ABSTRACT
Background and aims: The natural history of Hepatitis C Virus (HCV) demonstrates an asymptomatic disease that often leads to liver degeneration in approximately three decades. In HIV/HCV coinfection, liver degeneration is accelerated with decompensated cirrhosis occurring in less than two decades resulting in higher mortality rates. The asymptomatic nature of HCV, increased rate of disease progression in HIV, low awareness, and poor care seeking behaviour emphasizes the need to improve HCV case finding in People Living with HIV (PLHIV). In Nigeria, the Nasarawa State Government has committed to HCV elimination, with an initial focus on PLHIV, necessitating integration of services to screen ART patients for HCV. However, due to the COVID pandemic and the resultant scale-up of Differentiated Service Delivery (DSD) models within the HIV program, screening yield from facility-based case finding reduced significantly. To ensure last mile linkage to HCV screening, the Patient Navigator pilot was conducted from March-October 2021. This analysis aims to assess screening coverage before and during this pilot period. Method: One healthcare worker across three secondary facilities i.e., General Hospitals Keana, Awe, and Uke, labelled patient navigator (PN) was charged with the responsibility of identifying unscreened PLHIV using facility screening records and enrolment data. These PNs were HIV program defaulter trackers, consequently integrating this service within the HIV program. The PN employed strategic patient tracking approaches like phone calls, community engagements and peer group meetings. Using laboratory screening registers, screening progress was compared pre-intervention (July 2020 to February 2021) versus during the intervention (March to October 2021). Results: A total of 125, 560, and 923 were active on ART care as of January 2020 in General Hospitals Keana, Awe, and Uke respectively. Across sites, the first 4 months of the pre-intervention phase sawhigh screening numbers as all available patients presenting to facilities were screened. Subsequently, a decline in screening numbers across all facilities. However, the intervention phase demonstrated extended coverage, reaching the last mile patients leading to an increase in case finding by 18% in GH Keana, and 23% in GH Awe and GH Uke respectively. (Figure Presented) Conclusion: The use of patient navigators demonstrates the feasibility and cost-effectiveness of increasing case-finding through HCV/HIV program integration.
ABSTRACT
The conduct of elections in Nigeria is generally associated with manipulation, which has often undermined the credibility and fairness of the process since the country gained its independence. COVID-19 poses a very serious challenge to the electoral process, considering the nature of the disease, which has led to the promotion of limited physical interaction as an approach to mitigate its transmission and safeguard the health of the people while at the same time impacting negatively on state’s electoral justice. While elections remain a key factor to the attainment of political positions in a democratic setting globally, several scholars and media reports have made attempts to assess the political intrigues in the state of Edo as a result of the tense atmosphere created by political gladiators. The use of the pandemic and various forms of propaganda to destabilise the camp of perceived opponents with the aim of winning public support are notable strategies employed by the main contending political parties and their candidates as the election approaches. Therefore, this article evaluates the impediments and political manoeuvrings in the electoral process in the state of Edo, considering the increasing number of corona-virus infections, the country’s frail electoral system, and the desire to maintain credible democratic consolidation in the country. © 2021. Lifescience Global