COVID-19 Pandemic In Nigeria Research Articles

A cross-sectional study on the perceived risk of COVID-19 and its association with the usage patterns of e-cigarettes among adolescents and young adults during the COVID-19 pandemic in Nigeria

The study aimed to assess the perception of a higher risk of COVID-19 infection among young people who used e-cigarettes, and its association with a change in the use of e-cigarettes during the pandemic in Nigeria. A secondary analysis of the Nigerian component of a multi-country online survey data, which was obtained from adolescents and young adults on e-cigarette use from November 1st to December 30th, 2021, was conducted. Multi-nominal regression analyses were done to determine the associations between the dependent (use of e-cigarettes) and independent (perception that e-cigarette users are more likely to be infected with COVID-19) variables after adjusting for confounders (health status, COVID-19 status, HIV status, anxiety level, age and sex). Of the 568 respondents (52.8% male), 122 (21.5%) perceived that e-cigarette users were more likely to be infected with COVID-19. In addition, 188 (33.1%) respondents increased e-cigarette smoking during the pandemic. A greater percentage of participants who perceived that e-cigarette use is associated with a greater risk of COVID-19 infection, and a significantly higher percentage of participants with high levels of anxiety reported decreased e-cigarette use (28.6% versus 13.3%, p = 0.029). The perception that e-cigarette use increased the risk for COVID-19 was associated with higher odds of an increase in e-cigarette use (AOR: 1.328) and lower odds of a decrease in e-cigarette use (AOR: 0.580) during the COVID-19 pandemic, though these associations were not statistically significant. The persistence of e-cigarette use among the youth in Nigeria despite awareness of COVID-19 risks highlights the need for stronger public health interventions. Simply providing information on risks is insufficient; targeted strategies addressing addiction, social factors, and accessibility are crucial for meaningful behavioural change.

COVID-19 hand hygiene practices and its barriers among health care workers in a low-resource setting: a cross-sectional study in Nigeria

Abstract Background Poor hand hygiene (HH) among health care workers (HCWs) in low-resource healthcare settings has continued to increase the spread of infectious diseases, including COVID-19. The present study aimed to assess the knowledge, attitude, adherence, and barriers to HH practices among HCWs during the COVID-19 pandemic in Nigeria. Methods The study was an online cross-sectional survey using a tailored questionnaire distributed through chain referral sampling among southern Nigerian HCWs during the first wave of the COVID-19 pandemic (February to August 2020). The primary outcomes were knowledge, attitude, adherence to HH guidelines, and the barriers limiting compliance with the guidelines. Data were analysed using percentage, frequency, mean, standard deviation, one-way ANOVA, and multiple linear regression. The study timeline was from 15 April to 31 July 2020. Results Four hundred and fifty-four HCWs (236 males and 218 females) participated in the study. The participants had a moderate knowledge of standard HH protocol (mean ± SD) 62.45 ± 10.82%, positive attitude 84.34 ± 11.32%, and high adherence to the standard guidelines 81.21 ± 9.49%. There was no significant difference in knowledge, attitude, and adherence across the healthcare professions. Increasing age (β = 0.186, p < 0.003) and knowledge (β = 0.229, p < 0.001), and decreasing negligence (β = − 0.178, p = 0.004), and forgetfulness (β = − 0.159, p = 0.012) were the significant predictors of effective HH practices. Conclusion Nigerian HCWs had moderate knowledge, a positive attitude, and adhered to the standard HH practices during the COVID-19 pandemic. However, the major barriers were institutional-based factors such as the inadequate supply of HH items, competing job demands, emergencies, increased workload, and personal characteristics such as age, poor knowledge, negligence, and forgetfulness. We recommend that hospital management provide their staff with adequate HH materials and continued infectious disease training.

Monitoring the Reproduction Number and Stringency Index of Covid-19 Pandemic in Nigeria

In order to track the Covid-19 pandemic's reproduction number and stringency index in Nigeria, this research presents the implementation of control chart approaches. This will assist in monitoring these pertinent parameters and assist decision-makers in determining whether to impose stricter or less strict containment measures to stop the spread of the disease. The data for this study was sourced from the Our World In Data (OWID) website (https://www.owid.org). This database contains information about how the Covid-19 pandemic has spread globally. The data consists of the reproduction number and the stringency index of the pandemic from February 2020 to July 2022. The range chart was used to monitor the variability in these indices. The findings indicate that during the first 42 days of infection, the pandemic's reproduction number and stringency index are not within statistically significant ranges, and hence out of statistical control. This could explain the virus's quick spread as well as the nation's economy's suffering due to harsh government measures. The study concludes, therefore, that statistical quality control charts are a viable option for tracking a few key pandemic metrics. This would assist in educating interested parties about the necessity of taking the necessary actions to stop the spread of such a pandemic.

