Associations between Interleukin-4 and COVID-19 severity: A systematic review and meta-analysis

Introduction: This systematic review and meta-analysis aimed to determine the correlation between IL-4 concentrations and COVID-19 severity. Methods: This study was designed as a systematic review and meta-analysis and was performed in accordance to the PRISMA statement. Titles, abstracts, and full texts of articles were independently reviewed by at least 2 authors. Continuous variables were compared by the mean difference (MD) with 95% confidence interval (CI). Results: Thirty-three studies reported IL-4 levels among severe versus non-severe COVID-19 patients. Pooled analysis showed that levels of IL-4 among those groups varied and amounted to 2.72 ± 3.76 pg/mL vs 3.08 ± 4.14 pg/mL (MD =-0.26;95%CI:-0.43 to-0.10;p = 0.002. In addition, eight studies reported levels of IL-4 among COVID-19 patients who survived vs deceased and was 2.61 ± 0.49 pg/mL vs (3.44 ± 16.4 pg/mL, respectively (MD = 0.22;95%CI: 0.08 to 0.37;p = 0.002). Discussion: This detailed systematic review and meta-analysis revealed that the plasma concentration of IL-4 is a potential risk factor for COVID-19 severity and mortality. Specifically, old age and male gender were associated with high IL-4 levels. Lung damage could result from the change in IL-4 concentration, thus making critical and severe COVID-19 cases at a very high risk of dying, thereby reducing their quality of life. Therefore, strategies such as using monoclonal antibodies to inhibit Th2 cytokines could be explored in developing an effective treatment regimen for COVID-19 patients. Take-home message: An independent risk factor for the severity and fatality of COVID-19 is the plasma levels of IL-4. High IL-4 levels are specifically related to old age and male gender. Lung damage may be a result of the change in IL-4 concentration, placing COVID-19 critically and severely ill at a high risk of dying. © 2022 by the authors.

COVID-19 Health Literacy in Rural and Urban Communities in Nigeria: A Key Strategy for Improving the COVID-19 Outbreak Response

Background: This study aimed to describe COVID-19 health literacy in urban and rural communities in Nigeria. Methods: A descriptive cross-sectional design was used to enrol adults from households in rural and urban communities in Akure, Southwest Nigeria. Nine questions were asked to determine respondents' health literacy, each arranged on a scale of ‘1' (very difficult) to ‘7' (very easy). We defined good health literacy as cumulative scores ≥50 points, and poor health literacy as scores <50 points. Chi-square tests and binary logistic regression were conducted on COVID-19 health literacy. Statistical significance levels were set at p <0.05. Results: The median age of the 691 respondents was 27 years (Range:18-80 years). Overall, 229 (45.8%) individuals had good COVID-19 health literacy. Among them, 143 (49.7%) individuals in urban communities had good COVID-19 health literacy (ᵡ2: 4.062, p = 0.044). Thirty-six (66.7%) adults aged >40 years in urban communities had good COVID-19 health literacy (ᵡ2: 8.995, p = 0.029), compared to 28 (56.0%) adults within the same age group in rural communities (ᵡ2: 8.387, p = 0.039). In urban communities, people >40 years had nearly two times the odds of having good COVID-19 health literacy compared to people aged ≤20 years (AOR: 1.640, 95% CI: 0.769-3.495, p = 0.200). In rural communities, people >40 years had nearly four times the odds of having good COVID-19 health literacy compared to people aged ≤20 years (AOR: 3.523, 95% CI: 1.420-8.742, p = 0.007). Conclusions: COVID-19 health education should be integrated into national health programs to address urban-rural differences in COVID-19 health literacy. © 2022 The Author(s).

