Determinants of mortality among hospitalized patients with COVID-19 during first and second waves of the pandemic: A retrospective cohort study from an isolation center in Kano, Nigeria.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has emerged as an important cause of morbidity and mortality worldwide. The aim of this study is to identify the clinical predictors of mortality among patients with COVID-19 pneumonia during first and second waves in a treatment center in northwestern Nigeria. METHODS: This was a retrospective cohort study of 195 patients hospitalized with COVID-19 between April 2020 to March 2021 at a designated COVID-19 isolation center in Kano State, Northwest Nigeria. Data were summarized using frequencies and percentages. Unadjusted odds ratios and 95% confidence intervals and p-values were obtained. To determine independent determinants of mortality, we performed a stepwise multivariate logistic regression model. RESULTS: Of 195 patients studied, 21(10.77%) patients died. Males comprised 158 (81.03%) of the study population. In the adjusted stepwise logistic regression analysis, age>64 years (OR = 9.476, 95% CI: 2.181-41.165), second wave of the pandemic (OR = 49.340, 95% CI:6.222-391.247), cardiac complications (OR = 24.984, 95% CI: 3.618-172.508), hypertension (OR = 5.831, 95% CI:1.413-24.065) and lowest systolic blood pressure while on admission greater than or equal to 90mmHg were independent predictors of mortality (OR = 0.111, 95%CI: 0.021-0.581). CONCLUSION: Strategies targeted to prioritize needed care to patients with identified factors that predict mortality might improve patient outcome.

Transmission Dynamics of Monkeypox Virus in Nigeria during the Current COVID-19 Pandemic and Estimation of Effective Reproduction Number.

Monkeypox virus (MPXV) continues to pose severe threats to global public health, especially in non-endemic areas. Like all other regions, Africa faces potential public health crises due to the ongoing COVID-19 pandemic and other infectious disease outbreaks (such as Lassa fever and malaria) that have devastated the region and overwhelmed the healthcare systems. Owing to the recent surge in the MPXV and other infections, the COVID-19-control efforts could deteriorate and further worsen. This study discusses the potential emergencies of MPXV transmission during the current COVID-19 pandemic. We hypothesize some of the underlying drivers that possibly resulted in an increase in rodent-to-human interaction, such as the COVID-19 pandemic's impact and other human behavioral or environmental factors. Furthermore, we estimate the MPXV time-varying effective reproduction number (Rt) based on case notification in Nigeria. We find that Rt reached a peak in 2022 with a mean of 1.924 (95% CrI: 1.455, 2.485) and a median of 1.921 (95% CrI: 1.450, 2.482). We argue that the real-time monitoring of Rt is practical and can give public health authorities crucial data for circumstantial awareness and strategy recalibration. We also emphasize the need to improve awareness programs and the provision of adequate health care resources to suppress the outbreaks. These could also help to increase the reporting rate and, in turn, prevent large community transmission of the MPXV in Nigeria and beyond.

COVID-19 and Lassa fever in Nigeria: A deadly alliance?

As the COVID-19 pandemic poses serious threats to global public health, Nigeria faces a potential public health crisis owing to COVID-19 and other infectious diseases, such as Lassa fever (LF) and malaria. In this study, we discuss the possible determinants behind the decreased number of LF cases in Nigeria, which was likely due to the synergistic impact of the COVID-19 pandemic. During the COVID-19 pandemic, the epidemic curve of LF seems to have deviated from the general seasonal scale seen in past years, which could be due to underreporting of cases. In addition, partial compliance with nonpharmaceutical interventions, limited resources, or human behavior could be contributing factors. Thus, we suggest that better differentiation in terms of human and resource allocation between COVID-19 and LF could help curtail the transmission effectively.

A national survey of hospital readiness during the COVID-19 pandemic in Nigeria.

INTRODUCTION: The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak. METHOD: Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50-79.9%) and not ready (score <50%). RESULTS: Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%). CONCLUSION: Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.