Alternative to health consultations or safe spaces? Pregnant women’s health information-seeking behaviour online during the COVID-19 pandemic in Nigeria

Alternative to health consultations or safe spaces? Pregnant women’s health information-seeking behaviour online during the COVID-19 pandemic in Nigeria

Disposition of health-care workers toward hospital patients during the COVID-19 pandemic in Nigeria

During the second wave of the COVID-19 pandemic, the World Health Organization declared health-care workers “the last line of defense against the COVID-19 pandemic.” Against this backdrop, this study investigated the state, responses, and attitudes of health-care workers toward hospital patients during the pandemic in Nigeria, alongside the attitudes of patients and the responsibilities of Nigerian social workers in ensuring adequate patient care. Employing a descriptive research design, the study sampled 17 respondents from Enugu State and utilized a qualitative research approach with an in-depth interview guide for data collection. The findings revealed that Nigerian healthcare workers exhibited a negative attitude toward hospital patients during the pandemic. Factors contributing to this negative attitude include fear of contracting the virus due to inadequate personal protective equipment, lack of incentives, insufficient hazard allowances, and inadequate hospital facilities. The death rate of patients with complications unrelated to COVID-19 was high because patients avoided hospital care even when critically ill due to fear of contracting the virus. Consequently, there was an increase in self-medication and reliance on alternative medicine among patients. Social workers played a significant role by advocating for improved hospital care and welfare for patients. They engaged in dialogue with hospital management to secure better attention and treatment for patients and advocated for adequate welfare provision for health-care workers. Social workers undertook educational initiatives to raise awareness among patients about the dangers of alternative medicine, self-medication, and the imperativeness of complying with the stipulated COVID-19 preventive protocol. In conclusion, this study recommends policy reforms aimed at enhancing budgetary allocations to the health-care sector and institutionalizing the social work profession in Nigeria through constitutional provisions.

Fortitude in the face of crisis: Unraveling the nexus of grit, motivation, and self-esteem among health workers in COVID-19 treatment and diagnostic centres in Nigeria

Objective: Few studies have been conducted to assess the psychological status of healthcare workers during the COVID-19 pandemic in Nigeria. This study aims to assess the grit, motivation, and self-esteem of health workers in the COVID-19 treatment centres and the relationship between grittiness, low self-esteem, and motivation. Method: A cross-sectional study was performed via an online survey on 113 consenting and consecutively enrolled health workers in 56 public and private COVID-19 management centres in Nigeria. The grit questionnaire instrument developed by Duckworth, Hellriegel and Slocum’s motivation instrument and Rosenberg-validated self-esteem scale was adopted. Results: The demographic characteristics showed their average age was 39.876 years (M = 39.876, SD = 9.0289), with a median age of 38 years (Mdn = 38). Nurses (27.19%), health attendants (16.67%), medical laboratory scientists (14.04), medical doctors (12.28%) and others participated in the study, Grittiness is positively and weakly correlated with self-esteem (r = 0.24675, p = 0.00842). There is a significant correlation between grittiness and motivation (p < 0.05). Also, there is no statistically significant correlation between motivation and self-esteem (p > 0.05). Motivation is negatively and weakly correlated with grittiness (r = -0.33316, p = 0.00031). Conclusion: The findings suggest that grittiness plays a significant role in influencing self-esteem. Additionally, gender was a significant predictor, indicating that males may have lower self-esteem compared to females. However, motivation did not show a significant association with self-esteem. Encouraging the development of grit and resilience among health workers may contribute to improved self-esteem and overall well-being.

Public trust and state management of the COVID-19 pandemic in Nigeria

The COVID-19 pandemic generated an unprecedented global crisis with long-lasting consequences. In this study, I examine the bi-directional nexus between public trust and the management of the pandemic in Nigeria. I argue that there is a relationship between government management of public policies and the level of public trust. The research draws on the Theory of Trust, in-depth interviews (IDI), and focus group discussions (FGD) and is supported by other secondary sources. I found that the main reason for citizens’ resistance to major policies introduced to contain the spread of the pandemic was due to an entrenched lack of trust in the government, its agencies, and officials. The findings also indicate that a lack of transparency and accountability in the management of the pandemic deepened the already fractured public trust. This was particularly visible in the shrouded pattern of disbursing cash transfers, allegations of corruption against the managers of the pandemic, and evidence of concealed palliatives meant to cushion the negative economic effects of the pandemic. The article recommends that the government needs to promote public trust by adopting an open governance approach that institutionalises transparency and accountability, fosters constant and consistent citizen engagement on government policies and programmes, strengthens critical agencies, and engenders a sense of belonging for all citizens.

