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Nevins EJ, Greene K, Bawa S, Horgan L. Robotic Heller's cardiomyotomy for achalasia: early outcomes for a high-volume UK centre. Ann R Coll Surg Engl 2024; 106:353-358. [PMID: 37843105 PMCID: PMC10981992 DOI: 10.1308/rcsann.2023.0065] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Heller's cardiomyotomy (HCM) is the gold standard treatment for achalasia. Laparoscopic HCM has been shown to be effective with low rates of symptom recurrence, though oesophageal mucosal perforation rates remain high. The aim of this prospective case series is to assess the short-term complication rates and perioperative outcomes for the first cohort of patients undergoing robotic-assisted HCM for achalasia in a single high-volume UK centre. METHODS Data were collected from a prospective cohort of patients who underwent robotic HCM at a single high-volume UK centre. Outcomes were assessed using the Eckhard score, which was calculated after their routine postoperative clinic appointments. RESULTS Thirteen patients underwent robotic HCM during the study period; this is the second largest reported case series in the European literature. There were no intraoperative oesophageal perforations. Six patients were discharged as day cases, six patients were discharged on the first postoperative day and one patient's hospital stay was two nights. There was a single perioperative complication of urinary retention. All patients reported improvement of symptoms following their operation, and all had a postoperative Eckhard score of less than 3, indicating their achalasia was in remission. CONCLUSIONS This cohort has demonstrated that robotic HCM has an exceptional safety profile and results in high levels of symptom resolution, even early in the learning curve. The robotic approach may be superior to laparoscopy as it allows more precise identification and dissection of the oesophageal muscle fibres, which likely reduces the risk of inadvertent mucosal damage or incomplete myotomy.
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Affiliation(s)
- EJ Nevins
- Northumbria Healthcare NHS Foundation Trust, UK
| | - K Greene
- Northumbria Healthcare NHS Foundation Trust, UK
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust, UK
| | - L Horgan
- Northumbria Healthcare NHS Foundation Trust, UK
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Asekun A, Nkwogu L, Bawa S, Usman S, Edukugho A, Ocheh J, Banda R, Nganda GW, Nsubuga P, Archer R, Nebechukwu T, Mohammed A, Shuaib F, Bolu O, Adamu U. Deployment of novel oral polio vaccine type 2 under emergency use listing in Nigeria: the rollout experience. Pan Afr Med J 2023; 45:3. [PMID: 38370105 PMCID: PMC10874098 DOI: 10.11604/pamj.supp.2023.45.2.38033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/27/2022] [Indexed: 02/20/2024] Open
Abstract
In 2011, a dedicated consortium of experts commenced work on the development of the novel oral poliovirus vaccine type 2 (nOPV2). After careful and rigorous analysis of data to enable early, targeted use of the vaccine, World Health Organization´s (WHO´s) Strategic Advisory Group of Experts on Immunization (SAGE) reviewed data from accelerated clinical development of nOPV2 and endorsed entering assessment under WHO´s Emergency Use Listing (EUL) procedure. In November 2020, nOPV2 received an interim recommendation for use under EUL to enable rapid field availability and potential wider rollout of the vaccine. In December 2020, Nigeria initiated preparation to meet all criteria for initial use of nOPV2 in the country and the documentation process to verify meeting them. The process entailed addressing the status of meeting 25 readiness criteria in nine categories for nOPV2 use in Nigeria for response efforts to ongoing cVDPV2 outbreaks. During January-February 2021, Nigeria submitted the required documentation for all required indicators for nOPV2 initial use. In February 2021, the country obtained approval from the GPEI nOPV2 Readiness Verification Team to introduce nOPV2 and in March 2021, rolled out the novel vaccine in mass vaccination campaigns for outbreak response in Bayelsa, Delta, Niger, Sokoto and Zamfara states, and one area council in the Federal Capital Territory (FCT). The lessons learned from this rollout experience in Nigeria are being applied as the country streamlines and strengthens the nOPV2 rollout process across the remaining states.
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Affiliation(s)
- Adeyelu Asekun
- US Centers for Disease Control and Prevention, Georgia, United States of America
| | | | | | | | | | | | | | - Gatei wa Nganda
- US Centers for Disease Control and Prevention, Georgia, United States of America
| | - Peter Nsubuga
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Roodly Archer
- US Centers for Disease Control and Prevention, Georgia, United States of America
| | | | - Aminu Mohammed
- Global Public Health Solutions, Georgia, United States of America
| | | | - Omotayo Bolu
- US Centers for Disease Control and Prevention, Georgia, United States of America
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Jean Baptiste AE, Van der Schans J, Bawa S, Masresha B, Wagai J, Oteri J, Dieng B, Soyemi M, Eshuchi R, Yehualashet YG, Afolabi O, Braka F, Bita A, Hak E. The cost of implementing measles campaign in Nigeria: comparing the stand-alone and the integrated strategy. Health Econ Rev 2023; 13:36. [PMID: 37310530 PMCID: PMC10262122 DOI: 10.1186/s13561-023-00441-y] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 04/22/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Effective integration, one of the seven strategic priorities of the Immunization Agenda 2030, can contribute to increasing vaccination coverage and efficiency. The objective of the study is to measure and compare input costs of "non-selective" measles vaccination campaign as a stand-alone strategy and when integrated with another vaccination campaign. METHODS We conducted a cost-minimization study using a matched design and data from five states of Nigeria. We carried-out our analysis in 3 states that integrated measles vaccination with Meningitis A and the 2 states that implemented a stand-alone measles campaign. The operational costs (e.g., costs of personnel, training, supervision etc.) were extracted from the budgeted costs, the financial and technical reports. We further used the results of the coverage surveys to demonstrate that the strategies have similar health outputs. RESULTS The analysis of the impact on campaign budget (currency year: 2019) estimated that savings were up to 420,000 United States Dollar (USD) with the integrated strategies; Over 200 USD per 1,000 children in the target population for measles vaccination (0.2 USD per children) was saved in the studied states. The savings on the coverage survey components were accrued by lower costs in the integration of trainings, and through reduced field work and quality assurance measures costs. CONCLUSIONS Integration translated to greater value in improving access and efficiency, as through sharing of costs, more life-saving interventions are made accessible to the communities. Important considerations for integration are resource needs, micro-planning adjustments, and health systems delivery platforms.
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Affiliation(s)
| | - Jurjen Van der Schans
- Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
| | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria
| | - Balcha Masresha
- World Health Organization, African Regional Office, Brazzaville, Congo
| | - John Wagai
- World Health Organization, Country Office, Abuja, Nigeria
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunizations (GAVI), Abuja, Nigeria
| | - Margaret Soyemi
- United Nations Children's Fund (UNICEF) - Country Office for Nigeria, Abuja, Nigeria
| | - Rufus Eshuchi
- United Nations Children's Fund (UNICEF) - Country Office for Nigeria, Abuja, Nigeria
| | | | | | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
| | - André Bita
- World Health Organization, African Regional Office, Brazzaville, Congo
| | - Eelko Hak
- Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
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Jean Baptiste AE, Bawa S, Oteri AJ, Dieng B, Shuaib F, Mulombo WK. Nationwide measles supplementary immunization activities to increase immunity levels in Nigeria. Vaccine 2021; 39 Suppl 3:C1-C2. [PMID: 34531080 DOI: 10.1016/j.vaccine.2021.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Samuel Bawa
- World Health Organization (WHO), Country Office, Abuja, Nigeria.
| | - Avuwa Joseph Oteri
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria.
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
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Terna Richard M, Taiwo L, Jean Baptiste AE, Bawa S, Dieng B, Wiwa O, Lambo K, Braka F, Shuaib F, Oteri J. Planning for supplemental immunization activities using the readiness assessment dashboard: Experience from 2017/2018 Measles vaccination campaign, Nigeria. Vaccine 2021; 39 Suppl 3:C21-C28. [PMID: 34247903 DOI: 10.1016/j.vaccine.2021.06.070] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/09/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Globally, supplemental immunization activities (SIAs) are known to be a major strategy for attainment of the global measles elimination goal of less than one measles case per million population within a geographic area by the year 2020. Adequate planning is critical to the success of a vaccination campaign. To achieve a quality SIA implementation for effective interruption of measles transmission, the World Health Organization introduced the SIA Readiness Assessment Tool, which includes the readiness dashboard. It is a strategic planning tool used to ensure critical activities are completed before SIAs. Nigeria implemented a phased measles SIA in 2017/2018 and used the readiness assessment tool in the planning for the campaign. In this article, we report the use of the readiness assessment dashboard in the 2017/2018 measles SIA, we also reviewed its contributions to the outcome of the campaign looking at the post campaign coverage survey results for the states. METHODS We conducted a retrospective review of the readiness assessment dashboard used during the 2017/2018 measles vaccination campaign in Nigeria. The readiness dashboard tool was designed using Microsoft Excel 2016. We reported results in frequencies and proportions using charts and tables. RESULTS The states with 100% readiness a week prior to the campaign scored a post campaign coverage survey result of 84.6 - 96.5% with just one out of the eight states in this category getting a score below 90%. In the same vein, of the eight states that their readiness score at one week to the campaign was below 85%, six had post campaign coverage survey score of less than 90% with the highest score in this category being 92.3%. Some states with good readiness scores also had poor post campaign coverage survey which has been attributed to other factors other than readiness. CONCLUSION The readiness assessment dashboard for the measles vaccination campaign provided a platform for tracking states readiness. It is our view that a link between readiness assessment and coverage should be examined in future studies.
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Affiliation(s)
| | - Lydia Taiwo
- Nigeria Field Epidemiology & Laboratory Training Program (NFELTP), Abuja, Nigeria
| | | | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunizations, Nigeria
| | - Owens Wiwa
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | | | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
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Oteri AJ, Adamu U, Dieng B, Bawa S, Terna N, Nsubuga P, Owoaje ET, Kassogue M, Jean Baptiste AE, Braka F, Shuaib F. Nigeria experience on the use of polio assets for the 2017/18 measles vaccination campaign follow-up. Vaccine 2021; 39 Suppl 3:C3-C11. [PMID: 33962837 DOI: 10.1016/j.vaccine.2021.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/05/2021] [Accepted: 04/20/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The global polio eradication initiative has made giant stride by achieving a 99% reduction in Wild poliovirus (WPV) cases, with Nigeria on the verge of being declared polio-free following over 36 months without a WPV. The initiative has provided multiple resources, assets and lessons learnt that could be transitioned to other public health challenges, including improving the quality and vaccination coverage of measles campaigns in order to reduce the incidences of measles in Nigeria. We documented the polio legacy and assets used to support the national measles campaign in 2017/2018. METHODS We documented the integration of the measles campaign coordination with the Polio Emergency Operation Centre (EOC) at national and state levels for planning and implementing the measles SIA. Specific polio strategies and assets, such as the EOC incident command framework and facilities, human resource surge capacity, polio GIS resource These strategies were adapted and adopted for the MVC implementation overcome challenges and improve vaccination coverage. We evaluated the performance through a set process and outcome indicators. RESULTS All the 36 states and Federal Capital Territory used the structure and resources in Nigeria and provided counterpart financing for the MVC 2017/ 2018. The 11 polio high-risk states deployed the use of GIS for microplanning process, while daily call-in data were tracked in 99.7% of the LGAs and 70,846 reports were submitted real-time by supervisors using Open data kit (ODK). The national coverage achieved was 87.5% by the post-campaign survey with 65% of states reporting higher coverage in 2018 compared to 2015. CONCLUSION Polio eradication assets and lessons learned can be applied to measles elimination efforts as the eradication and elimination efforts have similar strategies and programme implementation infrastructure needs. Leveraging these strategies and resources to support MVC planning and implementation resulted in more realistic planning, improved accountability and availability of human and fiscal resources. This approach may have resulted in better MVC outcomes and contributed to Nigeria's efforts in measles control and elimination.
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Affiliation(s)
| | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunisations, Nigeria
| | - Samuel Bawa
- World Health Organisation, Country Office, Abuja, Nigeria.
| | | | | | - Eme T Owoaje
- College of Medicine, University of Ibadan. Nigeria
| | - Modibo Kassogue
- United Nations Children's Fund, Country Office, Abuja, Nigeria
| | | | - Fiona Braka
- World Health Organisation, Country Office, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
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Hamisu M, Dieng B, Taiwo L, Jean Baptiste AE, Bawa S, Wagai J, Ibizugbe S, Braka F, Nsubuga P, Shuaib F, Oteri J. Microplanning verification and 2017/2018 measles vaccination campaign in Nigeria: Lessons learnt. Vaccine 2021; 39 Suppl 3:C46-C53. [PMID: 33892983 DOI: 10.1016/j.vaccine.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The measles supplemental immunisation activity is an effective strategy that improves vaccination coverage and reduces measles-related morbidity and mortality. However, the lack of compliance with microplanning processes, contributes to improper estimation of resources needed for a good SIA in Nigeria. We described the microplanning verification process for 2017/2018 measles vaccination campaign and highlighted the contribution of selected variables to the output of the microplan. METHODS We conducted microplanning verification in 2 phases. In Phase 1, we verified at least 30% of randomly selected microplans to assess compliance with the steps and processes of developing good microplans. In Phase 2 we conducted desk review of the entire states micoplans and verified some selected variables at the ward level to corroborate the findings of the microplans. We collected data using open data kit and verification checklist. We conducted data analysis using SPSS and Microsoft Excel version 2016. RESULTS All states in Nigeria verified their wards' microplans, 21 states (57%) verified more than 30% ,16 states (43%) verified less than 30%, Kebbi State verified the lowest (5.3%). Over 90% of microplans verified complied with the microplanning processes. We observed that overall, there was no significant difference in the number of target population, vaccination teams and qualified vaccinators after the verification process. CONCLUSION The microplans for 2017/2018 measles vaccination campaign were developed according to the required procesesses, the target population, vaccination teams and qualified vaccinators were physically and realistically estimated. Adherence to microplanning processes is critical to the success of immunization programs.