Keeping in-school adolescents safe from COVID-19 sequelae to the suspension of school lockdown restriction

Rapid transmission of the Coronavirus disease (COVID-19) and resulting fatalities necessitated the closure of educational institutions in March, 2020 globally, and affected nearly 1.6 billion learners globally. However, presently lockdown measures have been lifted in many countries, and resumption of physical learning in schools has commenced. At this notable period, it is pertinent to ensure the safety of schoolchildren and teachers from COVID-19 while preventing the risk of further transmission of COVID-19 in school settings. Therefore, we recommend adherence to the reduction of contact between in-school adolescents during school hours. Provision of face masks and handwashing equipment such as soap, clean water, bucket(s), and disposable tissue papers positioned at different points should be ensured in schools, with the modalities for such practice exemplified on information, education, and communication materials. Also, maintaining a minimal physical distance of 1m, use of face masks, regular hand washing and disinfection of classrooms, toilet facilities, and surfaces is important. In addition, adequate ventilation in classrooms through the opening of windows or the use of air purifiers must be ensured among teachers and other school personnel would contribute effectively to the safety of in-school adolescents while schools have reopened amid the COVID-19 pandemic. © 2020 The Author(s).

Descriptive analysis of the COVID-19 pandemic during the first and second waves in a North-Central State in Nigeria

Introduction: COVID-19 is a novel infection caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). This study was a descriptive analysis of COVID-19 during the first and second waves in Kwara State, North-Central Nigeria.

A disease of the rich and mighty: A misnomer in COVID-19 communication across the media in Nigeria

Introduction: Given the high coverage of the mass media and its significant influence in communicating evidence-based health information, the aim of this study was to describe the misnomer in COVID-19 communication across the media in Nigeria. Methods: This was a review of newspaper articles that had been published between 1st February and 31st May 2020. Quantitative content analysis was used to describe and analyze the themes which characterized media representations of the COVID-19 outbreak in Nigeria. Identification of codes and themes was done by the researchers and were used to broadly categorize the data obtained into ‘general’ and ‘thematic’ categories. Coding for the general category included 14 news media outlets during the first three months of COVID-19 pandemic in Nigeria. Codes for the thematic category included: Description of COVID-19 in Nigeria, Assurances on COVID-19 containment in Nigeria, Support for COVID-19 management, COVID-19 education, Treatment of COVID-19, and the effects of COVID-19 in Nigeria. Results: In all, 289 news articles met the inclusion criteria and were thus analyzed. The reporting was as follows: Description of COVID-19 (18.3%), Assurances of readiness and containment (13.5%), COVID-19 education (25.3%), Support for management of Coronavirus in Nigeria (14.9%), Treatment of COVID-19 in Nigeria (13.8%), and Effects of COVID-19 (14.2%). Overall, 64 (22.1%) of COVID-19 information across the media was fake news;35 (12.2%) pertained to the “Description of COVID-19” theme, while 29 (9.9%) pertained to the “Treatment of COVID-19” theme. Discussion: To facilitate accurate reporting of detailed information by the news media, a collaboration between health agencies and news media outlets should be enhanced to curtail false information ravaging the society. Take-home message: The role of the media in reporting disease outbreaks cannot be disregarded, although a times they could be misleading, inaccurate, or speculative. To address inaccurate media reporting of health events, open data sharing between scientists, governments, and policymakers, as well as the communication of these to the media should be commenced early in any pandemic situation. © 2022 by the authors.

Perception and Learning Satisfaction of Resident Doctors Amid COVID-19 Pandemic: Adaptation Experience at a Virtual Educational Course in Internal Medicine.

