Center In Nigeria Research Articles

The scope of hysteroscopy in the diagnosis and management of intrauterine conditions at a public fertility center in north-central Nigeria: A retrospective study

The scope of hysteroscopy in the diagnosis and management of intrauterine conditions at a public fertility center in north-central Nigeria: A retrospective study

Mortality review in a maxillofacial center in Northern Nigeria

Context: Mortality pattern is an essential component in health delivery globally. It is an important medical appraisal that should be made regularly. Mortality in maxillofacial patients often results from co-morbidity from others diseases as seen in Ludwig's angina and advanced stage malignancies. Aim: To document the causes of maxillofacial mortalities during a 12-year period. Materials and Methods: An analysis of all cases of death recorded in the Department of Oral and Maxillofacial Surgery of a Nigerian tertiary health Centre from January 2006 to December 2018. Results: A total of 3255 oral and maxillofacial patients were seen during 12-year period. About 65 deaths were recorded accounting for 2.0% of all cases of which 69.2% were males, whereas 30.8% females. The age group most affected was 30 to 39 with 23.1% closely followed by 20 to 29 with 21.5%. Conclusion: Cervicofacial infection was the commonest causes of mortality in oral and maxillofacial surgery in our environment.

Paediatric cataracts in a tertiary eye centre in South-South Nigeria: An initial audit of surgical outcome

Background: Paediatric cataracts is a leading cause of treatable blindness and a major cause of blindness in developing nations. Aim: To present an audit of paediatric cataract and paediatric cataract surgery in a Tertiary Eye Care facility in the South-South Geopolitical Zone of Nigeria during the Seeing is Believing Project intervention. Materials and Methods: A retrospective study of case notes of children who received surgical and adjunctive treatment for cataracts in the Calabar Children's Eye Centre during the 24-month study period from November 1, 2017, to October 31, 2019, was undertaken. Results: Of the 128 children who met the inclusion criteria, 73 (57.0%) were males and 55 (43.0%) were females, giving a male: female ratio of 1.3:1.0. The mean age of patients in years was 5.9 ± 4.1 years, median/interquartile range was 5.0/5. The most frequent diagnosis was bilateral cataracts affecting 80 (62.5%) children. Systemic comorbidities were found in 13/128 (10.2%), of which 7/13 (53.8%) were congenital rubella syndrome. Ocular comorbidities (40.6%) were more common than systemic comorbidities, and sensory esotropia presented most frequently (16.4%). More patients with congenital cataracts had ocular comorbidities, and this association was statistically significant, P < 0.001. The proportion of patients with good visual outcomes was highest among those with bilateral cataracts (64.8%), and ocular comorbidities were a significant negative predictor of best corrected postoperative visual acuity. A total of 94/128 (73.4%) patients received intraocular lens implants, and the most common postoperative complications were visual axis opacification (VAO) 37/69 (53.6%) and fibrinous uveitis 26/69 (37.7). Conclusion: Paediatric cataracts were often bilateral and congenital. Postoperative complications like VAO are common and can be detected early and treated to improve visual outcomes with good follow-up strategies.

The role of ICT during COVID-19 pandemic in Nigeria

ICT has played a significant role through social media platforms and other information media in providing accurate information and curbing the coronavirus disease 2019 (COVID-19) across Nigeria. The response to COVID-19 has reduced face-to-face contact and as a result communication via social media has increased. This study draws on information gathered during the process of mapping and discussion to present analysis and make recommendations about priority issues related to the use of ICTs in curbing the menace of Covid-19. ICT tools are used to facilitate communication, processing, and transmission of information and sharing of knowledge by electronic means among healthcare providers either through telephones, computers, electronic-based media such as digital text and audio-video recording, or the Internet. This paper aims to highlight the significance of ICT tools used during and after the pandemic. Therefore, the government should take necessary initiatives to deploy and technological development of ICT infrastructures or digital interventions followed by financial support and other basic amenities to combat the pandemic spread of COVID-19. This concludes that the importance of ICT tools during the pandemic cannot be overemphasize with a way out to information dissemination on updated cases regarding COVID-19 provided by Nigeria Centre for Diseases and Control (NCDC).