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Affiliation(s)
- Maimuna Hamisu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunizations
| | - Lydia Taiwo
- Nigeria Field Epidemiology & Laboratory Training Program (NFELTP), Abuja, Nigeria
| | | | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria
| | - John Wagai
- World Health Organization, Country Office, Abuja, Nigeria
| | | | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
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Jean Baptiste AE, Masresha B, Wagai J, Luce R, Oteri J, Dieng B, Bawa S, Ikeonu OC, Chukwuji M, Braka F, Sanders EAM, Hahné S, Hak E. Trends in measles incidence and measles vaccination coverage in Nigeria, 2008-2018. Vaccine 2021; 39 Suppl 3:C89-C95. [PMID: 33875267 DOI: 10.1016/j.vaccine.2021.03.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 02/21/2021] [Accepted: 03/31/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children 9-59 months), and intensified measles case-based surveillance system. METHODS We reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017-18. Additionally, we analyzed measles case-based surveillance reports from 2008-2018 to determine annual, regional and age-specific incidence rates. FINDINGS Survey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9-11 months (524.0 per million) and 12-59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million). CONCLUSION The aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals.
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Affiliation(s)
| | - Balcha Masresha
- World Health Organization, African Regional Office, Brazzaville, Congo
| | - John Wagai
- World Health Organization, Country Office, Abuja, Nigeria
| | - Richard Luce
- World Health Organization, Inter-country Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunizations, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria
| | | | | | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
| | - E A M Sanders
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands
| | - Susan Hahné
- Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands
| | - Eelko Hak
- Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
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Momoh J, Oteri AJ, Mogekwu F, Onwu N, Dieng B, Bawa S, Braka F, Nsubuga P, Shuaib F. Ensuring accountability in implementation of supplementary immunisation activities: A case study of the 2017/2018 measles vaccination campaign in Nigeria. Vaccine 2021; 39 Suppl 3:C12-C20. [PMID: 33714654 DOI: 10.1016/j.vaccine.2021.02.068] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 01/27/2021] [Accepted: 02/26/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Globally, there is a growing concern with accountability and health systems. This has been attributed majorly to discontent with health system performance. Within the Nigerian health system, weak accountability has been consistently singled out as a key challenge underpinning the poor performance of the immunisation programme. In preparation for the 2017/2018 Measles Vaccination Campaign in Nigeria, the National Measles Technical Coordinating Committee (NMTCC) was inaugurated with one of its key mandates being to ensure accountability in the conduct of the 2017/2018 MVC. This paper aims to share the innovative measures applied in the 2017/2018 Measles MVC to improve accountability and to highlight the contribution of the accountability framework to improving measles vaccination coverage. METHODS We identified gaps in accountability from the post-campaign coverage reports and reviews of previous campaigns. We adapted an accountability framework developed by the Nigeria National Routine Immunization Strategic Plan (2013-2015),- which cuts across all levels. Selected indicators were used to monitor the implementation of the framework. Administrative actions such as sanctions and rewards were taken as necessary. FINDINGS We found that the implementation of the accountability framework was highly instrumental in achieving a high level of coordination among all stakeholders and to improving efficient utilization of resources. We also found that the implementation of the accountability framework in the 2017/2018 MVC contributed to the improved performance of states in terms of measles vaccination coverage compared to the 2015/2016 campaign. CONCLUSION We have demonstrated that the implementation of the accountability framework in the 2017/2018 MVC led to a considerable reduction in the misuse and abuse of resources and also contributed to remarkable improvement in the measles vaccination coverages across states compared to the 2015/2016 MVC.
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Affiliation(s)
- Jenny Momoh
- Volunteer, National Measles Technical Coordinating Committee, Nigeria
| | | | - Fred Mogekwu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Nneka Onwu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Boubacar Dieng
- Technical Assistance Consultant, Gavi Vaccine Alliance, Switzerland
| | - Samuel Bawa
- World Health. Organization, Country Office, Abuja, Nigeria
| | - Fiona Braka
- World Health. Organization, Country Office, Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, United States
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
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Oteri J, Idi Hussaini M, Bawa S, Ibizugbe S, Lambo K, Mogekwu F, Wiwa O, Seaman V, Kolbe-Booysen O, Braka F, Nsubuga P, Shuaib F. Application of the Geographic Information System (GIS) in immunisation service delivery; its use in the 2017/2018 measles vaccination campaign in Nigeria. Vaccine 2021; 39 Suppl 3:C29-C37. [PMID: 33478790 DOI: 10.1016/j.vaccine.2021.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 12/18/2020] [Accepted: 01/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND As global effort is made towards measles elimination, the use of innovative technology to enhance planning for the campaign has become critical. GIS technology has been applied to track polio vaccination activities in Nigeria with encouraging outcomes. Despite numerous measles vaccination campaigns after the first catch up campaign in 2005, sub-optimal outcomes of previous measles supplemental immunization activities necessitated the use of innovative ideas to achieve better outcomes especially when planning for the 2017/2018 measles vaccination campaign. This led to the application of the use of the GIS technology for the Northern states in 2017/2018 campaign. This study is a report of what was achieved with the use of the GIS in the 2017/2018 measles vaccination campaign in Nigeria. METHODS GIS generated ward maps were used for the microplanning processes for the 2017/2018 measles vaccination campaign. These ward maps had estimates of the target population by settlements, the number and location of vaccination posts ensuring that a vaccination post is sited within one-kilometer radius of a settlement, and the number of teams needed to support the vaccination campaign as well as the catchment area and daily implementation plans. The ward microplans were verified by checking for accuracy and consistency of the target population, settlements, number of teams, vaccination posts and daily implementation work plans using a standard checklist. The ward maps were deployed into use for the measles vaccination campaign after the state team driven validation and verification by the National team (Government and Partners) RESULTS: The Northern states that applied the GIS technology had a closer operational target population to that on the verified microplan than those of the non-GIS technology states. Greater than 90% of the ward maps had all that is expected in the maps - i.e settlements, target populations, and vaccination posts captured, except Kaduna, Katsina and Adamawa states. Of all enumeration areas sampled during the post-campaign survey in states with GIS ward maps, none had a zero-vaccination coverage of the surveyed children, with the exception of one in Borno state that had security issues. In the post campaign coverage survey, the percentage of responses that gave vaccination post being too far as a reason for non-vaccination of children in the Northern zones that used GIS generated ward maps was less than half the rate seen in the southern zones where the GIS microplanning was not used. CONCLUSION The use of GIS-generated wards maps improved the quality of ward micro plans and optimized the placement of vaccination posts, resulting in a significant reduction in zero-dose clusters found during the post campaign coverage survey.
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Affiliation(s)
- Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria.
| | | | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria
| | | | | | - Fred Mogekwu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Owen Wiwa
- Clinton Health Access Initiative (CHAI), Abuja, Nigeria
| | | | | | - Fiona Braka
- World Health Organization, Country Office, Abuja, Nigeria
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
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Korave J, Bawa S, Ageda B, Ucho A, Bem-Bura DM, Onimisi A, Dieng B, Nsubuga P, Oteri J, Fiona B, Shuaib F. Internal displacement; an impediment to the successful implementation of planned measles supplemental activities in Nigeria, a case study of Benue State. Vaccine 2021; 39 Suppl 3:C76-C81. [PMID: 33461836 DOI: 10.1016/j.vaccine.2020.12.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 11/12/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Measles is a highly infectious disease with great burden and implication on a displaced population with low immunity status. The disease can cause up to 140,000 deaths annually. Internal displacement during supplemental immunization activities often affects optimal reach and coverage of the campaign as people move and implementation and logistic plans are usually disrupted with attendant missed children. This study documented the process of extension of the measles vaccination campaign (MVC) 2018 for five internally displaced persons (IDPs) camps in Benue state, not previously in the microplan, to increase population herd immunity. METHODS We obtained population figures and disease surveillance data for five IDPs camps and used it to conduct detailed microplanning to determine the requirement for the conduct of additional days of measles vaccination. Vaccination teams used fixed posts in the camps and temporary posts strategy in designated locations in the host communities. RESULTS The estimated total population of the IDPs was 170,000 with MVC target population of 9374 which was not earlier planned for. There was reported measles outbreaks in IDP camps in both Guma and Makurdi Local Government areas (LGAs) during period of displacement. Microplans requirement determined 10,421 bundled measles vaccine, 30 health workers, 5 vehicles and 15 motorcycles. A total of 7679 out of 9374 (81.9%) of the eligible children aged 9-59 months were vaccinated during the 3 days of the campaign. CONCLUSION Non-inclusion of plans on internally displaced population in supplemental immunization activities (SIAs) microplans have a potential risk of vaccine preventable diseases (VPDs) outbreak. Future Measles Vaccination campaigns should take cognizance of internal displacement due to insecurity and other humanitarian emergencies.
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Affiliation(s)
- Joseph Korave
- Primary Health Care Development Board, Benue State, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Office, Abuja, Nigeria.
| | - Bem Ageda
- Primary Health Care Development Board, Benue State, Nigeria
| | | | | | | | - Boubacar Dieng
- Technical Assistance Consultant, Global Alliance for Vaccines and Immunizations, United States
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, United States
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Braka Fiona
- World Health Organization, Country Office, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
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Fatiregun A, Famiyesin E, Bawa S, Ogunbodede N. Field investigation and response to a vaccine-derived poliovirus pre-tOPV switch in Southwest Nigeria, October 2015. Pan Afr Med J 2020; 37:6. [PMID: 32983324 PMCID: PMC7501745 DOI: 10.11604/pamj.2020.37.6.17344] [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: 10/13/2018] [Accepted: 08/14/2020] [Indexed: 11/11/2022] Open
Abstract
A vaccine-derived poliovirus (VDPV) was isolated in an acute flaccid paralysis (AFP) case reported from Ile-Ife, in Osun state, Southwest Nigeria. We investigated the epidemiological characteristics of the polio event and described the immediate public health response that followed. We interviewed the primary caregiver of the case and conducted active case searches for additional AFP cases in the communities in Ife East Local Government Area (LGA) of Osun state. Stool samples of contacts and non-contacts were collected and sent for laboratory investigation. A public health response with mass supplementary immunization in the affected areas followed immediately in the ward the case was located in October 2015. Also, we reviewed the administrative record of the oral polio vaccine (OPV) coverage in the LGA in the previous four years. The VDPV case was a female, one-month-old child with adequate vaccination history for her age. However, the environment of the child was relatively filthy with inappropriate facilities. Laboratory reports from contact samples were negative for VDPV or any polio isolates. A missed AFP case was found from active case searches and a high proportion of under-five children was immunized with tOPV. The OPV3 administrative coverage in the LGA peaked in 2014 (103%) and dropped in 2015 (67%). Efforts directed toward improving environmental hygiene in households and improving OPV coverage in subsequent routine and supplementary immunization are suggested.