OBJECTIVES: This study aimed to assess the perception of the significance of the revision course and satisfaction of resident doctors with the West African College of Physicians (WACP) revision course in internal medicine. METHODS: This was a post-training evaluation of resident doctors who had enrolled for the 2021 membership revision course in internal medicine between August 9-13, 2021. Data were collected through an electronic questionnaire composed of five sections: Sociodemographic characteristics, involvement in research, perception on the significance/expectations from the course, lessons learnt, and perception of the overall coordination of the revision course/recommendations. Descriptive statistics were summarized using frequency tables. Chi-square tests were conducted to determine the association between participants' sociodemographic characteristics and satisfaction with the WACP revision course. RESULTS: The mean age (±SD) of the 119 resident doctors was 34.30 (± 4.81) years and the median duration (range) of residency training was 7 (4-10) years. All participants were currently in medical practice either in teaching hospitals (104,87.4%) or secondary health facilities (15, 12.6%). Overall, 108 (90.8%) doctors were satisfied with the course. Variables that were associated with satisfaction with the WACP revision course included: duration in residency training (doctors that had spent two years or less in the residency training programme) (Chi-square = 21.703, p = <0.001), place of residency training (teaching hospitals) (Chi-square = 67.461, p = <0.001), and participation in research (Chi-square = 47.976, p = <0.001). CONCLUSION: The WACP revision course in internal medicine met its objectives. Engagement of resident doctors in research activities should be undertaken intensely.

OBJECTIFS: Cette étude visait à évaluer la perception de l'importance du cours de révision et la satisfaction des médecins résidents à l'égard du cours de révision en médecine interne du West African College of Physicians (WACP). MÉTHODES: Il s'agissait d'une évaluation post-formation des médecins résidents qui s'étaient inscrits au cours de révision en médecine interne pour les membres de 2021 entre le 9 et le 13 août 2021. Les données ont été recueillies au moyen d'un questionnaire électronique composé de cinq sections : Caractéristiques sociodémographiques, implication dans la recherche, perception de l'importance/attentes du cours, leçons apprises, et perception de la coordination globale du cours de révision/recommandations. Les statistiques descriptives ont été résumées à l'aide de tableaux de fréquence. Des tests de Chi-carré ont été effectués pour déterminer l'association entre les caractéristiques sociodémographiques des participants et la satisfaction du cours de révision WACP. RÉSULTATS: L'âge moyen (±SD) des 119 médecins résidents était de 34,30 (± 4,81) ans et la durée médiane (fourchette) de la formation en résidence était de 7 (4-10) ans. Tous les participants exerçaient actuellement la médecine dans des hôpitaux universitaires (104, 87,4%) ou des établissements de santé secondaires (15, 12,6 %). Dans l'ensemble, 108 (90,8%) médecins étaient satisfaits de la formation. Les variables qui étaient associées à la satisfaction du cours de révision du WACP comprenaient : la durée de la formation en résidence (les médecins ayant passé deux ans ou moins dans le programme de formation en résidence) (Chi-carré = 21.703, p = <0.001), le lieu de formation en résidence (hôpitaux universitaires) (Chi-carré = 67.461, p = <0.001), et la participation à la recherche (Chi-carré = 47.976, p = <0.001). CONCLUSION: Le cours de révision WACP en médecine interne a atteint ses objectifs. L'engagement des médecins résidents dans des activités de recherche devrait être entrepris de manière intensive. Mots-clés: Pratique médicale, Enseignement médical, Formation des résidents, Médecine interne, Afrique.

Missed first dose of the COVID-19 vaccine: a qualitative study on vaccine hesitancy among healthcare workers in Nigeria

Introduction This study aimed to explore the factors contributing to COVID-19 vaccine hesitancy (VH) among healthcare workers (HCWs) who missed the first dose of the COVID-19 vaccine in Nigeria. Methods We conducted a qualitative study of the factors contributing to COVID-19 VH among HCWs at the University College Hospital, Ibadan using purposive sampling technique. Each interview session was held through telephone conversation. Qualitative data were analyzed using Colaizzi's phenomenological method. Results The mean age of the 15 HCWs was 34.33±3.77 years;10 (66.7%) were females;6 (40.0%) were physiotherapists. Three themes were identified. The first theme, “Factors contributing to COVID-19 VH among healthcare workers” had five clusters: i) Lack of adequate information regarding the COVID-19 vaccine;ii) Challenges with immunization schedule;iii) Fear of side effects of the COVID-19 vaccine;iv) Lack of trust in the government;and v) Concerns about the safety of the COVID-19 vaccine. The second theme, “Healthcare workers' perception on the solution to COVID-19” had three clusters: i) Adherence to non-pharmaceutical measures;ii) Vaccine production: key to submerging the COVID-19 pandemic;and iii) Healthcare workers' perception of their roles in patient education on the COVID-19 vaccine. The third theme;“Recommendations to encourage COVID-19 vaccine acceptance among healthcare workers” had three clusters: i) Disclosure of extensive information on COVID-19 vaccine components;ii) Decentralization of COVID-19 vaccine collection points;and iii) Procurement of other brands of the COVID-19 vaccine. Conclusions Public health authorities should promote information on the safety and efficacy of the COVID-19 vaccine.

