knowledge and practice among healthcare workers in Lagos, August 2014. Trop Med Int Health 2015; 20:1162-1170. [PMID: 25943138 DOI: 10.1111/tmi.12528] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Healthcare workers (HCWs) play pivotal roles in outbreak responses. Ebola virus disease (EVD) outbreak spread to Lagos, Nigeria, in July 2014, infecting 11 HCWs (case fatality rate of 45%). This study was conducted during the outbreak to assess HCWs' EVD-related knowledge and practices. METHODS A health facility-based cross-sectional study was conducted among HCWs across Lagos State using stratified sampling technique. An interviewer-administered questionnaire was administered to elicit respondents' socio-demographic characteristics, knowledge and practices. A checklist assessing health facility's level of preparedness and HCWs' EVD-related training was employed. HCWs' knowledge and practices were scored and classified as either good or poor. Multivariate analysis was performed with confidence interval set at 95%. RESULTS A total of 112 health facilities with 637 HCWs were recruited. Mean age of respondents was 40.1 ± 10.9 years. Overall, 72.5% had good knowledge; doctors knew most. However, only 4.6% of HCWs reported good practices. 16.6% reported having been trained in identifying suspected EVD patient(s); 12.2% had a triaging area for febrile patients in their facilities. Higher proportions of HCWs with good knowledge and training reported good practices. HCWs with EVD-related training were three times more likely to adopt good practices. CONCLUSION Lagos State HCWs had good knowledge of EVD without a corresponding level of good practices. Training was a predictor of good practices.
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Affiliation(s)
- Abisola M Oladimeji
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Saheed Gidado
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | | | - Femi Oladosu
- eHealth Systems Africa Foundation, Kano, Nigeria
| | - Alero Ann Roberts
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | | | | | | | | | | | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Adebola Olayinka
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Oladoyin Odubanjo
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | | | - Gabriele Poggensee
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
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Gidado S, Oladimeji AM, Roberts AA, Nguku P, Nwangwu IG, Waziri NE, Shuaib F, Oguntimehin O, Musa E, Nzuki C, Nasidi A, Adewuyi P, Daniel TA, Olayinka A, Odubanjo O, Poggensee G. Public knowledge, perception and source of information on ebola virus disease - lagos, Nigeria; september, 2014. PLoS Curr 2015; 7. [PMID: 25914860 PMCID: PMC4401256 DOI: 10.1371/currents.outbreaks.0b805cac244d700a47d6a3713ef2d6db] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The first ever outbreak of Ebola virus disease (EVD) in Nigeria was declared in July, 2014. Level of public knowledge, perception and adequacy of information on EVD were unknown. We assessed the public preparedness level to adopt disease preventive behavior which is premised on appropriate knowledge, perception and adequate information. METHODS We enrolled 5,322 respondents in a community-based cross-sectional study. We used interviewer-administered questionnaire to collect data on socio-demographic characteristics, EVD-related knowledge, perception and source of information. We performed univariate and bivariate data analysis using Epi-Info software setting p-value of 0.05 as cut-off for statistical significance. RESULTS Mean age of respondents was 34 years (± 11.4 years), 52.3% were males. Forty one percent possessed satisfactory general knowledge; 44% and 43.1% possessed satisfactory knowledge on mode of spread and preventive measures, respectively. Residing in EVD cases districts, male respondents and possessing at least secondary education were positively associated with satisfactory general knowledge (p-value: 0.01, 0.001 and 0.000004, respectively). Seventy one percent perceived EVD as a public health problem while 61% believed they cannot contract the disease. Sixty two percent and 64% of respondents will not shake hands and hug a successfully treated EVD patient respectively. Only 2.2% of respondents practice good hand-washing practice. Television (68.8%) and radio (55.0%) are the most common sources of information on EVD. CONCLUSIONS Gaps in EVD-related knowledge and perception exist. Targeted public health messages to raise knowledge level, correct misconception and discourage stigmatization should be widely disseminated, with television and radio as media of choice.
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Affiliation(s)
- Saheed Gidado
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Abisola M Oladimeji
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Alero Ann Roberts
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | | | | | | | | | | | | | - Peter Adewuyi
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Tom-Aba Daniel
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Adebola Olayinka
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | | | - Gabriele Poggensee
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
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