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Batool S, Bawa S. AB0633 REAL WORLD EXPERIENCE OF THE IMPACT OF SECUKINUMAB ON DISEASE ACTIVITY AND FATIGUE IN PATIENTS WITH ANKYLOSING SPONDYLITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Fatigue is one of the most commonly reported symptom of ankylosing spondylitis (AS). It impacts functional ability, quality of life, and ability to maintain employment1. Secukinumab, a fully human monoclonal IgG1 antibody that neutralizes IL-17A, has shown significant and sustained improvement in the signs and symptoms of active AS in the MEASURE 2 study2. It has also shown to improve fatigue scores. Despite this, the published literature on real life experience is scarce. We report our experience of Secukinumab use at Gartnavel General Hospital, Glasgow, UK.Objectives:We performed a retrospective review to assess the response of our AS patients to Secukinumab. We also reviewed the impact of treatment on fatigue.Methods:AS patients commenced on Secukinumab 150mg subcutaneously from mid-2016 to September 2019 were identified using the clinical records on our database. Response using Bath AS disease activity index (BASDAI) and Bath AS function index (BASFI) were recorded. Impact on fatigue and pain was measured using single-item fatigue and pain visual analogue scale (VAS) within the BASDAI questionnaire.Results:30 AS patients, 11 anti-TNF naïve and 19 anti-TNF inadequate responders (IR), on Secukinumab were identified. Retention rate was 76.66% (23/30). Sustained improvement was observed across all outcome measures over 3.5 years. Fatigue and pain improvement were somewhat lower than expected but did show slow improvement. Responses were greater in anti-TNF naïve patients. There was no significant difference in response between smokers (33.34%, 10/30) and non-smokers (36.67%, 11/30). There were 4 patients with inflammatory bowel disease, none of whom flared. No new safety signals were identified.Table.Clinical response to Secukinumab in patients with active ASTimeBASADIBASFIFatigueAS painMean%changeMean%changeMean%changeMean%changeBaseline7.097.37.67.993M6.71-5%7.24-8%6.9-9%6.89-14%6M5.4-24%5.8-20%6.29-17%6.06-24%9M6.01-15%6.56-10%6.41-16%6.1-24%12M5.04-29%5.42-26%6.35-16%5.55-30%18M4.98-30%3.73-49%6.38-16%4.91-38%24M5.52-22%5.72-22%6.79-11%5.6-30%%Change from baselineAnti-TNF naïveAnti-TNF IRAnti-TNF naïveAnti-TNF IRAnti-TNF naïveAnti-TNF IRAnti-TNF naïveAnti-TNF IR3M-37%-9%-44%6%-10%-14%-53%-14%6M-34%-27%-38%-29%-28%-6%-43%-6%9M-27%-4%-30%1%-23%-6%-41%-6%12M-41%-22%-31%-29%-31%0%-44%0%18M-32%-11%-57%-22%-35%5%-34%5%24M-26%-12%-32%-1%-16%3%-32%3%There were <3 patients in >2 years follow up group therefore results were omitted from analysisConclusion:In our real-life cohort of AS patients, significant improvement was seen over 3.5 years in both BASDAI and BASFI. Fatigue was significantly improved in anti-TNF naïve group, but results were disappointing in anti-TNF IR group. This may be explained by the fact that there are older patients with established disease and background degenerative changes in anti-TNF IR group. Although fatigue data had slightly discordant results compared with the MEASURE 2 study2, considering the use of single item VAS rather than multidimensional measures such as FACEIT fatigue scale, clear improvement has been observed.References:[1]E. E. Schneeberger, M. F. Marengo, F. Dal Pra, J. A. Maldonado Cocco, and G. Citera, “Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis,” Clin Rheumatol, vol. 34, no. 3, pp. 497–501, 2015.[2]H. Marzo-Ortega, J. Sieper, A. Kivitz, R. Blanco, M. Cohen, R. Martin, A. Readie, H. B. Richards, and B. Porter, (2017) ‘Secukinumab and Sustained Improvement in Signs and Symptoms of Patients With Active Ankylosing Spondylitis Through Two Years: Results From a Phase III Study’, Arthritis Care & Research, Vol. 69, No. 7, July 2017,(DOI 10.1002/acr.23233), pp. 1020–1029.Acknowledgments:S. Kerr, K. Anderson and Rheumatology department, Gartnavel General Hospital, Glasgow, UKDisclosure of Interests:None declared
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Masresha B, Nwankwo O, Bawa S, Igbu T, Oteri J, Tafida H, Braka F. The use of WhatsApp group messaging in the coordination of measles supplemental immunization activity in Cross Rivers State, Nigeria, 2018. Pan Afr Med J 2020; 35:6. [PMID: 32373257 PMCID: PMC7196332 DOI: 10.11604/pamj.supp.2020.35.1.19216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/22/2019] [Accepted: 07/11/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Cross Rivers State, in southern Nigeria, conducted measles Supplemental Immunization Activities (SIAs) in 2 phases from 2 -15 March, 2018. The SIAs coordination was led by the State technical coordination committee. A total of 90 supervisors from the national and subnational levels, including consultants were deployed to support the SIAs. The instant messaging service - WhatsApp was utilized to help in the communication and coordination among the State and field teams. Methods We reviewed the chat logs from the WhatsApp group exchanges made between 28 February 2018 and 31 March 2018. Thematic content analysis was done. Results A total of 653 WhatsApp messages were posted among the 55 group members during the study period, including text messages and media content. Eleven percent of the posts related to monitoring processes and data sharing, while posts related to vaccine logistics and waste management made up about 6% of the total. Overall coordination and deployment was covered in 6% of the posts. Forty percent of the media content showed vaccination service delivery and SIAs launching events or monitoring meetings in various areas. The coordination team used WhatsApp to send reminders to the field staff about data sharing, vaccine and waste management, as well as feedback on coverage and completeness of data sharing. The WhatsApp group discussions did not include most of the logistical and hesitancy challenges documented in the State SIAs technical report. Conclusion We recommend focusing group discussions on instant messaging platforms so that they can be used for problem solving and sharing best practices, integrating it with other supervisory processes and tools, as well as providing feedback based on processed data from the field.
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Affiliation(s)
| | - Ogonna Nwankwo
- Department of Community Medicine, University of Calabar, Calabar, Cross Rivers State, Nigeria
| | | | - Thompson Igbu
- WHO Sierra Leone Country Office, Freetown, Sierra Leone
| | - Joseph Oteri
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Halima Tafida
- National Primary Health Care Development Agency, Abuja, Nigeria
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15
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Ningi AI, Shuaib F, Ibrahim LM, Saleh JEA, Abdelrahim K, Bello IM, Abba B, Muluh TJ, Braka F, Tegegne SG, Wallah A, Korir C, Bawa S, Saidu M, Nsubuga P. Polio eradication in Nigeria: evaluation of the quality of acute flaccid paralysis surveillance documentation in Bauchi state, 2016. BMC Public Health 2018; 18:1307. [PMID: 30541495 PMCID: PMC6292152 DOI: 10.1186/s12889-018-6185-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a cross-sectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. METHODS We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet. RESULTS Of the 18 LGA Disease Surveillance and Notification Officers (DSNOs), only 2 (11%) and 5 (28%) had reports of polio outbreak investigations and supervisory visits at the lower levels, respectively. Furthermore, only 6 (33%) and 7 (39%) of the DSNOs had minutes of meetings and surveillance work plans, respectively. Of the 31 AFP cases investigated, only 39, 26, 23, and 23% had correct and complete information for the birth day, birth month, date of onset of paralysis, and date of investigation, respectively. Seventy-one percent of the clinicians at the AFP focal sites knew the correct definition for AFP compared with only 30% at the non-focal sites. Of the 38 caregivers (mothers), 16 (42%) did not remember the day or month the AFP investigation was conducted. However, 95% gave a correct number of stool samples collected and 40% mentioned that the samples were collected 24 h apart. Feedback was not given to 26 (68%) of the caregivers. The majority (79%) of the community leaders knew how to recognize a case of AFP and knew that the stool was the specimen required for the investigation, but 21% did not know to whom they should report a case of AFP in their community. CONCLUSION This study revealed a gap in the quality indicators for polio eradication in the state, especially regarding knowledge and documentation for AFP surveillance at the operational level. Regular training of the DSNOs and focal persons, regular sensitization of clinicians, community education, supplies of reporting tools, and ensuring their judicious use will improve AFP surveillance in the state.
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Affiliation(s)
| | - Faisal Shuaib
- National Primary Healthcare Development Agency, Abuja, Nigeria
| | | | | | - Khalid Abdelrahim
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Abdullahi Wallah
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Mahmood Saidu
- World Health Organization, Country Representative Office, Abuja, Nigeria
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Korir C, Shuaib F, Adamu U, Bawa S, Musa A, Bashir A, Isiaka A, Ningi A, Warigon C, Richard B, Fiona B, Pascal M, Loveday N, Tegegne SG, Abdul-Aziz M, Suleiman A, Mohammed K, Corkum M, Onoka C, Nsubuga P, Yehualashet YG, Vaz RG, Alemu W. Targeting the last polio sanctuaries with Directly Observed Oral Polio Vaccination (DOPV) in northern Nigeria, (2014-2016). BMC Public Health 2018; 18:1314. [PMID: 30541493 PMCID: PMC6291915 DOI: 10.1186/s12889-018-6182-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Indexed: 11/19/2022] Open
Abstract
Background The declaration of poliomyelitis eradication as a programmatic emergency for global public health by the 65th World Health Assembly in 2012 necessitated innovations and strategies to achieve results. Review of the confirmed polio cases in 2013 showed that most of the cases were from non-compliant households, where parents connived with vaccinators to finger mark the children without actually vaccinating the children with oral polio vaccine or children were absent from home at the time of the visit of vaccinators. Methods We used pre-post design to quantify the outcomes of directly observed vaccination in 90 local government areas from 12 northern Nigeria states at very high risk of polio transmission. The strategy is an intervention, vaccinating children under the direct supervision of an independent supervisor to ensure compliance. Attractive incentives (pluses) were used to make parents willingly submit their children for vaccination or directly attract children to the vaccination teams or post as part of this strategy. Results There was a steady increase in population immunity in all the 90 DOPV implementing LGAs since the introduction of DOPV in 2013. The number of states in which > 90% of children received > 4 OPV doses increased from 7 in 2013 to 11 states by July 2016. Yobe state reported the highest proportional increase from 75 to 99% by July 2016 (22% increase), while Kano state reported 17% increase, from 82 to 99% by July 2016. Conclusion Directly observed polio vaccination strategy improved uptake of polio vaccines and population immunity in high-risk areas for polio transmission.
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Affiliation(s)
- Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | | | - Usman Adamu
- National Primary Health Care Agency, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Abba Bashir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ayodeji Isiaka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Adamu Ningi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Banda Richard
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Braka Fiona
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Mkanda Pascal
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Nkwogu Loveday
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Abdullahi Suleiman
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | | | - Chima Onoka
- National Primary Health Care Agency, Abuja, Nigeria
| | | | | | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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Warigon C, Alemu W, Braka F, Tashikalmah H, Yehushualet Y, Hammanyero K, Bawa S, Oviaesu D, Tegegne S, Maiiyali MU, Jean Baptiste AE, Nsubuga P, Agyemang CB. Institutionalizing documentation for WHO Nigeria country office visibility and improved donor relations, 2013-2016. BMC Public Health 2018; 18:1315. [PMID: 30541609 PMCID: PMC6291914 DOI: 10.1186/s12889-018-6191-1] [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] [Indexed: 11/10/2022] Open
Abstract
Background The mandate and unique experience of the World Health Organization (WHO) globally, enables over 190 countries, Nigeria inclusive, to depend on the technical support provided by the organization to define and mitigate the threats to public health. With other emerging health actors competing for scarce donors’ resources, the demand for visibility has invariably equaled expectations on WHO’s expertise and technical support. However, the inability to systematically document activities conducted by WHO personnel before 2013 overshadowed most of its invaluable contributions due to poor publicity. The inauguration of the Communications Group in December 2013 with a visibility plan necessitated a paradigm shift towards building a culture of documentation to engender visibility. Methods We used a pre-post design of activities to evaluate the effectiveness of specific interventions implemented to improve visibility from 2013 to 2016. The paper highlights how incorporating communication strategies into the accountability framework of staff contributed in changing the landscape as well as showcasing the activities of WHO in Nigeria for improved donor relations. Results With the specific interventions implemented to improve WHO’s visibility in Nigeria, we found that donor relations improved between 2013 and 2015. It is not a mere coincidence that the period corresponds with the era of incorporation of documentation into the accountability framework of technical staff for visibility as locally mobilized resources increased to record 112% in 2013 and 2014. The intervention assisted in the positive projection of WHO and its donors by the Nigeria media. Conclusion Despite several interventions, which worked, made WHO ubiquitous and added awareness and visibility for donors who funded various projects, other factors could have contributed towards achieving results. Notwithstanding, incorporating documentation component into the accountability framework of field staff and clusters has significantly improved communication of WHO’s work and promoted healthy competition for increased visibility.
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Affiliation(s)
- Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | | | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Hallah Tashikalmah
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
| | - Yared Yehushualet
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - David Oviaesu
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
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18
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Abba B, Abdullahi S, Bawa S, Getso KI, Bello IW, Korir C, Musa A, Braka F, Ningi A, Nsubuga P, Banda R, Tegegne SG, Shuaib F, Adamu US, Haladu S. Mobilizing political support proved critical to a successful switch from tOPV to bOPV in Kano, Nigeria 2016. BMC Public Health 2018; 18:1302. [PMID: 30541496 PMCID: PMC6291921 DOI: 10.1186/s12889-018-6195-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kano is one of the high-risk states for polio transmission in Northern Nigeria. The state reported more cases of wild polioviruses (WPVs) than any other state in the country. The Nigeria Demographic and Health Survey of 2013 indicated that OPV3 coverage in the routine immunization (RI) programmewas 57.9%. Additionally, serial polio seroprevalence studies conducted from 2011 to 2015 in the eightmetropolitan LGAs indicated low immunity levels against all three polio serotypes in children below one year. Areas with sub-optimal RI coverage such as Kanothat fail to remove all tOPV during the tOPV-bOPV switchwill be at increased risk of VDPV2 circulation. METHODS We assessed the impact of political leadership engagement in mobilizing other stakeholders on the outcomes of the bOPV-tOPV switch in Kano State from February to May 2016 using nationally-selected planning and outcome indicators. RESULTS A total of 670 health facilities that provide RI services were assessed during the pre-switch activities. Health workers were aware of the switch exercise in 520 (95.1%) of the public health facilities assessed. It was found that health workers knew what to do should tOPV be found in any of the 521 (95.2%)public health facilities assessed. However, there was a wide disparity between the public and private health practitioners' knowledge on basic concepts of the switch. There was 100% withdrawal of tOPV from the state and the seven zonal cold stores. Unmarked tOPVwas found in the cold chain system in 2 (4.5%) LGAs. Only one health facility (0.8%) had tOPV in the cold chain. No tOPVwas identified outside the cold chain without the "Do not use" sticker in any of the health facilities. CONCLUSION The engagement of the political leadership to mobilize other key stakeholders facilitated successful implementation of the tOPV-bOPVswitch exercise and provided opportunity to strengthen partnerships with the private health sector in Kano State.