A Review of the Coronavirus Epidemic in Nigeria

Nigeria has experienced serious difficulties as a result of the COVID-19 epidemic, which has affected the entire world. With a focus on public health response, socioeconomic effects, and epidemiology, this thorough review aims to offer an in-depth review of the COVID-19 pandemic in Nigeria. The epidemiological overview examines the COVID-19 pandemic's spread in Nigeria. This research aims to provide an in-depth review of Nigeria's techniques and efforts in fighting COVID-19, focusing on what contributes to Nigeria's low COVID-19 mortality toll compared to other nations. In summary, the review concludes with recommendations for future approaches to managing the COVID-19 pandemic in Nigeria, highlighting the significance of ongoing public health initiatives, fair vaccination programs, and international cooperation. It emphasizes how adaptive techniques are necessary to deal with changing issues and guarantee that the nation is ready for future health emergencies. This comprehensive review, in its entirety, provides insightful information about the COVID-19 pandemic in Nigeria, laying the groundwork for well-informed policy development, research projects, and decision-making targeted at halting the pandemic and preserving public health in the country.

Oil and Food Price Before and During COVID-19 Pandemic in Nigeria: A Non-Linear ARDL Approach

Abstract This paper analyzes the relationship between food and oil prices in Nigeria before and during the COVID-19 pandemic, using monthly data from January 2018 to December 2021. The ARDL and NARDL models are applied to estimate the symmetry and asymmetric relationship that exists in food price behavior. The NARDL confirms the presence of asymmetries, and the bound test affirms the co-integration and long-run relationship among the variables. In the long run, there is a significant positive relation between oil price increases and food prices, but the long-run impact of oil price reductions on food prices is not significant. In the short run, only increases in oil prices exert a significant influence on food prices, while decreases in oil prices do not. Furthermore, the COVID-19 period exerts a positive and significant impact on food prices, while COVID-19 cases do not influence food prices in Nigeria.

Nursing Students’ Perception and Attitude towards Online Learning during COVID-19 Pandemic in Nigeria

The COVID-19 pandemic affected nursing students dramatically when the clinical sites and the onsite classrooms closed to physical participation. The study is on nursing students’ perception, attitude and perceived benefits of online learning during the COVID-19 Pandemic. Methods: This is a descriptive cross-sectional online survey of nursing students. A multistage sampling technique was used for the study. Data were collected using Google Forms from 429 nursing students. Descriptive data of respondents were presented in tables, charts, percentages, means, and standard deviation, while the inferential data were tested with Chi-square at a significance level of P< 0.05. Results: Mean age is 23.15± 3.10 years, 396(92.3%) had positive perception and 396(92.3%) had a good attitude towards online learning. There is a relationship between the perception of online learning and attitudes toward online learning as all the variables showed a statistically significant relationship of p<0.001. Conclusion: Nursing students had a positive view of online learning in nursing education. To be successful, online learning must be reliable, accessible, and user‐friendly with tech support available 24 hours a day.

A Review of the Impact of Patent Medicine Vendors in Driving Community Tuberculosis Case Finding in the COVID-19 Pandemic in Nigeria

This review elucidates the pivotal role of patent medicine vendors (PMVs) in advancing community tuberculosis (TB) case finding in Nigeria, amidst the disruptions caused by the COVID-19 pandemic. By synthesizing insights from in-depth analyses, the article explores PMVs’ adaptability, knowledge, community trust, and contributions to TB case-finding efforts during this unprecedented period. The study reveals that PMVs, despite varying levels of knowledge on TB symptoms and diagnosis, have demonstrated significant resilience and adaptability, incorporating innovative approaches such as virtual consultations to sustain case finding during the pandemic. Their substantial involvement in health-care delivery, especially in underserved areas, and the evident community trust in their services, positions them as crucial health-care resources in regions with limited access to formal health-care services. However, the review also uncovers challenges, including the need for quality assurance and adherence to guidelines, and emphasizes the importance of tailored training programs to bridge knowledge gaps and empower PMVs to contribute more effectively to early TB detection. The study underscores the potential of PMVs to bridge gaps in health-care access and advocates for strengthened collaborations between PMVs and formal health-care systems to optimize their role in identifying and referring suspected TB cases effectively. In conclusion, the article highlights the transformative contribution of PMVs in TB case finding in Nigeria, during the COVID-19 pandemic and proposes recommendations to enhance their impact through capacity strengthening, integration into formal health-care systems, and leveraging innovative technologies. The findings suggest that harnessing the potential of PMVs can significantly contribute to controlling TB and improving public health outcomes, especially in anticipation of further outbreaks, by fostering a more community-centered approach to case finding.