Implementing Antimicrobial Stewardship Program in Pediatrics Across Six Hospitals in Six States in Nigeria: Needs Assessment

Antimicrobial resistance (AMR) is the ability of microorganisms to withstand treatment with antimicrobial agents. Antimicrobial use in children tends to be higher than in adults, especially in developing countries such as Nigeria. In 2017, the percentage of antibiotics prescribed per patient encounter ranged from 26.8% to 71.1 with the highest proportion reported among children under five years of age, underscoring the need for AMS in pediatrics in Nigeria. A review of the literature on AMS in pediatrics across Nigeria show scanty studies. In view of this, the Centre for Initiative and Development (CFID) in collaboration with Nigeria Centre for Disease Control (NCDC) through a grant from Pfizer conducted needs assessment in six healthcare facilities in six States of Nigeria. This was a hospital based cross sectional study conducted using well-structured questionnaire. The structured tools were administered to key hospital management in pediatrics department and data was analyzed using simple percentages. The study recorded low pediatrics AMS structures across all the six hospitals in six states. Results show that all the six hospitals do not produce antibiogram, Five hospitals 5(83.3%) do not have formal organizational structure for antimicrobial stewardship in pediatrics, most hospitals do not have formulary. Results also show that most hospitals do not have specific clinical guidelines for management of common infectious diseases in pediatrics. This reflects that pediatrics AMS practice is still in its infancy across hospitals in Nigeria. Findings from this study identifies useful drivers that will help to effectively implement pediatrics AMS in Nigeria. This study therefore, calls for urgent need of implementing antimicrobial stewardship in pediatrics across Nigeria which will be instrumental in spurring behavioral change towards rational dispensing and use of antibiotics in pediatrics and ultimately contribute towards reducing the risk of antimicrobial resistance development and spread of resistant bugs, improve pediatrics patient health outcomes and preserve the effectiveness of antibiotic therapy in pediatrics age groups.

Assessment of the utility of a screening tool for COVID-19 diagnosis in an accident and emergency department in Lagos, Nigeria: A pilot study

We retrospectively reviewed the data of 113 non-surgical patients presenting to the Accident and Emergency Department (A and E) of Lagos University Teaching Hospital, Lagos, Nigeria. Patients were stratified based on screening scores into low (0-2), moderate (3-5) and high (6) pre-test categories. Patients with low and high scores ≥6 were admitted to the A and E and the COVID-19 holding ward, respectively, while the moderate group had chest computed tomography scans to aid further decision-making, pending the outcome of their RT-PCR results. The validity of the triage score as compared to the RT-PCR test result was calculated and the kappa score of agreement was utilised to evaluate the concordance between two triage scores. The optimum cut-off score was also obtained based on the maximal Younden's index. The frequencies of low, moderate and high pre-test scores were 34 (30%), 43 (38.1%) and 36 (31.9%), respectively. Overall, 38.1% (43/113) were RT-PCR positive. RT-PCR was positive in 26.5% (9/34) with low screening scores, 55.8% (24/43) with moderate scores and 27.8% (10/36) with high scores. The sensitivity and specificity of a high score of 6 were 25% and 92.86%, while the lower score of 3 had sensitivity and specificity of 62.5% and 58.6%, respectively. The screening tool showed a high specificity in its initial design, which suggests that anyone with a low score using this tool has a high probability of testing negative. We recommend a cut-off score of 4 (score A) or 6 (score B) of the current screening tool be used to increase the chances of identifying persons with COVID-19 for RT-PCR testing.

Yellow fever outbreak in Ebonyi State, Nigeria, May-August 2019

An outbreak of yellow fever (YF) occurred in Ebonyi State, Nigeria in the year 2019 and a Rapid Response Team (RRT) from the Nigeria Centre for Disease Control, Abuja was deployed to investigate and characterize the outbreak and institute control measures. All suspected cases were identified, line-listed and analyzed. Between May and August 2019, 78 suspected YF cases were identified from 5 LGAs in Ebonyi State. Of these, 17 (21.8%) confirmed YF cases [including 4 deaths (case fatality rate (CFR): 23.5%)] were reported in 4 LGAs, with majority 13 (76.5%) from Izzi LGA. Age groups mostly affected were 0-9 years 5(29.4%) and 20-29 years 5(29.4%) with mean age 19 ±12 years. Majority were males 10 (58.8%). Overall, 50 eligible children participated in the YF VCS, 36(72.0%) had their vaccination cards available and only 24 (48.0%) of the cards had a record of YF vaccination. Aedes larva was found in 9(90.0%) of 10 households surveyed and adult species Aedes simpsoni complex emerged from the collections. The 2019 YF outbreak in Ebonyi state was as a result of an abundance of Aedes mosquitoes and low vaccination coverage. We recommend a Statewide YF risk assessment, mass YF vaccination campaign, vector control and enhanced YF surveillance is important to prevent future outbreaks and mortality.