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Affiliation(s)
- Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | - Sule Abdullahi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | | | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Adamu Ningi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | | - Sulaiman Haladu
- Africa Field Epidemiology Network, Hospital Road, Kano, Kano State, Nigeria
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19
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Hammanyero KI, Bawa S, Braka F, Bassey BE, Fatiregun A, Warigon C, Yehualashet YG, Tegene SG, Banda R, Korir C, Erbeto TB, Chukwuji M, Mkanda P, Adamu US, Nsubuga P. Lessons learnt from implementing community engagement interventions in mobile hard-to-reach (HTR) projects in Nigeria, 2014-2015. BMC Public Health 2018; 18:1306. [PMID: 30541514 PMCID: PMC6292166 DOI: 10.1186/s12889-018-6193-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The year 2014 was a turning point for polio eradication in Nigeria. Confronted with the challenges of increased numbers of polio cases detected in rural, hard-to-reach (HTR), and security-compromised areas of northern Nigeria, the Nigeria polio program introduced the HTR project in four northern states to provide immunization and maternal and child health services in these communities. The project was set up to improve population immunity, increase oral polio vaccine (OPV) and other immunization uptake, and to support Nigeria's efforts to interrupt polio transmission by 2015. Furthermore, the project also aimed to create demand for these services which were often unavailable in the HTR areas. To this end, the program developed a community engagement (CE) strategy to create awareness about the services being provided by the project. The term HTR is operationally defined as geographically difficult terrain, with any of the following criteria: having inter-ward/inter-Local Government Area/interstate borders, scattered households, nomadic population, or waterlogged/riverine area, with no easy to access to healthcare facilities and insecurity. METHODS We evaluated the outcome of CE activities in Kano, Bauchi, Borno, and Yobe states to examine the methods and processes that helped to increase OPV and third pentavalent (penta3) immunization coverage in areas of implementation. We also assessed the number of community engagers who mobilized caregivers to vaccination posts and the service satisfaction for the performance of the community engagers. RESULTS Penta3 coverage was at 22% in the first quarter of project implementation and increased to 62% by the fourth quarter of project implementation. OPV coverage also increased from 54% in the first quarter to 76% in the last quarter of the 1-year project implementation. CONCLUSIONS The systematic implementation of a CE strategy that focused on planning and working with community structures and community engagers in immunization activities assisted in increasing OPV and penta3 immunization coverage.
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Affiliation(s)
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Bassey Enya Bassey
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Akinola Fatiregun
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Sisay Gashu Tegene
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Martin Chukwuji
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Usman Saidu Adamu
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
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Bawa S, Shuaib F, Saidu M, Ningi A, Abdullahi S, Abba B, Idowu A, Alkasim J, Hammanyero K, Warigon C, Tegegne SG, Banda R, Korir C, Yehualashet YG, Bedada T, Martin C, Nsubuga P, Adamu US, Okposen B, Braka F, Wondimagegnehu A, Vaz RG. Conduct of vaccination in hard-to-reach areas to address potential polio reservoir areas, 2014-2015. BMC Public Health 2018; 18:1312. [PMID: 30541501 PMCID: PMC6291919 DOI: 10.1186/s12889-018-6194-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Global Vaccine Action Plan (GVAP) seeks to achieve the total realization of its vision through equitable access to immunization as well as utilizing the immunization systems for delivery of other primary healthcare programs. The inequities in accessing hard-to-reach areas have very serious implications for the prevention and control of vaccine-preventable diseases, especially the polio eradication initiative. The Government of Nigeria implemented vaccination in hard-to-reach communities with support from the World Health Organization (WHO) to address the issues of health inequities in the hard-to-reach communities. This paper documents the process of conducting integrated mobile vaccination in these hard-to-reach areas and the impact on immunization outcomes. METHODS We conducted vaccination using mobile health teams in 2311 hard-to-reach settlements in four states at risk of sustaining polio transmission in Nigeria from July 2014 to September 2015. RESULTS The oral polio vaccine (OPV)3 coverage among children under 1 year of age improved from 23% at baseline to 61% and OPV coverage among children aged 1-5 years increased from 60 to 90%, while pentavalent vaccine (penta3) coverage increased from 22 to 55%. Vitamin A was administered to 78% of the target population and 9% of children that attended the session were provided with treatment for malaria. CONCLUSIONS The hard-to-reach project has improved population immunity against polio, as well as other routine vaccinations and delivery of child health survival interventions in the hard-to-reach and underserved communities.
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Affiliation(s)
- Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Mahmoud Saidu
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Adamu Ningi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Suleiman Abdullahi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Audu Idowu
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Jibrin Alkasim
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Tesfaye Bedada
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Chukwuji Martin
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Usman S Adamu
- National Polio Emergency Operation Center, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Bassey Okposen
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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21
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Nkwogu L, Shuaib F, Braka F, Mkanda P, Banda R, Korir C, Bawa S, Mele S, Saidu M, Mshelia H, Shettima A, Tegegne SG, Yehualashet YG, Adamu U, Nsubuga P, Vaz RG, Wondimagegnehu A. Impact of engaging security personnel on access and polio immunization outcomes in security-inaccessible areas in Borno state, Nigeria. BMC Public Health 2018; 18:1311. [PMID: 30541498 PMCID: PMC6292175 DOI: 10.1186/s12889-018-6188-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nigeria was polio free for almost 2 years but, with the recent liberation of areas under the captivity of insurgents, there has been a resurgence of polio cases. For several years, these inaccessible areas did not have access to vaccination due to activities of Bokoharam, resulting in a concentration of a cohort of unvaccinated children that served as a polio sanctuary. This article describes the processes of engagement of security personnel to access security-compromised areas and the impact on immunization outcomes. METHODS We assessed routine program data from January 2016 to July 2016 in security-inaccessible areas and we evaluated the effectiveness of engaging security personnel to improve access to settlements in security-compromised Local Government Areas (LGAs) of Borno state. We thereafter evaluated the effects of this engagement on postcampaign evaluation indicators. RESULTS From 15 LGAs accessible to vaccination teams in January 2016, there was a 47% increase in July 2016. The number of wards increased from 131 in January to 162 in July 2016, while the settlement numbers increased from 6050 in January to 6548 in July 2016. The average percentage of missed children decreased from 8% in January to 3% in July 2016, while the number of LGAs with ≥ 80% coverage increased from 85% in January to 100% in July 2016. CONCLUSION The engagement of security personnel in immunization activities led to an improved access and improvement in postcampaign evaluation indicators in security-compromised areas of a Nigerian state. This approach promises to be an impactful innovation in reaching settlements in security-compromised areas.
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Affiliation(s)
- Loveday Nkwogu
- World Health Organization Country Representative's Office, Abuja, Nigeria.
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Sule Mele
- Borno State Primary Health Care Development Agency, Maiduguri, Nigeria
| | - Mahmud Saidu
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Hyelni Mshelia
- Borno State Primary Health Care Development Agency, Maiduguri, Nigeria
| | - Aliyu Shettima
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization Country Representative's Office, Abuja, Nigeria
| | | | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Care Solutions, Atlanta, GA, USA
| | - Rui G Vaz
- World Health Organization, Geneva, Switzerland
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22
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Bawa S, Afolabi M, Abdelrahim K, Abba G, Ningi A, Tafida SY, Tegegne SG, Warigon C, Nomhwange T, Umar SA, Aregay A, Fanti A, Ahmed B, Nsubuga P, Adamu U, Braka F, Wondimagegnehu A, Shuaib F. Transboundary nomadic population movement: a potential for import-export of poliovirus. BMC Public Health 2018; 18:1316. [PMID: 30541502 PMCID: PMC6292162 DOI: 10.1186/s12889-018-6190-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Indexed: 11/10/2022] Open
Abstract
Background Nomadic populations have a considerably higher risk of contracting a number of diseases but, despite the magnitude of the public health risks involved, they are mostly underserved with few health policies or plans to target them. Nomadic population movements are shown to be a niche for the transmission of diseases, including poliomyelitis. The nomadic routes traverse the northern states of Nigeria to other countries in the Lake Chad subregion. As part of the February 2016 polio supplemental immunization activity (SIA) plans in Bauchi state, a review of nomadic routes and populations identified a nomadic population who originated from outside the international borders of Nigeria. This study describes the engagement process for a transboundary nomadic population and the interventions provided to improve population immunity among them while traversing through Nigeria. Methods This was an intervention study which involved a cross-sectional mixed-method (quantitative and qualitative) survey. Information was collected on the nomadic pastoralists entry and exit points, resting points, and health-seeking behavior using key informant interviews and semistructured questionnaire. Transit vaccination teams targeted the groups with oral polio vaccines (OPVs) and other routine antigens along identified routes during the months of February to April 2016. Mobile health teams provided immunization and other child and maternal health survival interventions. Results A total of 2015 children aged under 5 years were vaccinated with OPV, of which 264 (13.1%) were zero-dose during the February 2016 SIAs while, in the March immunization plus days (IPDs), 1864 were immunized of which 211 (11.0%) were zero-dose. A total of 296 children aged under 1 year old were given the first dose of pentavalent vaccine (penta 1), while 119 received the third dose (penta 3), giving a dropout rate of 59.8%. Conclusions Nomadic pastoralists move across international borders and there is a need for transboundary policies among the countries in the Lake Chad region to improve population immunity and disease surveillance through a holistic approach using the One-health concept.
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Affiliation(s)
- Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | | | | | - Goni Abba
- World Health Organization, Bauchi State Office, Bauchi, Nigeria
| | - Adamu Ningi
- World Health Organization, Bauchi State Office, Bauchi, Nigeria
| | | | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Terna Nomhwange
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Aron Aregay
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ahmed Fanti
- Bauchi state Primary Health Care Development Agency, Bauchi, Nigeria
| | - Bakoji Ahmed
- Bauchi state Primary Health Care Development Agency, Bauchi, Nigeria
| | | | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
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23
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Bawa S, McNab C, Nkwogu L, Braka F, Obinya E, Galway M, Mirelman AJ, Hammanyero KI, Safiyanu G, Chukwuji M, Ongwae K, Mkanda P, Corkum M, Hegg L, Tollefson D, Umar S, Audu S, Gunda H, Chinta M, Jean Baptiste AE, Bagana M, Shuaib F. Using the polio programme to deliver primary health care in Nigeria: implementation research. Bull World Health Organ 2018; 97:24-32. [PMID: 30618462 PMCID: PMC6307512 DOI: 10.2471/blt.18.211565] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria. Methods In 2013, Nigeria’s polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively). Findings From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households’ use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%). Conclusion Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions.
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Affiliation(s)
- Samuel Bawa
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | | | - Loveday Nkwogu
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | - Fiona Braka
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | - Esther Obinya
- United Nations Children's Fund, Nigeria Country Office, Abuja, Nigeria
| | - Michael Galway
- Bill & Melinda Gates Foundation, Seattle, United States of America
| | | | - Kulchumi Isa Hammanyero
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | - Garba Safiyanu
- United Nations Children's Fund, Nigeria Country Office, Abuja, Nigeria
| | - Martin Chukwuji
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | | | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Lea Hegg
- Bill & Melinda Gates Foundation, Seattle, United States of America
| | - Deanna Tollefson
- Bill & Melinda Gates Foundation, Seattle, United States of America
| | - Sani Umar
- World Health Organization, Kano Office, Kano, Nigeria
| | - Sunday Audu
- World Health Organization, Borno Office, Maiduguri, Nigeria
| | - Hassan Gunda
- World Health Organization, Bauchi Office, Bauchi, Nigeria
| | - Modu Chinta
- World Health Organization, Yobe Office, Damaturu, Nigeria
| | - Anne Eudes Jean Baptiste
- World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria
| | - Murtala Bagana
- National Primary Health Care Development Agency, Ministry of Health, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Ministry of Health, Abuja, Nigeria
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24
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Paudel YN, Ali MR, Bawa S, Shah S, Adil M, Siddiqui A, Basheer AS, Hassan MQ, Sharma M. Evaluation of 4-methyl-2-[(2-methylbenzyl) amino]-1,3-thiazole-5-carboxylic acid against hyperglycemia, insulin sensitivity, and oxidative stress-induced inflammatory responses and β-cell damage in the pancreas of streptozotocin-induced diabetic rats. Hum Exp Toxicol 2017; 37:163-174. [PMID: 29233026 DOI: 10.1177/0960327117692133] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
4-Methyl-2-[(2-methylbenzyl) amino]-1,3-thiazole-5-carboxylic acid (bioactive compound (BAC)), a novel thiazole derivative, is a xanthine oxidase inhibitor and free radical scavenging agent. Effects of BAC on hyperglycemia, insulin sensitivity, oxidative stress, and inflammatory mediators were evaluated in streptozotocin (STZ)-induced neonatal models of non-insulin-dependent diabetes mellitus (NIDDM) rats where NIDDM was induced in neonatal pups with single intraperitoneal injection of STZ (100 mg/kg). The effect of BAC (10 and 20 mg/kg, p.o.) for 3 weeks was evaluated by the determination of blood glucose, oral glucose tolerance test (OGTT), HbA1c level, insulin level, insulin sensitivity, and insulin resistance (IR). Furthermore, inflammatory mediators (tumor necrosis factor-alpha and interleukin-6) and oxidative stress were estimated in serum and pancreatic tissue, respectively. Significant alteration in the level of blood glucose, OGTT, HbA1c, insulin level, insulin sensitivity, in addition variation in the antioxidant status and inflammatory mediators, and alteration in histoarchitecture of pancreatic tissue confirmed the potential of BAC in STZ-induced neonatal models of NIDDM rats. Pretreatment with BAC restored the level of glucose by decreasing the IR and increasing the insulin sensitivity. Furthermore, BAC balanced the antioxidant status and preserved the inflammatory mediators. Histological studies of pancreatic tissues showed normal architecture after BAC administration to diabetic rats. Altogether, our results suggest that BAC successfully reduces the blood glucose level and possesses antioxidant as well as anti-inflammatory activities. This leads to decreased histological damage in diabetic pancreatic tissues, suggesting the possibility of future diabetes treatments.