The politics of COVID-19: analysis of government strategies and public perception in Nigeria

The study examined the politics of the management of the COVID-19 pandemic in Nigeria with a particular focus on government strategic responses and measures that curtailed the spread of the virus and the citizen's perception of the implementation of these strategies across the Nations. The federal government adopted measures to curtail the spread of the disease through the establishment of the Presidential Task Force on COVID-19 and the Multi-sectored Pandemic Response Plan. The measures include economic and social welfare interventions, and healthcare strategies such as the closure of schools, and borders, the use of face masks, social distancing, lockdowns, and restrictions of travel, testing and contact tracing. The study adopted the historical method of data collection to elicit information and relevant data for the study. It was found that the efforts of the government to slow down and mitigate the rapid spread of COVID-19 were greatly hindered by public negative reactions. The study observed from the findings that corruption and stiff opposition from the opposition Party against the ruling party posed severe challenges to the effective implementation of the strategies and measures put in place by the government at the Centre. On the strength of these findings, the author recommended that in future, national challenges must be viewed and tackled evenly across all the levels of government and parties not along party lines for the benefit of all. In addition, the federal must leverage public sensitization and effective communication strategy for policy achievement and management of public opinion.

Beyond the COVID-19 pandemic in Nigeria: Improving awareness and preparedness for managing Viral Haemorrhagic Fevers

Beyond the COVID-19 pandemic in Nigeria: Improving awareness and preparedness for managing Viral Haemorrhagic Fevers

Volatility Spill-Over and Financial Contagion Effect of Conventional Stock on Islamic Equity in Nigeria: Evidence from Covid-19

This study empirically investigated volatility spill-over and financial contagion effect between conventional stocks and shariah compliant equities before and during covid-19 pandemic in Nigeria. Banking and insurance sectoral stocks indices were selected to represent conventional equities while Nigerian stock exchange lotus islamic index represent islamic stocks. Daily closing stock price data from 02-01-2018 to 26-02-2020 for pre-covid and 27-02-2020 to 31-12-2021 for pre-covid and during covid were considered. DCC-GARCH model (Dynamic conditional correlation- Generalized Autoregressive Conditional Heteroskedasticity Model) was deployed to examine the spill-over effect while t-test was applied to check the consistency of the DCC coefficient before and during the pandemic. The result of the multivariate GARCH show that both banking and insurance stocks have long run volatility spillover effect on lotus islamic index, the result also revealed no significant increase in conditional correlation during covid-19 pandemic which indicate absence of financial contagion from the conventional to islamic stocks. The results provide important information to researchers, investors, and policymakers

Immunological insights into COVID-19 in Southern Nigeria.

One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic. We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.

Whole genome sequencing and phylogenetic analysis of SARS-CoV-2 strains isolated during the COVID-19 pandemic in Nigeria

ObjectivesThe emergence and spread of SARS-CoV-2 have stimulated ongoing research into the virus transmission dynamics, circulating variants, and potential mutations. This study was conducted to understand the genomic dynamics of the epidemic in Nigeria. DesignWhole genome sequencing was conducted on SARS-CoV-2 samples collected during the first and second outbreaks using the Oxford Nanopore MinION sequencing platform. Phylogenetic analysis was conducted, and genomes were grouped into different pangolin lineages. ResultsThe study revealed four circulating SARS-CoV-2 variants. The Alpha (B.1.1.7) variant was the most prevalent (32.7%), followed by Beta (B.1 B.1.1, L.3, and B.1.1.318) (30.8%), Eta (B.1.525) (28.9%), and Delta (B.1.617, AY.1, AY.109, and AY.36) (7.7%). Phylogenetic analysis revealed three clusters with four Nextstrain clades (20I, 20B, 21D, and 21J). The Alpha lineages (B.1.1.7) clustered with references from Italy. The Beta lineages (Clade 20B) (B.11, B.11318, and L3) and sub-lineage B.11 were distinct. Sub-lineage B.11318 is clustered with references from the USA, whereas sub-lineage L3 is clustered with references from Russia, the Philippines, Australia, and Japan. The 21D and 21J, belonging to two Pango lineages, Eta (B.1525) and Delta (B.1.617 and AY.109), showed high genetic similarity. ConclusionThe phylogenetic relatedness of the lineages suggests multiple virus introduction, which could be a source of more virulent, locally adapted variants.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