Lessons from Nigeria's Adaptation of Global Health Initiatives during the COVID-19 Pandemic.

Nigeria receives funds from several global health initiatives that are aimed at addressing elevated risks and overall burden of infectious disease outbreaks. These funds include the Global Fund to Fight AIDS, Tuberculosis and Malaria; US President's Emergency Plan for AIDS Relief; US President's Malaria Initiative; and Global Polio Eradication Initiative. These initiatives have contributed to a substantial reduction in illness and death from HIV, tuberculosis, malaria, and polio. However, Nigeria has experienced mixed success with leveraging the capacities built through these donor-funded vertical programs to respond to new health threats. This report describes experiences using resources from vertical disease programs by the Nigeria Centre for Disease Control in response to the 2014-2016 Ebola outbreak in West Africa and the COVID-19 pandemic. Integrating resources from different disease programs with government-led systems and institutions will improve responses to endemic outbreaks and preparedness for future pandemics in Nigeria.

Epidemiology of brain tumors among adolescents and young adults in Nigeria

Adolescents and Young Adults (AYA), have distinct endocrine and psychosocial peculiarities. Brain tumors occur less among AYAs, compared to other age groups and with better prognosis. There is however a paucity of literature about brain tumors in AYA in sub-Saharan Africa. We aim to describe the clinical characteristics of brain tumors in AYA across five neurosurgical centers in Nigeria and the associated factors. We report results for older children (10–14 years), adolescents (15–19 years) and young adults (20–24 years). This was a retrospective review of AYA with brain tumors over a 10-year period (2010–2019). Data analysis was by descriptive statistics, Chi square test and multinomial regression at α0.05. There were 104 AYAand the male to female ratio was 1.2:1. Headache (79.8%) and visual symptoms (65.4%) were the most common presenting symptoms. Focal limb weakness (44.1%) occurred less frequently. Median duration of symptoms prior to presentation was 9 months. Glioma was the most common tumor (31, 29.8%) while pituitary adenoma and craniopharyngioma constituted 30.8% of the tumors. Patients with symptom duration of ≤one year were more likely to have infratentorial tumors. There was no significant association between the KPS following intervention and the AYA characteristics. Age group was not significantly associated with any of the presenting symptoms except ataxia, which was significantly higher among the 10 to 14 years group.We have described the epidemiology of brain tumors within AYA in Nigeria and highlighted a need to maximize their care and meet their special needs.

The Role of Weather in the Spread of Lassa Fever in Parts of Northern Nigeria

This study employed multiple regression analysis to evaluate the impact of weather variables (relative humidity, rainfall amount and maximum temperature) on the reported number of Lassa fever cases and to assess the strength of relationship between same for thirteen states in northern Nigeria (Adamawa, Bauchi, Jigawa, Borno, Kaduna, Katsina, Kano, Kebbi, Sokoto, Taraba, Yobe, Zamfara and Gombe states) over a five-year period (2016-2020). Secondary data on Lassa fever disease and weather variables were described on a weekly basis from the data base of the Nigeria Centre for disease control (NCDC) as well as weather variables from the National Aeronautics Space Administration, U.S.A. (NASA). The study seeks to establish the role of weather in the occurrence of Lassa fever in parts of Northern Nigeria and also to evaluate the impact of these weather variables on the occurrence of the disease. The study reveals that these weather variables accounted for 70% (r2=0.70) of the cases of Lassa fever reported in Northern Nigeria. It occurred all year round but cases peaked during the dry months, from December to March where relative humidity is low and rainfall amount small. At confidence level of 0.05, there was a significant (p=0.000) strong positive correlation of r=0.83 between Lassa fever cases and weather variables. Of the three weather parameters, maximum temperature had a weak positive and insignificant (p=0.3) relationship with Lassa fever while relative humidity and rainfall had strong and moderate negative relationships of r = -0.7 and r = -0.5 respectively which were both significant at (r2=0.000). In conclusion, there is need to cultivate sufficient preparedness strategies in order to cope with the burden to ensure general wellbeing of people resident in these affected areas using these weather parameters.