Inequalities in accessing healthcare in the United States of America: a major contributor to the increasing COVID-19 morbidity and mortality

Introduction: Many COVID-19 cases and deaths have been reported from the United States (US). This study aimed to assess the health system inequalities as a determinant of COVID-19 case morbidity and mortality in the US.

RISK PERCEPTION, KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS COVID-19 AND LASSA FEVER PREVENTION AMONG DOCTORS AND NURSES IN A TREATMENT CENTRE IN NIGERIA

BACKGROUND: Infection Prevention and Control practices are required to manage COVID-19 and Lassa fever (LF). We aimed to assess COVID-19 and LF risk perception and knowledge, attitude, and practices (KAP) towards prevention among doctors and nurses in a treatment centre in Ondo State, Nigeria. METHODS: We conducted a comparative cross-sectional study using semi-structured interviewer-administered questionnaires. We computed KAP scores with "+1" for correct response and "0" for incorrect response. Cumulative scores >80% implied good KAP of LF and COVID-19. Chi-square test was used to assess associations between sociodemographic characteristics and COVID-19 and LF KAP. P-values<0.05 were statistically significant. RESULT: The mean age of respondents was 37.81±8.46 years. Risk perception scores were 2.82±0.53 for LF and 2.76±0.58 for COVID-19 (p=0.002). Mean overall knowledge scores towards prevention were 18.48±2.08 for LF and 15.59±3.22 for COVID-19 (p<0.001). Practices towards prevention scores were 18.18±2.27 for LF and 15.89±1.47 for COVID-19 (p<0.001). Concerning LF, 72.8% of doctors had good knowledge of prevention compared to 42.9% nurses (p<0.001), 18.3% of doctors had good attitude to LF prevention compared to 27.2% nurses (p=0.039). Also, 84.8% nurses had good LF preventive practices compared to doctors (64.5%) (p<0.001). A strong positive correlation (r=0.72) existed between COVID-19 and LF risk perception (p<0.001). CONCLUSION: Continuous on-the- job trainings are needed among doctors and nurses in LF and COVID-19 treatment centres.

REOPENING OF EDUCATIONAL INSTITUTIONS AMID THE COVID-19 OUTBREAK: NIGERIA'S PREPARATION FOR THE MITIGATION OF SCHOOL-ASSOCIATED COVID-19 RISKS

The global spread of the novel Coronavirus disease (COVID-19) has necessitated the implementation of non-pharmaceutical public health measures globally, including school closure. After five months of school closures, the Nigerian government is planning towards the suspension of school lockdown. However, in a bid to ensure that schoolchildren are academically equipped, and measures such as adequate ventilation, handwashing, social distancing, and increased infrastructure need to be implemented to ensure that school reopening does not result to a spike in COVID-19 cases and fatalities in Nigeria.