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Affiliation(s)
- Y N Paudel
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - M R Ali
- 2 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - S Bawa
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - S Shah
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - M Adil
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - A Siddiqui
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - A S Basheer
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - M Q Hassan
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
| | - M Sharma
- 1 Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India
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25
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Abstract
Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22-90 minutes) and 35 minutes for consultant surgeons (range 18-80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40-120 minutes) and 51 minutes for consultant surgeons (range 30-130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.
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Affiliation(s)
- D Light
- Northumbria NHS Trust, North Shields, UK
| | - S Bawa
- Northumbria NHS Trust, North Shields, UK
| | | | - L Horgan
- Northumbria NHS Trust, North Shields, UK
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok J, Woodman T, Deguara J, Garcea G, Babu BI, Dennison AR, Malde D, Lloyd D, Satheesan S, Al-Taan O, Boddy A, Slavin JP, Jones RP, Ballance L, Gerakopoulos S, Jambulingam P, Mansour S, Sakai N, Acharya V, Sadat MM, Karim L, Larkin D, Amin K, Khan A, Law J, Jamdar S, Smith SR, Sampat K, M O'shea K, Manu M, Asprou FM, Malik NS, Chang J, Johnstone M, Lewis M, Roberts GP, Karavadra B, Photi E, Hewes J, Gould L, Chambers A, Rodriguez D, O'Reilly DA, Rate AJ, Sekhar H, Henderson LT, Starmer BZ, Coe PO, Tolofari S, Barrie J, Bashir G, Sloane J, Madanipour S, Halkias C, Trevatt AEJ, Borowski DW, Hornsby J, Courtney MJ, Virupaksha S, Seymour K, Robinson S, Hawkins H, Bawa S, Gallagher PV, Reid A, Wood P, Finch JG, Parmar J, Stirland E, Gardner-Thorpe J, Al-Muhktar A, Peterson M, Majeed A, Bajwa FM, Martin J, Choy A, Tsang A, Pore N, Andrew DR, Al-Khyatt W, Taylor C, Bhandari S, Chambers A, Subramanium D, Toh SKC, Carter NC, Mercer SJ, Knight B, Tate S, Pearce B, Wainwright D, Vijay V, Alagaratnam S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, Rajaganeshan R, Hancorn K, Hargreaves A, Prasad R, Longbotham DA, Vijayanand D, Wijetunga I, Ziprin P, Nicolay CR, Yeldham G, Read E, Gossage JA, Rolph RC, Ebied H, Phull M, Khan MA, Popplewell M, Kyriakidis D, Hussain A, Henley N, Packer JR, Derbyshire L, Porter J, Appleton S, Farouk M, Basra M, Jennings NA, Ali S, Kanakala V, Ali H, Lane R, Dickson-Lowe R, Zarsadias P, Mirza D, Puig S, Al Amari K, Vijayan D, Sutcliffe R, Marudanayagam R, Hamady Z, Prasad AR, Patel A, Durkin D, Kaur P, Bowen L, Byrne JP, Pearson KL, Delisle TG, Davies J, Tomlinson MA, Johnpulle MA, Slawinski C, Macdonald A, Nicholson J, Newton K, Mbuvi J, Farooq A, Sidhartha Mothe B, Zafrani Z, Brett D, Francombe J, Spreadborough P, Barnes J, Cheung M, Al-Bahrani AZ, Preziosi G, Urbonas T, Alberts J, Mallik M, Patel K, Segaran A, Doulias T, Sufi PA, Yao C, Pollock S, Manzelli A, Wajed S, Kourkulos M, Pezzuto R, Wadley M, Hamilton E, Jaunoo S, Padwick R, Sayegh M, Newton RC, Hebbar M, Farag SF, Spearman J, Hamdan MF, D'Costa C, Blane C, Giles M, Peter MB, Hirst NA, Hossain T, Pannu A, El-Dhuwaib Y, Morrison TEM, Taylor GW, Thompson RLE, McCune K, Loughlin P, Lawther R, Byrnes CK, Simpson DJ, Mawhinney A, Warren C, McKay D, McIlmunn C, Martin S, MacArtney M, Diamond T, Davey P, Jones C, Clements JM, Digney R, Chan WM, McCain S, Gull S, Janeczko A, Dorrian E, Harris A, Dawson S, Johnston D, McAree B, Ghareeb E, Thomas G, Connelly M, McKenzie S, Cieplucha K, Spence G, Campbell W, Hooks G, Bradley N, Hill ADK, Cassidy JT, Boland M, Burke P, Nally DM, Hill ADK, Khogali E, Shabo W, Iskandar E, McEntee GP, O'Neill MA, Peirce C, Lyons EM, O'Sullivan AW, Thakkar R, Carroll P, Ivanovski I, Balfe P, Lee M, Winter DC, Kelly ME, Hoti E, Maguire D, Karunakaran P, Geoghegan JG, Martin ST, McDermott F, Cross KS, Cooke F, Zeeshan S, Murphy JO, Mealy K, Mohan HM, Nedujchelyn Y, Fahad Ullah M, Ahmed I, Giovinazzo F, Milburn J, Prince S, Brooke E, Buchan J, Khalil AM, Vaughan EM, Ramage MI, Aldridge RC, Gibson S, 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
| | - R S Vohra
- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
| | - M Elmasry
- Aintree University Hospital NHS Foundation Trust
| | - Q Nunes
- Aintree University Hospital NHS Foundation Trust
| | - D Kennedy
- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
| | | | - S Zafar
- Barnet and Chase Farm Hospital
| | | | - N Samuel
- Barnsley District General Hospital
| | - F Dar
- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
| | - S Ayaani
- Sandwell and West Birmingham Hospitals NHS Trust
| | - H Youssef
- Heart of England Foundation NHS Trust
| | | | - H Watkin
- Heart of England Foundation NHS Trust
| | - D Naumann
- Heart of England Foundation NHS Trust
| | - S Emeshi
- Heart of England Foundation NHS Trust
| | | | - K Lee
- Heart of England Foundation NHS Trust
| | - N Joji
- Heart of England Foundation NHS Trust
| | - J Heath
- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
| | - H Welbourn
- Bradford Teaching Hospitals NHS Foundation Trust
| | - L Forster
- Bradford Teaching Hospitals NHS Foundation Trust
| | - D Finch
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | - W Robb
- University Hospitals Bristol NHS Trust
| | | | | | | | | | | | | | | | - B Dobbins
- Calderdale and Huddersfield NHS Trust
| | | | | | | | - M Pellen
- Hull and East Yorkshire NHS Trust
| | | | - W-M Ho
- Hull and East Yorkshire NHS Trust
| | - V Miu
- Hull and East Yorkshire NHS Trust
| | - T J White
- Chesterfield Royal Hospital NHS Foundation Trust
| | - K A Hodgkins
- Chesterfield Royal Hospital NHS Foundation Trust
| | - A Kinghorn
- Chesterfield Royal Hospital NHS Foundation Trust
| | - M G Tutton
- Colchester Hospital University NHS Foundation Trust
| | - Y A Al-Abed
- Colchester Hospital University NHS Foundation Trust
| | - D Menzies
- Colchester Hospital University NHS Foundation Trust
| | - A Ahmad
- Colchester Hospital University NHS Foundation Trust
| | - J Reed
- Colchester Hospital University NHS Foundation Trust
| | - S Khan
- Colchester Hospital University NHS Foundation Trust
| | - D Monk
- Countess of Chester NHS Foundation Trust
| | - L J Vitone
- Countess of Chester NHS Foundation Trust
| | - G Murtaza
- Countess of Chester NHS Foundation Trust
| | - A Joel
- Countess of Chester NHS Foundation Trust
| | | | - D Shier
- Croydon Health Services NHS Trust
| | - C Zhang
- Croydon Health Services NHS Trust
| | | | | | | | - M J Jones
- North Cumbria University Hospitals Trust
| | - M Elsayed
- North Cumbria University Hospitals Trust
| | - L Tuck
- North Cumbria University Hospitals Trust
| | - J Wayman
- North Cumbria University Hospitals Trust
| | - K Carney
- North Cumbria University Hospitals Trust
| | | | | | | | | | | | | | | | | | | | | | - M P Tilston
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - M Gough
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T Wallace
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - S Singh
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - J Downing
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - K A Mockford
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - E Issa
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Shah
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Chauhan
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T R Wilson
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - A Forouzanfar
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - J R L Wild
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - E Nofal
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - C Bunnell
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - K Madbak
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - S T V Rao
- Dorset County Hospital NHS Foundation Trust
| | - L Devoto
- Dorset County Hospital NHS Foundation Trust
| | - N Siddiqi
- Dorset County Hospital NHS Foundation Trust
| | - Z Khawaja
- Dorset County Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | - D M Rae
- Frimley Park Hospital NHS Trust
| | | | | | | | | | - O J Old
- Gloucestershire Hospitals NHS Trust
| | | | - R Shah
- Gloucestershire Hospitals NHS Trust
| | | | - K Keogh
- Gloucestershire Hospitals NHS Trust
| | - L Frank
- Gloucestershire Hospitals NHS Trust
| | - M Al-Akash
- Great Western Hospitals NHS Foundation Trust
| | | | - R J Frame
- Harrogate and District NHS Foundation Trust
| | - M Hughes
- Harrogate and District NHS Foundation Trust
| | - C Jelley
- Harrogate and District NHS Foundation Trust
| | | | | | | | | | - T Cuming
- Homerton University Hospital NHS Trust
| | - P Cunha
- Homerton University Hospital NHS Trust
| | - S Tayeh
- Homerton University Hospital NHS Trust
| | | | | | - A Eisawi
- Tees Hospitals NHS Foundation Trust
| | | | - W S Ngu
- Tees Hospitals NHS Foundation Trust
| | | | | | - V Chitre
- Paget University Hospitals NHS Foundation Trust
| | - K Aryal
- Paget University Hospitals NHS Foundation Trust
| | - P Ferris
- Paget University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | - H Ebdewi
- Kettering General Hospital NHS Foundation Trust
| | - M Elshaer
- Kettering General Hospital NHS Foundation Trust
| | - G Gravante
- Kettering General Hospital NHS Foundation Trust
| | - B Drake
- Kettering General Hospital NHS Foundation Trust
| | - A Ogedegbe
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - D Mukherjee
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - C Arhi
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | | | | | | | | | | | | | - K Wa
- Kingston Hospital NHS Foundation Trust
| | - J Mok
- Kingston Hospital NHS Foundation Trust
| | - T Woodman
- Kingston Hospital NHS Foundation Trust
| | - J Deguara
- Kingston Hospital NHS Foundation Trust
| | - G Garcea
- University Hospitals of Leicester NHS Trust
| | - B I Babu
- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
| | - D Lloyd
- University Hospitals of Leicester NHS Trust
| | | | - O Al-Taan
- University Hospitals of Leicester NHS Trust
| | - A Boddy
- University Hospitals of Leicester NHS Trust
| | - J P Slavin
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - L Ballance
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - S Gerakopoulos
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - P Jambulingam
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - S Mansour
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - N Sakai
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - V Acharya
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - M M Sadat
- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
| | - S R Smith
- Central Manchester NHS Foundation Trust
| | - K Sampat
- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
| | - J Lodhia
- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
| | - J Ahmed
- Royal Derby NHS Foundation Trust
| | - P Leeder
- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - Y Li Goh
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - V Shetty
- Lancashire Teaching Hospitals NHS Foundation Trust
| | | | | | | | - S R Preston
- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
| | - D J Puntis
- Royal Surrey County Hospital NHS Foundation Trust
| | - S V Williams
- Royal Surrey County Hospital NHS Foundation Trust
| | | | | | - J Batt
- Royal United Hospital Bath NHS Trust
| | - M Doe
- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
| | - N Carty
- Salisbury Hospital Foundation Trust
| | - J Ahmed
- Salisbury Hospital Foundation Trust
| | | | | | | | - H Lennon
- Southport and Ormskirk Hospital NHS Trust
| | - C Hindley
- Southport and Ormskirk Hospital NHS Trust
| | - M Reddy
- St George's Healthcare NHS Trust
| | - R Kenny
- St George's Healthcare NHS Trust
| | | | | | | | - K Hancorn
- St Helens and Knowsley Teaching Hospitals NHS Trust
| | - A Hargreaves
- St Helens and Knowsley Teaching Hospitals NHS Trust
| | | | | | | | | | - P Ziprin
- Imperial College Healthcare NHS Trust
| | | | - G Yeldham
- Imperial College Healthcare NHS Trust
| | - E Read
- Imperial College Healthcare NHS Trust
| | | | | | | | | | - M A Khan
- Mid Staffordshire NHS Foundation Trust
| | | | | | - A Hussain
- Mid Staffordshire NHS Foundation Trust
| | | | | | | | | | | | | | | | | | - S Ali
- City Hospitals Sunderland NHS Foundation Trust
| | - V Kanakala
- City Hospitals Sunderland NHS Foundation Trust
| | - H Ali
- Tunbridge Wells and Maidstone NHS Trust
| | - R Lane
- Tunbridge Wells and Maidstone NHS Trust
| | | | | | - D Mirza
- University Hospital Birmingham NHS Foundation Trust
| | - S Puig
- University Hospital Birmingham NHS Foundation Trust
| | - K Al Amari
- University Hospital Birmingham NHS Foundation Trust
| | - D Vijayan
- University Hospital Birmingham NHS Foundation Trust
| | - R Sutcliffe
- University Hospital Birmingham NHS Foundation Trust
| | | | - Z Hamady
- University Hospital Coventry and Warwickshire NHS Trust
| | - A R Prasad
- University Hospital Coventry and Warwickshire NHS Trust
| | - A Patel
- University Hospital Coventry and Warwickshire NHS Trust
| | - D Durkin
- University Hospital of North Staffordshire NHS Trust
| | - P Kaur
- University Hospital of North Staffordshire NHS Trust
| | - L Bowen
- University Hospital of North Staffordshire NHS Trust
| | - J P Byrne
- University Hospital Southampton NHS Foundation Trust
| | - K L Pearson
- University Hospital Southampton NHS Foundation Trust
| | - T G Delisle
- University Hospital Southampton NHS Foundation Trust
| | - J Davies
- University Hospital Southampton NHS Foundation Trust
| | | | | | | | - A Macdonald
- University Hospital South Manchester NHS Foundation Trust
| | - J Nicholson
- University Hospital South Manchester NHS Foundation Trust
| | - K Newton
- University Hospital South Manchester NHS Foundation Trust
| | - J Mbuvi
- University Hospital South Manchester NHS Foundation Trust
