First and Second Waves of Covid-19: A Comparative Study of the Clinical Presentation and Outcome among Hospitalized Patients in Lagos Nigeria

OBJECTIVE

Nigeria experienced many waves of the COVID-19 pandemic. This study compared the clinical presentations and mortality among hospitalized patients during the first and second waves of the pandemic in Lagos State, Nigeria.

METHODS

A retrospective cohort study was conducted. Deidentified medical records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos, Nigeria between February 27, 2020, and September 30, 2020 (first wave) and October 1, 2020, and April 30, 2021 (second wave) were reviewed. IBM Statistics version 25 was used for data analysis.

RESULTS

More patients were hospitalized during the first wave of the pandemic. The mean age of patients was higher during the second wave (54.5±15.8 years vs. 42.2±15.5 years, p <0.001). More patients admitted during the second wave had comorbidities (56.0% vs 28.6%, p <0.001), were symptomatic (90.8% vs 52.0%, p <0.001), had severe COVID-19 disease (58.9% vs 25%, p <0.001) and died (14.9% vs 6.4%, p<0.001) compared with the first wave. The odds of death increased with age and severity of COVID-19 disease during the first and second waves.

CONCLUSION

A higher proportion of the patients admitted in Lagos, Nigeria during the second wave were older, had comorbidities, and had severe COVID-19 disease than the first wave. Despite the fewer hospitalized patients, there were more deaths during the second wave.

Application of the UNAIDS Incidence Patterns Model to Determine the Distribution of New HIV Infection in Lagos State, Nigeria

BACKGROUND

Identifying patterns in the distribution of new HIV infections in the population is critical for HIV programmatic interventions. This study aimed to determine the distribution of New HIV infection by applying the incidence patterns mathematical model to data from Lagos state.

METHODS

The incidence patterns model (IPM) software is a mathematical model developed by UNAIDS to estimate the demographic and epidemic patterns of HIV infections. This model was adapted in Lagos state to predict the distribution of new HIV infections among specified risk groups in the next 12 months.

RESULTS

The IPM predicted a total HIV incidence of 37 cases per 100 000 individuals (3979 new infections) will occur among the 15 to 49 subpopulations. The results also showed that sero-concordant HIV-negative couples with external partners (29%), female sex workers (26%), men-having-sex-with-men (18%), and previously married females (6%) accounted for the majority of the estimated new HIV infections. Overall, key populations constitute almost half (48%) of the estimated number of new HIV infections.

CONCLUSION

The study helped to identify the population groups contributing significantly to new HIV infections. Therefore, priority interventions should be focused on these groups.

Challenges of Tuberculosis Control in Lagos State, Nigeria: A Qualitative Study of Health-Care Providers' Perspectives

Background:

Tuberculosis (TB) burden in Nigeria is a reflection of the challenges of TB control strategy in the country. This study explored the challenges encountered by the health workers in public and private TB treatment centers in Lagos, Nigeria.

Methods:

In-depth interviews were held with 34 health workers providing TB services in private and public health facilities and the Lagos state Program Officer between October 1, 2016 and January 31, 2017. The transcripts were read severally and coded for qualitative data analysis. Themes were developed from coding.

Results:

Insufficient or lack of funds to track patients lost to follow-up, conduct home visits, collect drugs from the central stores, and shortage of laboratory reagents were some of the logistical challenges encountered by the health workers. There was shortage of health workers and some were yet to be trained resulting in work overload. This was situation aggravated by the frequent redeployment and health worker attrition in the public and private sector respectively.

Conclusion:

The government need be proactive and show leadership by finding lasting solutions to the logistical and human resource challenges facing the LAgos State TB and Leprosy Program.

Trend of tuberculosis case notification and treatment outcome in Lagos State, Nigeria: a 5-year retrospective study

Background

This study assessed trends of tuberculosis (TB) case notification rate (CNR) and treatment outcomes between 2011 and 2015 in Lagos State, Nigeria.

Methods

A retrospective review of TB notification data to the Lagos State Tuberculosis and Leprosy Control Programme (LSTBLCP) between 1 January 2011 and 31 December 2015 was conducted.

Results

A total of 44 516 TB cases were notified during the study period, representing 9.4% of the national figure. The male:female ratio was 1.3:1. About 53%, 44.1% and 2.7% of patients were smear positive, smear negative and extrapulmonary TB cases, respectively. TB notification increased by 12.2% between 2011 and 2013 and subsequently declined by 7.2% in 2015 relative to 2013. The TB CNR declined from 82.9 per 100 000 in 2013 to 72.1 per 100 000 in 2015. However, directly observed treatment short course (DOTS) and microscopy site expansion increased from 0.3 to 0.64 per 25 000 population and from 0.16 to 0.4 per 50 000 population, respectively, from 2011 to 2015. Similarly, there was a slight increase in treatment success rate, from 80.1% in 2011 to 82% in 2015.

Conclusion

The CNR declined in Lagos State despite an increasing trend in DOTS and microscopy site expansions between 2013 and 2015. The LSTBLCPs need to re-engineer current strategies of active TB case findings in order to improve case notification in the state.