A Time Series Model on the Occurrence of COVID-19 Pandemic in Nigeria

Coronaviruses belong to a large family of viruses which affect the hepatic, gastrointestinal, neurological and respiratory systems. The increase in the daily number of COVID-19 confirmed and deaths cases from different countries of the world has brought social, economic and political activities to a standstill, affecting individuals, government, public and private sectors. In this study, autoregressive integrated moving average (ARIMA) time series model for modeling and forecasting daily confirmed, recovered, and deaths cases of COVID-19 in Nigeria was used with data on daily cases of confirmed, recovered and deaths due to COVID-19 in Nigeria from 27/02/2020-31/07/2020 obtained from Nigeria Centre for Disease Control (NCDC) website. The data from 27/02/2020-16/07/2020 were used for model building while 15 observations from 17/07/2020-31/07/2020 were used for training and forecast evaluations. Time plots and Dickey-Fuller Generalized Least Squares unit root test were used to investigate the stationarity properties of the data. Schwarz Information Criterion (SIC) in conjunction with log likelihood were used to search for optimal ARIMA models while Mean Absolute Percentage Error (MAPE) was used for forecast evaluation. Results showed that all the study variables were differenced stationary and hence integrated of order one, I (1). ARIMA (2,1,4), ARIMA (2,1,2) and ARIMA (2,1,3) models were selected as the best candidates for modeling and forecasting the confirmed, recovered and deaths cases of COVID-19 in Nigeria respectively. The study found an approximate COVID-19 life cycle of 12 days among the infected population. The 15 days’ forecasts from ARIMA (2,1,4) and ARIMA (2,1,2) models showed increases in the daily number of confirmed and recovered cases of COVID-19 in Nigeria. The forecasts from ARIMA (2,1,3) model however showed fluctuating trend with decline in the number of deaths cases due to the disease. The result of the study further showed that improving on the present approach to treatment will further decrease the number of casualties due to COVID-19 in Nigeria.

Building a University Partnership to Support Early Grade Reading in Nigeria

While most international educational development projects are engaged in capacity development, trainings rarely have enough depth to result in lasting changes in the capacity of local stakeholders. The case of the Nigeria Centre for Reading, Research and Development (NCRRD) at Bayero University Kano used a different model. Six NCRRD faculty spent six months at Florida State University (FSU) attending courses on literacy and elementary education, attending grant writing trainings and reading seminars, observing literacy instruction in schools, and participating in conferences. After returning to Nigeria, the fellows were mentored by FSU faculty through the stages of a research project; all fellows subsequently submitted articles to international journals. FSU supported the administrative structures of NCRRD, assisting in the development of financial and compliance infrastructure. The outcomes of the partnership included 1) the establishment of the NCRRD as a center for excellence in reading in West Africa, 2) the publication of contextually relevant literature to inform policymakers and practitioners, and 3) the establishment of graduate programs in reading. This paper discusses the challenges faced by the institutions during the establishment of the NCRRD and makes recommendations for institutions interested in developing long-term international partnerships.

“Miracle Examination Centres” as hubs for malpractices in Senior Secondary School Certificate Examination in Nigeria: A systematic review

Certificates obtained after taking Senior Secondary School Certificate Examinations (SSCE) are priority documents that qualify students to be admitted into tertiary level education and are also a minimum requirement to contest in some political elections in Nigeria. ‘Miracle’ Examination Centres (MECs) are rogue/corrupt business outfits that position as regular schools/examination centres, but in reality deploy deviant means to secure unmerited SSCE results/certificates, and hence undermine academic integrity and country-wide development. In these rogue centres, candidates can acquire unmerited desirable grades across subjects taken in SSCE, hence the ‘miracle’ commonly ascribed to such centres in Nigeria. This paper deploys a systematic review of Nigeria-focused exam malpractice literature to explore the drivers that facilitate the establishment and spread of MECs as well as interventions that can be used to eliminate them. Identified documents that met inclusion criteria (94: 48 non-traditional academic and 46 traditional academic publications) were retrieved and reviewed. Proximate drivers of MECs involve the actions and inactions of certain actors that are within immediate reach of influence and at grassroots, such as parents, community-based groups, and schools (school owners, principals, teachers, students, etc.). Remote drivers are the actions and inactions of the examination bodies and regulatory institutions that allow MECs to thrive. We consider the remote drivers to be away from immediate reach of influence as shown in our conceptual framework. Therefore, addressing the challenge of MECs by focusing on proximate drivers, appears to be feasible within the short and mid-terms, unlike the remote drivers.

Clinical and laboratory profile of systemic lupus erythematosus patients at a rural tertiary centre in South-South Nigeria: experience from a new rheumatology clinic.