| | - A Farooq
- Warrington and Halton Hospitals NHS Trust
| | | | - Z Zafrani
- Warrington and Halton Hospitals NHS Trust
| | - D Brett
- Warrington and Halton Hospitals NHS Trust
| | | | | | - J Barnes
- South Warwickshire NHS Foundation Trust
| | - M Cheung
- South Warwickshire NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M Wadley
- Worcestershire Acute Hospitals NHS Trust
| | - E Hamilton
- Worcestershire Acute Hospitals NHS Trust
| | - S Jaunoo
- Worcestershire Acute Hospitals NHS Trust
| | - R Padwick
- Worcestershire Acute Hospitals NHS Trust
| | - M Sayegh
- Western Sussex Hospitals NHS Foundation Trust
| | - R C Newton
- Western Sussex Hospitals NHS Foundation Trust
| | - M Hebbar
- Western Sussex Hospitals NHS Foundation Trust
| | - S F Farag
- Western Sussex Hospitals NHS Foundation Trust
| | | | | | | | - C Blane
- Yeovil District Hospital NHS Trust
| | - M Giles
- York Teaching Hospital NHS Foundation Trust
| | - M B Peter
- York Teaching Hospital NHS Foundation Trust
| | - N A Hirst
- York Teaching Hospital NHS Foundation Trust
| | - T Hossain
- York Teaching Hospital NHS Foundation Trust
| | - A Pannu
- York Teaching Hospital NHS Foundation Trust
| | | | | | - G W Taylor
- York Teaching Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - T Diamond
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - P Davey
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - C Jones
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - J M Clements
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - R Digney
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - W M Chan
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S McCain
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Gull
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Janeczko
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - E Dorrian
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Harris
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Dawson
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | - P Burke
- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
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- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
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- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Musa A, Abba B, Ningi AMI, Gali E, Bawa S, Manneh F, Mkanda P, Banda R, Yehuluashet YG, Tegegne SG, Umeh G, Nsubuga P, Etsano A, Shuaib F, Mohammed A, Vaz RG. Enhancing transit polio vaccination in collaboration with targeted stakeholders in Kaduna State, Nigeria: Lessons learnt: 2014-2015. Vaccine 2016; 34:5159-5163. [PMID: 27364095 DOI: 10.1016/j.vaccine.2016.05.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In Kaduna State of Nigeria, the high influx of people from neighboring states with eligible children for polio vaccination represents a significant proportion of the target population. Many of these children are often missed by the vaccination team. The purpose of the study was to determine the contribution of targeted stakeholders in transit polio vaccination. METHODS We used the trends of vaccinated children at transit points, motor parks and markets, well as total children vaccinated by transit teams in Chikun, Igabi and Sabon Gari Local Government Areas (LGAs) of Kaduna State, Nigeria, four rounds before and after the introduction of transit polio vaccination with targeted stakeholders in Kaduna State. RESULTS A total of 87,502 under-5 children were vaccinated by the various transit teams in the three LGAs, which accounted for 3.2% of the total 2,781,162 children vaccinated by the three LGAs. For transit point vaccination, the number of vaccinated children increased from 1026 to 19,289 (302%), while motor park vaccination increased from 1289 to 4106 (318%) and market vaccination increased from 10,488 to 14,511 (138%), four rounds after the introduction of transit polio vaccination with targeted stakeholders. CONCLUSION Engagement of targeted stakeholders significantly enhanced transit polio vaccination in Kaduna State, Nigeria.
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Affiliation(s)
- Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | - Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Adamu M I Ningi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Emanuel Gali
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Fadninding Manneh
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Gregory Umeh
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Andrew Etsano
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
| | - Ado Mohammed
- National Primary Health Care Development Agency (NPHCDA), Abuja, Nigeria
| | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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McCusker S, Leman J, Bawa S, Gordon MM. THU0452 Psoriatic Arthritis and Psoriasis: The Ongoing Need for A Multidisciplinary Approach To Management. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gali E, Mkanda P, Banda R, Korir C, Bawa S, Warigon C, Abdullahi S, Abba B, Isiaka A, Yahualashet YG, Touray K, Chevez A, Tegegne SG, Nsubuga P, Etsano A, Shuaib F, Vaz RG. Revised Household-Based Microplanning in Polio Supplemental Immunization Activities in Kano State, Nigeria. 2013-2014. J Infect Dis 2016; 213 Suppl 3:S73-8. [PMID: 26908755 PMCID: PMC4818558 DOI: 10.1093/infdis/jiv589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Remarkable progress had been made since the launch of the Global Polio Eradication Initiative in 1988. However endemic wild poliovirus transmission in Nigeria, Pakistan, and Afghanistan remains an issue of international concern. Poor microplanning has been identified as a major contributor to the high numbers of chronically missed children. METHODS We assessed the contribution of the revised household-based microplanning process implemented in Kano State from September 2013 to April 2014 to the outcomes of subsequent polio supplemental immunization activities using used preselected planning and outcome indicators. RESULTS There was a 38% increase in the number of settlements enumerated, a 30% reduction in the number of target households, and a 54% reduction in target children. The reported number of children vaccinated and the doses of oral polio vaccine used during subsequent polio supplemental immunization activities showed a decline. Postvaccination lot quality assurance sampling and chronically missed settlement reports also showed a progressive reduction in the number of children and settlements missed. CONCLUSIONS We observed improvement in Kano State's performance based on the selected postcampaign performance evaluation indicators and reliability of baseline demographic estimates after the revised household-based microplanning exercise.
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Affiliation(s)
- Emmanuel Gali
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Suleiman Abdullahi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ayodeji Isiaka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Kebba Touray
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ana Chevez
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Andrew Etsano
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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Warigon C, Mkanda P, Muhammed A, Etsano A, Korir C, Bawa S, Gali E, Nsubuga P, Erbeto TB, Gerlong G, Banda R, Yehualashet YG, Vaz RG. Demand Creation for Polio Vaccine in Persistently Poor-Performing Communities of Northern Nigeria: 2013-2014. J Infect Dis 2016; 213 Suppl 3:S79-85. [PMID: 26908717 PMCID: PMC4818551 DOI: 10.1093/infdis/jiv511] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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] [Indexed: 11/30/2022] Open
Abstract
Introduction. Poliomyelitis remains a global threat despite availability of oral polio vaccine (OPV), proven to reduce the burden of the paralyzing disease. In Nigeria, children continue to miss the opportunity to be fully vaccinated, owing to factors such as unmet health needs and low uptake in security-compromised and underserved communities. We describe the implementation and evaluation of several activities to create demand for polio vaccination in persistently poor-performing local government areas (LGAs). Methods. We assessed the impact of various polio-related interventions, to measure the contribution of demand creation activities in 77 LGAs at very high risk for polio, located across 10 states in northern Nigeria. Interventions included provision of commodities along with the polio vaccine. Results. There was an increasing trend in the number of children reached by different demand creation interventions. A total of 4 819 847 children were vaccinated at health camps alone. There was a reduction in the number of wards in which >10% of children were missed by supplementary immunization activities due to noncompliance with vaccination recommendations, a rise in the proportion of children who received ≥4 OPV doses, and a decrease in the proportion of children who were underimmunized or unimmunized. Conclusions. Demand creation interventions increased the uptake of polio vaccines in persistently poor-performing high-risk communities in northern Nigeria during September 2013–November 2014.
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Affiliation(s)
- Charity Warigon
- World Health Organization, Country Representative Office, and
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo; and
| | - Ado Muhammed
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Andrew Etsano
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, and
| | - Samuel Bawa
- World Health Organization, Country Representative Office, and
| | - Emmanuel Gali
- World Health Organization, Country Representative Office, and
| | | | | | - George Gerlong
- World Health Organization, Country Representative Office, and
| | - Richard Banda
- World Health Organization, Country Representative Office, and
| | | | - Rui G Vaz
- World Health Organization, Country Representative Office, and
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Warigon C, Mkanda P, Banda R, Zakari F, Damisa E, Idowu A, Bawa S, Gali E, Tegegne SG, Hammanyero K, Nsubuga P, Korir C, Vaz RG. The Journalists Initiatives on Immunisation Against Polio and Improved Acceptance of the Polio Vaccine in Northern Nigeria 2007-2015. J Infect Dis 2015; 213 Suppl 3:S86-90. [PMID: 26721745 PMCID: PMC4818555 DOI: 10.1093/infdis/jiv545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. METHODS We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers' sources of information about SIAs in 2007 before and after the JAP was formed. RESULTS Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. CONCLUSIONS The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria.
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Affiliation(s)
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Banda
- World Health Organization, Country Representative Office
| | - Furera Zakari
- World Health Organization, Country Representative Office
| | - Eunice Damisa
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Audu Idowu
- World Health Organization, Country Representative Office
| | - Samuel Bawa
- World Health Organization, Country Representative Office
| | - Emmanuel Gali
- World Health Organization, Country Representative Office
| | | | | | | | - Charles Korir
- World Health Organization, Country Representative Office
| | - Rui G Vaz
- World Health Organization, Country Representative Office
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Webb M, Murray S, Bawa S. An Assessment of Selected Macro- and Micro-Nutrients Intakes among Patients with HIV/AIDS in Barbados. J Acad Nutr Diet 2015. [DOI: 10.1016/j.jand.2015.06.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Clarke E, Bawa S. FRI0545 Safer Sleeping with Soap? Quinine, Cramps and Weighing Up Anecdotal Evidence. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Miller S, Bawa S. SAT0303 The Effect of Smoking on Treatment Response and Drug Survival in Psoriatic Arthritis Patients Treated with their First Anti-Tnf-A Drug: A Single-Centre Retrospective Analysis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agyarko-Poku T, Bawa S, Adomako-Boateng F, Siaw HA, Sarkodie YA. P2.146 CD4 Lymphocytes Count At First Presentation of HIV Positive Patients Accessing Antiretroviral Therapy At a District Hospital in Ghana. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cheng K, Bawa S. AB0517 Does smoking decrease the efficacy of anti-tumour necrosis factor-alpha therapy in patients with ankylosing spondylitis (as)? : a retrospective, case-control study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
INTRODUCTION Spigelian hernia are rarely reported lateral abdominal wall hernias. Clinical diagnosis of a suspected hernia can be challenging owing to vague presenting symptoms and signs. This study aimed to investigate the accuracy of preoperative imaging and clinical examination in the diagnosis of Spigelian hernias. METHODS A retrospective analysis was performed of patients who presented to North Tyneside and Wansbeck General Hospitals between 1998 and 2010. All patients were assessed by a consultant general surgeon in the outpatient clinic or on the surgical admissions ward. Patients were included who presented with a history suggestive of a Spigelian hernia and a palpable lump or equivocal clinical examination. All patients proceeded to surgery, which was used as the reference standard. RESULTS Overall, correlation with operative findings showed computed tomography (CT) to have a sensitivity of 100% and a positive predictive value (PPV) of 100%. Ultrasonography had a sensitivity of 90% and a PPV of 100%. Clinical assessment alone had a sensitivity of 100% and a PPV of 36%. CONCLUSIONS This study shows that ultrasonography and CT have a high sensitivity and PPV in relation to occult Spigelian hernias. When no obvious Spigelian hernia is present, patients should be evaluated with radiological investigation to establish a diagnosis. Owing to diagnostic uncertainty, a laparoscopic approach should be favoured.