Effect of the COVID-19 pandemic on malaria intervention coverage in Nigeria: Analysis of the Premise Malaria COVID-19 Health Services Disruption Survey 2020

INTRODUCTION The study aimed to assess the uptake of malaria intervention services in Nigeria before and during the COVID-19 pandemic. METHODS This study utilized secondary data collected in the COVID-19 Health Services Disruption Survey. The data collected included sociodemographic characteristics, the number of insecticide-treated nets, visit to healthcare facilities, enrollment in malaria tests, and treatment for malaria. Data analysis was performed using SPSS version 25.0. The association between visit to healthcare facilities and sociodemographic characteristics was determined using chi-squared tests. Binary logistic regression tests were conducted, and p<0.05 was considered statistically significant. RESULTS Among the 1985 respondents, 960 (48.4%) were aged ≤25 years. Before the COVID-19 pandemic, 485 (50.5%) people aged ≤25 years visited healthcare facilities (χ2=15.923, p≤0.001), while 385 (39.9%) persons aged ≤25 years visited healthcare facilities during the pandemic (χ2=15.53, p≤0.001). Among those with graduate/postgraduate education who visited healthcare facilities, 593 (45.9%) paid visits before the pandemic (χ2=7.33, p=0.026), while 445 (44.4%) paid visits during the pandemic (χ2=16.37, p≤0.001). Individuals aged 26–35 years had 21% less odds (AOR=0.79;95% CI: 0.65–0.97, p=0.021) of visiting healthcare facilities before the pandemic, and 23% less odds of visiting healthcare facilities during the pandemic (AOR=0.77;95% CI: 0.63–0.95, p=0.013). CONCLUSIONS The COVID-19 pandemic has had a negative impact on visits to healthcare facilities for malarial treatment. To promote malaria intervention during the pandemic, malaria diagnosis should be linked with COVID-19 screening and testing. © 2021. All Rights Reserved.

Interrelationship between noncommunicable diseases, COVID-19 and sociodemographic index in the economic community of West African States

Background: Noncommunicable diseases (NCD) increase COVID-19 morbidity and mortality. Objective: This study aimed to describe the interrelationship between NCD, COVID-19, and sociodemographic index (SDI) in the Economic Community of West African States (ECOWAS). Methods: We extracted data from the global burden of disease (GBD) estimates. The GBD was used to estimate variations in epidemiologic data sources, model predictions, and 95% corresponding uncertainty intervals (UIs) for disability-adjusted life years (DALY). COVID-19 data were extracted and collated from web-based repositories as of December 18, 2020. We assessed the strength of association between the number of COVID-19 cases per thousand population, COVID-19 deaths, case-fatality rate, SDI, and DALY due to NCD using Pearson's correlation test. The level of statistical significance was P < 0.01. <br>Results: Ghana's SDI of 0.56 and DALY% (95% UI) due to NCD of 40.66 (36.05-44.98) was the highest. Ghana had 177 COVID-19 cases/100,000 population while Niger has 11 cases/100,000 population as of December 18, 2020. Niger's SDI of 0.16 and DALY% (95% UI) due to NCD of 21.22 (16.72-25.6) were the minimum. We found a strong positive correlation between COVID-19 cases per thousand population and DALY due to NCD (r = 0.870, P < 0.001, n = 15) and a strong positive correlation between SDI and DALY due to NCD (r = 0.647, P = 0.009, n = 15). <br>Conclusion: Countries with higher SDI and DALY due to NCD experienced higher COVID-19 cases. NCD prevention and control should be promoted to reduce COVID-19-related mortality and morbidity in the ECOWAS.

Considerations for maintaining safety in biobanks during the COVID-19 pandemic: A systematic review