ObjectivesSystemic lupus erythematosus (SLE) is an autoimmune disorder with a poorly understood aetiology. It predominantly affects females and has a variety of clinical manifestations. In Nigeria, there are limited data on the prevalence and burden of the disease. This study aimed to determine the clinical and laboratory profiles of SLE patients seen in a new rheumatology clinic in South-South Nigeria.Material and methodsThis was a retrospective cross-sectional study conducted over five years (January 2016 to December 2020). The case files of patients that satisfied the diagnosis of SLE were reviewed. The diagnosis was based on the 1997 update of the American College of Rheumatology revised criteria for the classification of SLE. The sociodemographic, clinical, and immunological data were extracted from case records. Data analysis was carried out using IBM SPSS statistics® 2012 version 21.0.ResultsFifty-two patients were diagnosed with SLE, giving a frequency of 4.7%. Forty-seven (90.4%) of the study participants were females, with a female-to-male ratio of 9.4 : 1. The mean age of the study group was 28.42 years. The mean duration of disease before diagnosis was 4.04 months with a range of 1–15 months. The patients had various organ system manifestations, with polyarthritis being the commonest (86.5%). Others included mucocutaneous (78.8%), haematological (69.2%), serositis (40.4%), renal (38.5%), and neurological (25%) manifestations. Antinuclear antibody (ANA) assay and anti-double-stranded DNA were positive in 100% and 69.2% of patients, respectively. All patients were placed on steroids, and 96.2% had hydroxychloroquine. None of the patients were on biologic disease-modifying antirheumatic drugs.ConclusionsThis study’s results are consistent with data from other African countries. To fully understand the burden and epidemiology of SLE in Nigeria, a larger prospective study is needed.

Thematic Mapping of COVID-19 Spread in Nigeria: A Tool for Pandemic Rapid Containment Measures

Abstract. Since the end of 2019, pneumonia, later named 2019 novel corona virus disease (COVID-19), originated in Wuhan and rapidly spread throughout the globe including Nigeria. This study explored the techniques of Thematic mapping in assessing the spread of COVID-19 across the thirty-six states in Nigeria with the main objective of showing how thematic maps can be employed in explaining pandemic situations for easy interpretation and quick decisionmaking. The study relies on publicly available data on confirmed cases and death across Nigeria from the website of Nigeria Centre for Diseases Control (NCDC). Geo-visualization analysis technique was adopted for this study with results presented in form of maps. Results show that Lagos (34.7%, 18.8%) Kaduna (6.0%, 4.0%) Plateau (5.5%, 3.4%) Oyo (4.5%, 3.9%) Rivers (3.9%,4.9%) states and the Federal Capital Territory (FCT), Abuja (13.4%, 7.9%) are hardly hit by COVID-19 in terms of the total number of both confirmed cases (90,147) and deaths (1,311) cases respectively as at Sunday 3th of January, 2021. The use of thematic maps for easy explanations, effective planning, preparedness and response to pandemic phenomena was equally established by this study. Since the virus spreads easily through human to human contact, it is recommended that restrictions of movements should be the priority of every concern stakeholder.

Impact of pre-exposure and post-exposure prophylaxes prevention programme on HIV burden and services in a low-resource setting: a simulation modelling approach.

Introductionsub-Saharan African countries contribute substantially to the global HIV disease burden. Despite this burden, and the promises that prevention could deliver, the implementation and uptake of HIV prevention programmes are still low. The study used the decision support system model to explore the potential impacts of prevention implementation on HIV burden (incidence) and service delivery.Methodsan operational research technique known as discrete event simulation model was used to capture an individual patient´s pathways through the HIV care process from diagnosis to treatment and monitoring. The regular monitoring, over a 5-year period, including all the activities and resources utilized at each stage of the pathway were analysed, and the impact of increasing prevention measures for an HIV treatment service in a treatment centre in Nigeria was tested using the simulation model.Resultsforty-three patients currently access the Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) annually, with a 20% and 80% split in the number of patients offered PrEP and PEP, respectively. Scenarios-based on increasing the number of people offered PrEP and PEP from 43 to 250 with a 50/50 split were tested. The outputs revealed improved preventive care by averting new HIV cases, reduction in service demand and utilization, but an increase in the required human resource as well as financial burden. In the next 5 years, the cumulative averted HIV cases are expected to increase from 2 and 5 people (baseline) to 24 and 20 people for PrEP and PEP, respectively. The potentially averted 2 cases per infected persons based on the basic reproductive number of HIV.Conclusionthe effective implementation of PrEP/PEP programme offers an additional safety measure to prevent HIV transmission in at-risk individuals and possibility of ending HIV epidemic.