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Affiliation(s)
- D Light
- Northumbria Healthcare NHS Foundation Trust, UK.
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Campbell R, Hofmann D, Hatch S, Gordon P, Lempp H, Das L, Blumbergs P, Limaye V, Vermaak E, McHugh N, Edwards MH, Jameson K, Sayer AA, Dennison E, Cooper C, Salvador FB, Huertas C, Isenberg D, Jackson EJ, Middleton A, Churchill D, Walker-Bone K, Worsley PR, Mottram S, Warner M, Morrissey D, Gadola S, Carr A, Cooper C, Stokes M, Srivastava RN, Sanghi D, Srivastava RN, Sanghi D, Elbaz A, Mor A, Segal G, Drexler M, Norman D, Peled E, Rozen N, Goryachev Y, Debbi EM, Haim A, Rozen N, Wolf A, Debi R, Mor A, Segal G, Debbi EM, Cohen MS, Igolnikov I, Bar Ziv Y, Benkovich V, Bernfeld B, Rozen N, Elbaz A, Collins J, Moots RJ, Clegg PD, Milner PI, Ejtehadi HD, Nelson PN, Wenham C, Balamoody S, Hodgson R, Conaghan P, Wilkie R, Blagojevic M, Jordan KP, Mcbeth J, Peffers MJ, Beynon RJ, Thornton DJ, Clegg PD, Chapman R, Chapman V, Walsh D, Kelly S, Hui M, Zhang W, Doherty S, Rees F, Muir K, Maciewicz R, Doherty M, Snelling S, Davidson RK, Swingler T, Price A, Clark I, Stockley E, Hathway G, Faas H, Auer D, Chapman V, Hirsch G, Hale E, Kitas G, Klocke R, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Tucker M, Mellon SJ, Jones L, Price AJ, Dieppe PA, Gill HS, Ashraf S, Chapman V, Walsh DA, McCollum D, McCabe C, Grieve S, Shipley J, Gorodkin R, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Rajak R, Bennett C, Williams A, Martin JC, Abdulkader R, MacNicol C, Brixey K, Stephenson S, Clunie G, Andrews RN, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Clark EM, Gould VC, Carter L, Morrison L, Tobias JH, Pye SR, Vanderschueren D, O'Neill TW, Lee DM, Jans I, Billen J, Gielen E, Laurent M, Claessens F, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi I, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, Boonen S, Mercieca C, Webb J, Shipley J, Bhalla A, Fairbanks S, Moss KE, Collins C, Sedgwick P, Clark EM, Gould VC, Morrison L, Tobias JH, Parker J, Greenbank C, Evans B, Oldroyd AG, Bukhari M, Harvey NC, Cole ZA, Crozier SR, Ntani G, Mahon PA, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Cooper C, Bridges M, Ruddick S, Holroyd CR, Mahon P, Crozier SR, Godfrey K, Inskip HM, Cooper C, Harvey NC, Bridges M, Ruddick S, McNeilly T, McNally C, Beringer T, Finch M, Coda A, Davidson J, Walsh J, Fowlie P, Carline T, Santos D, Patil P, Rawcliffe C, Olaleye A, Moore S, Fox A, Sen D, Ioannou Y, Nisar S, Rankin K, Birch M, Finnegan S, Rooney M, Gibson DS, Malviya A, Ferris CM, Rushton SP, Foster HE, Hanson H, Muthumayandi K, Deehan DJ, Birt L, Poland F, MacGregor A, Armon K, Pfeil M, McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Gibson DS, Finnegan S, Newell K, Evans A, Manning G, Scaife C, McAllister C, Pennington SR, Duncan M, Moore T, Rooney M, Pericleous C, Croca SC, Giles I, Alber K, Yong H, Isenberg D, Midgely A, Beresford MW, Rahman A, Ioannou Y, Rzewuska M, Mallen C, Strauss VY, Belcher J, Peat G, Byng-Maddick R, Wijendra M, Penn H, Roddy E, Muller S, Hayward R, Mallen C, Kamlow F, Pakozdi A, Jawad A, Green DJ, Muller S, Mallen C, Hider SL, Singh Bawa S, Bawa S, Turton A, Palmer M, Grieve S, Lewis J, Moss T, McCabe C, Goodchild CE, Tang N, Scott D, Salkovskis P, Selvan S, Williamson L, Selvan S, Williamson L, Thalayasingam N, Higgins M, Saravanan V, Rynne M, Hamilton JD, Heycock C, Kelly C, Norton S, Sacker A, Done J, Young A, Smolen JS, Fleischmann RM, Emery P, van Vollenhoven RF, Guerette B, Santra S, Kupper H, Redden L, Kavanaugh A, Keystone EC, van der Heijde D, Weinblatt ME, Mozaffarian N, Guerette B, Kupper H, Liu S, Kavanaugh A, Zhang N, Wilkinson S, Riaz M, Ostor AJ, Nisar MK, Burmester G, Mariette X, Navarro-Blasco F, Oezer U, Kary S, Unnebrink K, Kupper H, Jobanputra P, Maggs F, Deeming A, Carruthers D, Rankin E, Jordan A, Faizal A, Goddard C, Pugh M, Bowman S, Brailsford S, Nightingale P, Tugnet N, Cooper SC, Douglas KM, Edwin Lim CS, Bee Lian Low S, Joy C, Hill L, Davies P, Mukherjee S, Cornell P, Westlake SL, Richards S, Rahmeh F, Thompson PW, Breedveld F, Keystone E, van der Heijde D, Landewe R, Smolen JS, Guerette B, McIlraith M, Kupper H, Liu S, Kavanaugh A, Byng-Maddick R, Penn H, Abdulkader R, Dharmapalaiah C, Shand L, Rose G, Clunie G, Watts R, Eldashan A, Dasgupta B, Borg FA, Bell GM, Anderson AE, Harry RA, Stoop JN, Hilkens CM, Isaacs J, Dickinson A, McColl E, Banik S, Smith L, France J, Bawa S, Rutherford A, Scott Russell A, Smith J, Jassim I, Withrington R, Bacon P, De Lord D, McGregor L, Morrison I, Stirling A, Porter DR, Saunders SA, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Baguley E, Patel Y, Alzabin S, Abraham S, Taher TE, Palfeeman A, Hull D, McNamee K, Jawad A, Pathan E, Kinderlerer A, Taylor P, Williams RO, Mageed RA, Iaremenko O, Mikitenko G, Ferrari M, Kamalati T, Pitzalis C, Tugnet N, Pearce F, Tosounidou S, Obrenovic K, Erb N, Packham J, Sandhu R, White C, Cardy CM, Justice E, Frank M, Li L, Lloyd M, Ahmed A, Readhead S, Ala A, Fittall M, Manson J, Ioannou Y, Sibilia J, Marc Flipo R, Combe B, Gaillez C, Le Bars M, Poncet C, Elegbe A, Westhovens R, Hassanzadeh R, Mangan C, France J, Bawa S, Weinblatt ME, Fleischmann R, van Vollenhoven R, Emery P, Huizinga TWJ, Goldermann R, Duncan B, Timoshanko J, Luijtens K, Davies O, Dougados M, Hewitt J, Owlia M, Dougados M, Gaillez C, Le Bars M, Poncet C, Elegbe A, Schiff M, Alten R, Kaine JL, Keystone E, Nash PT, Delaet I, Qi K, Genovese MC, Clark J, Kardash S, Wong E, Hull R, McCrae F, Shaban R, Thomas L, Young-Min S, Ledingham J, Genovese MC, Covarrubias Cobos A, Leon G, Mysler EF, Keiserman MW, Valente RM, Nash PT, Abraham Simon Campos J, Porawska W, Box JH, Legerton CW, Nasonov EL, Durez P, Pappu R, Delaet I, Teng J, Alten R, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Choy E, McAuliffe S, Roberts K, Sargeant I, Emery P, Sarzi-Puttini P, Moots RJ, Andrianakos A, Sheeran TP, Choquette D, Finckh A, Desjuzeur ML, Gemmen EK, Mpofu C, Gottenberg JE, Bukhari M, Shah P, Kitas G, Cox M, Nye A, O'Brien A, Jones P, Sargeant I, Jones GT, Paudyal P, MacPherson H, Sim J, Doherty M, Ernst E, Fisken M, Lewith G, Tadman J, Macfarlane GJ, Mariette X, Bertin P, Arendt C, Terpstra I, VanLunen B, de Longueville M, Zhou H, Cai A, Lacy E, Kay J, Keystone E, Matteson E, Hu C, Hsia E, Doyle M, Rahman M, Shealy D, Scott DL, Ibrahim F, Abozaid H, Choy E, Hassell A, Plant M, Richards S, Walker D, Simpson G, Kowalczyk A, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Nash PT, Ludivico CL, Delaet I, Qi K, Murthy B, Corbo M, Kaine JL, Emery P, Smolen JS, Samborski W, Berenbaum F, Davies O, Ambrugeat J, Bennett B, Burkhardt H, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Bykerk V, Ostor AJ, Roman Ivorra J, Wollenhaupt J, Stancati A, Bernasconi C, Sibilia J, Scott DGI, Claydon P, Ellis C, Buchan S, Pope J, Fleischmann R, Dougados M, Bingham CO, Massarotti EM, Wollenhaupt J, Duncan B, Coteur G, Weinblatt M, Hull D, Ball C, Abraham S, Ainsworth T, Kermik J, Woodham J, Haq I, Quesada-Masachs E, Carolina Diaz A, Avila G, Acosta I, Sans X, Alegre C, Marsal S, McWilliams D, Kiely PD, Young A, Walsh DA, Fleischmann R, Bolce R, Wang J, Ingham M, Dehoratius R, Decktor D, Rao V, Pavlov A, Klearman M, Musselman D, Giles J, Bathon J, Sattar N, Lee J, Baxter D, McLaren JS, Gordon MM, Thant KZ, Williams EL, Earl S, White P, Williams J, Westlake SL, Ledingham J, Jan AK, Bhatti AI, Stafford C, Carolan M, Ramakrishnan SA. Muscle disorders * 111. The impact of fatigue in patients with idiopathic inflammatory myopathy: a mixed method study. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Seiber C, Bawa S, Ritchie D, Mukherjee S, Ostridge K, Spinks K, Wong E, Edwards M, Ledingham J, Wijesooriya CS, Bharadwaj AN, Anilkumar A, Gendi NS, Evans SJ, Bevan M, Adams KR, Hunter R, Craddock L, Ali C, Ng N, Colaco R, Ali E, Colaco CB, Rao VK, Butler R, Matschke V, Jones JG, Lemmey AB, Maddison PJ, Thom JM, Haroon M, Eltahir A, Harney S, Moorthy A, Tripathi M, Hirsch G, Pace A, Yau WH, Cohen H, McCabe C, Mo N, O'Sullivan M, Williams E, Ledingham J, Gwynne C, Hale S, Negi A, Humphreys E, Nash J, Malipeddi AS, Neame R, Bharadwaj A, Gendi N, Abdulla A, Ginawi A, Malaviya AP, Dasgupta B, Das S, Tan AL, Miles S, Hordon L, Sivaramakrishhan N. Case Reports [3-24]: 3. An Unusal Case of Focal Myositis. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Travers B, Henderson S, Vasireddy S, SeQueira EJ, Cornell PJ, Richards S, Khan A, Hasan S, Withrington R, Leak A, Sandhu J, Joseph A, Packham JC, Lyle S, Martin JC, Goodfellow RM, Rhys-Dillon C, Morgan JT, Mogford S, Rowan-Phillips J, Moss D, Wilson H, McEntegart A, Morgan JT, Martin JC, Rhys Dillon C, Goodfellow R, Gould L, Bukhari M, Hassan S, Butt S, Deighton C, Gadsby K, Love V, Kara N, Gohery M, Keat A, Lewis A, Robinson R, Bastawrous S, Roychowdhury B, Roskell S, Douglas B, Keating H, Giles S, McPeake J, Molloy C, Chalam V, Mulherin D, Price T, Sheeran T, Benjamin SR, Thompson PW, Cornell P, Siddle HJ, Backhouse MR, Monkhouse RA, Harris NJ, Helliwell PS, Azzopardi L, Hudson S, Mallia C, Cassar K, Coleiro B, Cassar PJ, Aquilina D, Camilleri F, Serracino Inglott A, Azzopardi LM, Robinson S, Peta H, Margot L, David W, Mann C, Gooberman-Hill R, Jagannath D, Healey E, Goddard C, Pugh MT, Gilham L, Bawa S, Barlow JH, MacFarland L, Tindall L, Leddington Wright S, Tooby J, Ravindran J, Perkins P, McGregor L, Mabon E, Bawa S, Bond U, Swan J, O'Connor MB, Rathi J, Regan MJ, Phelan MJ, Doherty T, Martin K, Ruth C, Panthakalam S, Bondin D, Castelino M, Evin S, Gooden A, Peacock C, Teh LS, Ryan SJ, Bryant E, Carter A, Cox S, Moore AP, Jackson A, Kuisma R, Pattman J, Juarez M, Quilter A, Williamson L, Collins D, Price E, Chao Y, Mooney J, Watts R, Graham K, Birrell F, Reed M, Croyle S, Stell J, Vasireddy S, Storrs P, McLoughlin YM, Scott G, McKenna F, Papou A, Rahmeh FH, Richards SC, Westlake SL, Birrell F, Morgan L, Baqir W, Walsh NE, Ward L, Caine R, Williams M, Breslin A, Owen C, Ahmad Y, Morgan L, Blair A, Birrell F, Ramachandran Nair J, Zia A, Mewar D, Peffers GM, Larder R, Dockrell D, Wilson S, Cummings J, Bansal J, Barlow J. BHPR: Audit/Service Delivery [239-277]: 239. Arma-Based Audit of Rheumatology Service Delivered Predominantly Outside the Traditional Hospital Setting. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kanakala V, Bawa S, Gallagher P, Woodcock S, Attwood SE, Horgan LF, Seymour K. Outcome of patients in laparoscopic training courses compared to standard patients. Surgeon 2010; 8:132-5. [PMID: 20400021 DOI: 10.1016/j.surge.2009.10.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 10/28/2009] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIM Current Laparoscopic simulators have limited usefulness and patients have been used for training since the dawn of surgery. NUGITS (Northumbrian Upper Gastro Intestinal Team of Surgeons) Laparoscopic Skills courses utilise hands-on experience with simulators moving to live operating on volunteer patients. It is vital to know that the volunteer patient is not disadvantaged by greater surgical risk. METHODS This was a case-controlled prospective comparison of patients undergoing both Laparoscopic Cholecystectomy (LC) [n=51] and Laparoscopic Inguinal Hernia (LIH) [n=62] during NUGITS training courses. They are compared with a matched (age, sex and ASA grade) control group LC (n=51) and LIH (n=62) operated on by consultants. The outcome measures were surgical peri-and post-operative complications, post-operative hospital stay, readmission and early recurrence of inguinal hernia (<6 months). RESULTS In the LC cohort, there was no significant difference in the length of hospital stay (p=0.07) or readmission (p=0.16) in both the groups. The mean operating time was higher in the trainee compared to the control group (p=0.001). There was no difference in the post-operative morbidity or mortality in either group. In LIH cohort, the mean operating time was higher in the trainee compared with the control group. There was no significant difference in post-operative complications (p>0.05) and early post-operative recurrence of hernia (p>0.05). CONCLUSION The post-operative outcomes of patients undergoing laparoscopic surgery during laparoscopic training courses are similar to consultant-operated patients. Thus, it is acceptable and safe to encourage patients to volunteer for laparoscopic training courses.