Backgrounds: COVID-19 diagnostic testing and research substantially depend on high-quality COVID-19 specimens, for which biobanks are an important repository. This systematic review aimed to highlight the considerations for maintaining safety in biobanks during the COVID-19 pandemic. Materials & Methods: A systematic review of literature was conducted using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search was conducted across Google Scholar, PubMed, and Directory of Open Access Journal because of their high indexation on many journals. Pre-defined search terms were used in the literature search. Overall, 7,184 articles were retrieved, and 2,054 duplicates among them were removed. After screening for eligibility using pre-defined criteria, 12 articles were included in the review. Findings: Challenges faced by biobanks amid the COVID-19 pandemic include poor handling of COVID-19 specimens, poor sample collection, and sample contamination due to unclarified standard operating procedures. Strategies such as developing a framework for governing and monitoring the export of biological samples should be employed to overcome dangers eminent in the collection of biological samples. Total adherence to standard operating procedures should be ensured to maintain safety in COVID-19 samples collection, handling, and storage modalities. A deficit in material supply should be promptly addressed. Conclusion: Compliance with issued guidelines should be ensured by the management and staff of COVID-19 biobanks. © 2021, TMU Press.

Infection prevention and control during COVID-19 pandemic: realities from health care workers in a north central state in Nigeria.

Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs. We used a qualitative study design to conduct in-depth interview among 16 frontline HCWs participating in the COVID-19 response in Kwara State, Nigeria. Colaizzi's phenomenological method was used in the qualitative analysis of data. We found that HCWs were aware of their vulnerability to the COVID-19 infection, and the reasons attributed included poor knowledge of IPC measures for COVID-19, inadequate supply of personal protective equipment (PPE), poor political will and inadequate health facilities (HFs) management support. Improved political will and better involvement of HFs management teams in infection prevention and control (IPC) systems are needed to reduce the risk for COVID-19 infection among HCWs. We recommend scale-up training on IPC measures particularly hand washing and use of PPE as well as the development of effective points of care risk assessment with a high index of suspicion in HFs.

Patent medicine vendors' preparedness and response for the prevention and control of covid-19 infection in a north-central state in Nigeria

Objective: This report aimed to determine the immediate effect of the IPC training on the knowledge and role of patent medicine vendors (PMV) in the COVID-19 outbreak response in Nigeria. Methods: We conducted a quasi-experimental study before and after the IPC training among 1076 PMV in Ilorin, Kwara state, Nigeria. Data analysis was done using SPSS version 23. Eight questions were asked, for which each was assigned a score of "1". Participants who had scored<50% were categorized as "Fail", while those with scores ≥50% were categorized as "Pass"in both the pre and post-tests. The Chisquare test was used to test for the association between sociodemographic characteristics and performance of respondents in the pre-and post-IPC knowledge results, and paired t-test to test for significant differences between the pre and post-tests mean scores. The level of significance was set at p<0.05 for all statistical tests. Results: The mean age of the 1076 respondents was 37.06±10.96, 463(43%) passed the pre-test, while 617 (57.3%) passed the post-test. The mean pre-test IPC training score was 3.1310±1.5631, while the mean post-test IPC training score was 3.7351±1.6028 (t=-11.337, p=<0.001). In all, 617(57.3%) scored higher in posttest. Overall, 560 (92.41%) identified community sensitization and health education on COVID-19 preventive measures as roles of PMV. Conclusion: Regular trainings on COVID-19 preventive practices among PMV should be conducted. PMV should be empowered to sensitize and educate their clients on the prevention of COVID-19.

Overcoming covid-19 in west african countries: Is herd immunity an option?

The coronavirus infection (COVID-19) to date has no vaccine or effective treatment. Herd immunity offers indirect protection to susceptible members of the population. If the acquired immunity of a community rises above 67%, then a gradual decline in the number of incident cases is recorded. How many deaths would have occurred in the West African countries by the time at least 67% of our people are infected with the present case fatality rate (CFR)? The objective of this study was to develop a forecast of the number of COVID-19 deaths that would be recorded to attain herd immunity for each country in West-Africa. We predicted the numbers of deaths using publicly available demographic and COVID-19 data. To attain herd immunity in West Africa 5.2 million COVID-19 deaths would have occurred assuming the CFR is maintained at the current rates in the region. Attention should be focused on strategies that would limit the spread of infection and protect the most vulnerable population groups while the race to develop an effective vaccine should be hastened. © 2020, African Field Epidemiology Network. All rights reserved.