Care of Hearing Impaired and Physically Challenged People during Covid-19 Pandemic: Challenges and Prospects

This study examines the challenges encountered while providing care for physically challenged and hearing-impaired individuals during the COVID-19 pandemic in Nigeria. Taking into account the difficulties these individuals already face in their daily lives; the pandemic aggravated their situation. Due to their inability to see, talk, walk, and actively engage in social interactions, caring for them became especially challenging. The responsibility for their care was left to non-professionals, which worsened existing issues like caregiver shortages, a lack of learning materials, and inadequate medical attention. The pandemic added more problems, such as lockdowns, limited access to medical personnel, and a shift away from face-to-face learning methods. The Symbolic Interaction Theory was used in this research to analyze the communication of COVID-19 messages to hearing-impaired and physically challenged residents, as well as the interactions between caregivers and residents in care homes. The study followed a quantitative research design and obtained primary data from 114 hearing-impaired and physically challenged individuals across three senatorial districts in Lagos State, Nigeria. The study found that the pandemic had an unexpected and unprepared impact on individuals. It also revealed that pre-existing challenges were exacerbated by COVID-19. Participants in the study expressed a lack of essential resources, such as wheelchairs, electronic gadgets, and adequate training. Caregivers also faced difficulties in securing government and philanthropic support, with many contracting the virus and experiencing psychological and economic impacts. In conclusion, the research stresses the ongoing need for improved care for physically challenged and hearing-impaired individuals beyond the pandemic. It advocates for the inclusion of a curriculum on the care of these individuals in primary and secondary education to promote societal recognition and support for their unique needs

Corrigendum: Eschatological events in Matthew 24:1-15 and COVID-19 pandemic in Nigeria

No abstract available.

Nigeria Centre for Disease Control, awareness creation and risk communication of Covid-19 pandemic amongst non-literate population in South-West Nigeria: Lessons for future health campaign.

Risk communication of Covid-19 pandemic in Nigeria appeared to be urban-centered with the dominant use of social media, print communication and other controlled media. In such times of public health emergencies, non-literate population could be vulnerable as a result of their limited understanding of the nature of such health risk. Therefore, the study seeks to investigate the extent to which Nigeria Centre for Disease Control (NCDC) communicated the risk of Covid-19 disease to non-literate population in its public health campaign during the pandemic in South-West Nigeria. The study adopts risk communication theory which advances the approach communication should take during public health emergencies. Using descriptive cross-sectional mixed methods research design, a sample of 420 respondents were purposively selected from 6 towns in the rural areas of Lagos, Oyo and Osun states to examine the level of awareness on Covid-19 pandemic among non-literates. In addition, NCDC risk communication on Covid-19 for non-literate population were analyzed from 3 Jingles in Yoruba language as well as 9 flyers designed for Covid-19 disease from NCDC websites. Results showed that NCDC awareness creation on Covid-19 disease for non-literates in Southwest achieved significant success as a result of the medium used in creating awareness. Specifically, radio was highly rated among majority of the respondents (60.4%) followed by health workers (19.8%) as channels that created understandable message on Covid-19 safety protocols. Further findings on Jingles content revealed that all Covid-19 safety protocols were communicated in Yoruba language for Southwest populace. However, NCDC fall short in communicating Covid-19 risk effectively for non-literates in Southwest as jingles only buttressed the Covid-19 safety protocols and symptoms as well as the need to comply, without educating the masses on the dreadful nature of the disease and its dynamics. Though flyers designed by the NCDC communicated risk to an extent, nevertheless, graphics and symbols on Covid-19 disease were complimented by words in English language only, which could be difficult for non-literates to decipher. Based on the findings, the study recommends that public health agencies need to educate non-literate population about the nature of a disease more than creating awareness about the outbreak of a disease, and such education should be strategic, context-specific, and evidence-based.