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Affiliation(s)
- V Kanakala
- Department of General and Upper G I Surgery, North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields, Tyne & Wear, NE29 8NH, UK.
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Bawa S, McNally J. A pain in the foot and a serious complication. J R Soc Med 2007. [DOI: 10.1258/jrsm.100.6.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Xiao W, Fontanie T, Bawa S, Kohalmi L. REV3 is required for spontaneous but not methylation damage-induced mutagenesis of Saccharomyces cerevisiae cells lacking O6-methylguanine DNA methyltransferase. Mutat Res 1999; 431:155-65. [PMID: 10656494 DOI: 10.1016/s0027-5107(99)00203-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
O6-methylguanine (O6-MeG) DNA methyltransferase (MTase) removes the methyl group from a DNA lesion and directly restores DNA structure. It has been shown previously that bacterial and yeast cells lacking such MTase activity are not only sensitive to killing and mutagenesis by DNA methylating agents, but also exhibit an increased spontaneous mutation rate. In order to understand molecular mechanisms of endogenous DNA alkylation damage and its effects on mutagenesis, we determined the spontaneous mutational spectra of the SUP4-o gene in various Saccharomyces cerevisiae strains. To our surprise, the mgt1 mutant deficient in DNA repair MTase activity exhibited a significant increase in G:C-->C:G transversions instead of the expected G:C-->A:T transition. Its mutational distribution strongly resembles that of the rad52 mutant defective in DNA recombinational repair. The rad52 mutational spectrum has been shown to be dependent on a mutagenesis pathway mediated by REV3. We demonstrate here that the mgt1 mutational spectrum is also REV3-dependent and that the rev3 deletion offsets the increase of the spontaneous mutation rate seen in the mgt1 strains. These results indicate that the eukaryotic mutagenesis pathway is directly involved in cellular processing of endogenous DNA alkylation damage possibly by the translesion bypass of lesions at the cost of G:C-->C:G transversion mutations. However, the rev3 deletion does not affect methylation damage-induced killing and mutagenesis of the mgt1 mutant, suggesting that endogenous alkyl lesions may be different from O6-MeG.
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Affiliation(s)
- W Xiao
- Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Canada.
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Bawa S, Xiao W. Methionine reduces spontaneous and alkylation-induced mutagenesis in Saccharomyces cerevisiae cells deficient in O6-methylguanine-DNA methyltransferase. Mutat Res 1999; 430:99-107. [PMID: 10592321 DOI: 10.1016/s0027-5107(99)00163-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The exposure of DNA to reactive intracellular metabolites is thought to be a major cause of spontaneous mutagenesis. DNA alkylation is implicated in the above process by the fact that bacterial and yeast cells lacking DNA alkylation-specific repair genes exhibit elevated spontaneous mutation rates. The origin of the intracellular alkylating molecules is not clear; however, S-adenosylmethionine (SAM) has been proposed as one source because it has a reactive methyl group known to methylate proteins and DNA. We supplemented yeast cultures with excess methionine and examined the effects of increased endogenous SAM concentration on spontaneous and alkylation-induced mutagenesis in the absence of various DNA repair pathways. Our results show that either the excess methionine, or the increased SAM produced as a result of this treatment, is able to protect yeast cells from mutagenesis, and that this effect is alkylation-damage-specific. The protective effect was observed only in the mgt1 mutant deficient in the O(6)-methylguanine-DNA repair methyltransferase, but not in the wild type or other DNA repair-deficient strains, indicating that the protection is specific for O-methyl lesions. Thus, our results may lend support to the recently reported chemopreventive effect of SAM in rodents and further suggest that the observed tumor prevention by SAM may be, in part, due to its suppression of spontaneous mutagenesis in mammals. Given that a strong correlation has been established between O(6)-methylguanine and carcinogenicity, this study may offer a novel approach to preventing carcinogenesis.
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Affiliation(s)
- S Bawa
- Department of Microbiology and Immunology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada
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Bawa S, Xiao W. A mutation in the MSH5 gene results in alkylation tolerance. Cancer Res 1997; 57:2715-20. [PMID: 9205082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
DNA methylating agents such as N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) are potent carcinogens; their carcinogenic effect is mainly due to the effect of production of O6-methylguanine (O6 MeG) on DNA. O6 MeG is not only mutagenic but also toxic to the cell because Mer-/Mex- cells unable to remove O6 MeG are very sensitive to killing by MNNG. It has been proposed that repeated futile mismatch correction of O6 MeG-containing bp is responsible for the genotoxicity of the O6 MeG lesion and that loss of mismatch repair activity results in cellular tolerance to O6 MeG, but the hypothesis has not been proved. We used yeast as a model to test this hypothesis and found that chromosome deletion of any known nuclear mitotic mismatch repair genes, including MLH1, MSH2, MSH3, MSH6, and PMS1, did not rescue mgt1delta O6 MeG DNA repair methyltransferase-deficient cells from killing by MNNG. A large number of mgt1delta, MNNG-tolerant revertants were isolated, among which one cell line, XS-14, has been found to carry a mutated allele of the MSH5 gene. The mutation also affected spore survival but did not increase the spontaneous mutation rate. We further demonstrated that a mutated form of the MSH5 gene, msh5-14, not the msh5delta-null mutation, is responsible for the cellular tolerance to MNNG in XS-14 cells. This observation offers an alternative model that may reconcile seemingly contradictory observations of yeast and mammalian cells.
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Affiliation(s)
- S Bawa
- Department of Microbiology, University of Saskatchewan, Saskatoon, Canada
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Bawa S. Inheritance of endo-β-1,4-glucanase production in Trichoderma reesei. FEMS Microbiol Lett 1996. [DOI: 10.1016/s0378-1097(96)00407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Xiao W, Rathgeber L, Fontanie T, Bawa S. DNA mismatch repair mutants do not increase N-methyl-N'-nitro-N-nitrosoguanidine tolerance in O6-methylguanine DNA methyltransferase-deficient yeast cells. Carcinogenesis 1995; 16:1933-9. [PMID: 7634424 DOI: 10.1093/carcin/16.8.1933] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Treatment of cells with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) produces, among other lesions, mutagenic and carcinogenic lesions such as O6-methylguanine (O6MeG) and O4-methylthymine in DNA. An O6MeG DNA methyl-transferase (MTase) specifically and efficiently repairs such lesions. MTase-deficient bacterial, yeast and mammalian cells exhibit increased sensitivity not only to MNNG-induced mutagenesis, but also to MNNG-induced killing, suggesting that O6MeG-type lesions are also lethal to the cells. The lethal effect caused by O6MeG is not clear. Results from several recent experiments indicate that some MNNG-tolerant cell lines exhibit a loss of DNA mismatch binding/repair activity, suggesting that functional mismatch repair is probably responsible for the cellular sensitivity to DNA methylating agents. We tested this abortive O6MeG-T mismatch repair hypothesis in a well-defined lower eukaryote, Saccharomyces cerevisiae. We found that while mgt1-deleted MTase-deficient yeast strains are hypersensitive to MNNG-induced killing, combination of this mutation with any of the mlh1, msh2 or pms1 mutations did not render cells more tolerant to killing. msh3 mutation also did not rescue MNNG-induced genotoxicity. Furthermore, through the isolation and characterization of MNNG-tolerant cell lines from the MTase-deficient mutants we demonstrated that a DNA mismatch repair defect is neither sufficient nor required for this process. Since both DNA repair MTases and mismatch repair proteins are highly conserved between yeast and mammalian cells, our results could suggest alternative mechanisms in the cellular tolerance to O6MeG-induced killing.
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Affiliation(s)
- W Xiao
- Department of Microbiology, University of Saskatchewan, Saskatoon, Canada
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Bawa S, Scrutton MC. Relationship Between the Systems Responsible for Uptake of 5-hydroxytryptamine and of Noradrenaline by Human Blood Platelets. Platelets 1995; 6:190-4. [PMID: 21043727 DOI: 10.3109/09537109509078453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Human blood platelets carry a high affinity, but low capacity, saturable system for the uptake of noradrenalhe. The uptake is partially Na(+) dependent but cannot be categorised as uptake. It is distinct from the uptake system responsible for 5-hydroxytryptamine transport into the platelet since the selective inhibitors of the platelet uptake system for 5-hydroxytryptamine (citalopram, paroxetine) Wer from those for the uptake system for noradrenaline (normetanephrine, methylisoprenaline). 5-hydroxytryptamine inhibits noradrenaline uptake but with properties inconsistent with competition for the same uptake system while noradrenaline does not inhibit 5-hydroxytryptamine uptake. Neither noradrenaline nor 5-hydroxytryptamine uptake by human platelets is inhibited by dopamine.
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Affiliation(s)
- S Bawa
- Division of Life Sciences, King's College, Campden Hill Road, London, W8 7AH, UK
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Whitelaw DA, Meyer CJ, Bawa S, Jennings K. Post-discharge follow-up of stroke patients at Groote Schuur Hospital--a prospective study. S Afr Med J 1994; 84:11-3. [PMID: 8197482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A survey of 59 stroke patients was undertaken between 3 and 6 months after the event to determine whether a weekly stroke round would improve the rate of referral for rehabilitation. Comparison with a previous survey at Groote Schuur Hospital showed a marked improvement (40% for physiotherapy and 10% for occupational therapy v. 76% and 50% respectively). A comparison of referral rates between younger (< 65 years old) and older patients (> 65 years old) revealed a significantly higher rate of referral among the younger patients. Attendance for both groups was low (approx. 7 sessions per 3 months). Social work was an important requirement and 60% of all patients expressed a need for more help. Social needs of older and younger patients differ. Despite the improved referral rate the rehabilitation of stroke patients is unsatisfactory, mainly because of transport difficulties. Methods should be investigated to establish rehabilitation centres in the community to overcome this impasse.
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