Presentation and Management of Atypical Orofacial Clefts: A Single-Institution Experience for 13 Year Period.

This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients. A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases. The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria. Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study. The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.

Assessment of service readiness for maternity care in primary health centres in rural Nigeria: implications for service improvement.

Introductionseveral scientific reports from studies across Nigeria revealed a higher incidence of maternal mortality in rural parts of the country as compared to the urban areas. Part of the reasons is the paucity of health care infrastructure and personnel. This study was designed as part of an intervention program with the goal to improve the access of pregnant women to skilled pregnancy care in rural Nigeria. The specific objective of the study was to determine the nature and readiness of Primary Health Centres (PHCs) in two Local Government Areas (LGAs) in rural parts of Edo State, Southern Nigeria to deliver effective maternal and child health services.Methodsthe study was conducted in 12 randomly selected PHCs in the two LGAs. Data were obtained with a semi-structured questionnaire administered on health workers and through direct observation and verification of the facilities in the PHCs. The results obtained were compared with the national standards established for PHCs in Nigeria by the National Primary Health Care Development Agency (NPHCDA). Descriptive statistics were used to analyze the data.Resultsthe results showed severe deficits in buildings and premises, rooms, medical equipment, essential drugs, and personnel. Only 40% of items recommended by the NPHCDA were available for buildings; 41% of the PHCs had facilities available in the labour ward; while less than 30% had the recommended facilities in the antenatal care rooms. Only one PHC had a laboratory space, with only one item (a dipstick for urine analysis) identified in the laboratory. None of the PHCs had ambulances, mobile phones, internet or computers. There was no nurse/midwife in 4 PHCs; only one nurse/midwife each were available in 8 PHCs; while there was no Environmental/Medical Records Officer in any PHC. About 26% of the essential drugs were not available in the PHCs.Conclusionwe conclude that PHCs in Edo State, Nigeria have severe deficits in infrastructural facilities, equipment, essential drugs and personnel for the delivery of maternal and child health care. Efforts to improve these facilities will help increase the quality of delivery of maternal and child health, and therefore reduce maternal and child mortality in the country.

Experience with Mechanical Ventilation of COVID-19 Patients at a Treatment Center in Nigeria

Despite the global burden of coronavirus disease 2019 (COVID-19), the experience of intubation and mechanical ventilation among severely ill COVID-19 varies worldwide. This study shares our experience on mechanically ventilated COVID-19 patients admitted into the intensive care unit of an isolation and treatment center of Federal Medical Center Katsina, North-western Nigeria. The clinical data obtained from a review of patient's medical record and folder include clinical presentation, radiological and laboratory findings, treatment and outcome. All the patients were males with ages ranging from 47 to 89 years. All the patients had severe disease with fever and difficulty with breathing being the most common presenting symptoms. All the patients were mechanically ventilated for a period spanning 1–5 days. There was a 75% case-fatality rate. This study showed that a few critically ill patients with COVID-19 in developing countries such as Nigeria may benefit from mechanical ventilation. The most common indication for mechanical ventilation among COVID-19 patients during the period of the survey was acute respiratory distress syndrome. Comorbidities are associated with a high mortality rate.

Contributing to a Healthier Nigeria through Public Health Workforce Capacity Development: Afenet Experience in Nigeria

The recent upsurge in the number and magnitude of outbreaks of infectious diseases in Nigeria has been managed effectively and efficiently by the Nigeria Centre for Disease Control (NCDC) in an increasingly epidemiology guided approach led by a skilled workforce within the one health collaborative agenda.1–4 The increasing number of the outbreaks of re-emerging infectious diseases could not have been unconnected to the effect of global warming with its resultant effect in the changing population activities and interaction with nature.5–7 Nigeria could not have effectively contained these emerging public health challenges had she not taken steps in developing her public health infrastructure, the laboratory capabilities and manpower development. Since 2008, the Nigeria Field Epidemiology Laboratory Training Program (NFELTP), a collaborative effort by NCDC, Federal Ministry of Health, Federal Ministry of Agriculture and Rural Development, African Field Epidemiology Network (AFENET) with financial and technical support from the US Centers for Disease Control and Prevention (CDC) has been building epidemiology capacity for disease prevention and control. Field epidemiology, the art and practice of epidemiology in the field, has been adopted as an effective tool and practice in preventing, detecting and controlling emerging public health threats and crisis. Field epidemiology provides the scientific evidence for public health actions.