Gender-based violence in a rural Nigerian community during the COVID-19 era: a call for policy action

Introduction: gender-based violence (GBV) is a global pandemic which is deeply rooted in culture, hence the need to contextually understand its occurrence and patterns in rural settings. The objective of this study assessed respondents´ attitude, prevalence, the perceived risk factors, patterns and predictors of GBV in Ife-Odan, Osun State, Nigeria. Methods: cross-sectional study design was used and multi-stage sampling method employed to recruit 450 consenting adults. A pretested interviewer-administered, semi-structured questionnaire was used for data collection. Both descriptive and inferential statistics were carried out. Results: mean age (±SD) of the respondents was 30.73±7.0, 58.7% of them were females and 88.0% had negative attitude to GBV. Prevalence of any form of GBV was 16.2%. Predominant GBV types included intimate partner violence (IPV) (58.3%), female genital mutilation (FGM) (31.1%), Sexual violence (6.9%) and incest (3.4%). Perceived risk factors of GBV included cultural acceptance, substance abuse, lack of punishments for GBV offenders, indecent female dressing styles, social media influences, effects of COVID-19 lockdown and male dominance. However, gender (AOR=7.82;95%CI=2.35-8.17), marital status (AOR=3.23;95%CI=1.82-3.78), religion (AOR=5.02;95%CI=1.78-9.63) and attitude (AOR=4.23;95%CI=2.267-5.82) were the significant predictors of past GBV experiences in the study setting. Conclusion: gender-based violence (GBV) is prevalent in the study setting, with IPV being the most common. There is need for policymakers to focus on cultural transformation by designing a robust awareness campaign against GBV in rural Nigerian communities. Traditional and religious leaders should be sensitized and involved in the campaign programs using all available channels of communication. Laws prohibiting perpetration of GBV need to be fully implemented. © 2023, Pan African Medical Journal. All rights reserved.

Characterizing Antibiotic Prescribing for Nursing Home Residents with SARS-CoV-2 Infection, April 2020-November 2021

Background. Increased prescribing of antibiotics commonly used for respiratory infections, including azithromycin, ceftriaxone, and doxycycline was observed in nursing homes (NH) during the COVID-19 pandemic however antibiotic prescribing was not linked to resident diagnosis. Therefore, our objective was to characterize antibiotic prescribing in residents with SARS-CoV-2 infection in a large cohort of US NHs. Methods. We conducted a retrospective cohort study using PointClickCare (PCC) data containing longitudinal NH electronic health records. We included 4,891 NHs that reported >=1 medication order/month from April 2020-November 2021. We identified the first onset of SARS-CoV-2 infection using ICD-10-CM diagnosis code U07.1. To validate the number of SARS-CoV-2 infections per facility captured in PCC, we compared the total number of SARS-CoV-2 infections documented in PCC to those reported to the National Healthcare Safety Network (NHSN). Antibiotic orders were determined to be associated with a SARS-CoV-2 infection if 3 days before or <=7 days after diagnosis. We characterized the proportion of residents with a SARS-CoV-2 infection with an associated antibiotic by month. Results. We included 2,086 (43%) NHs that had <=20% difference in total number of SARS-CoV-2 infections documented in PCC and reported to NHSN. From April 2020-November 2021, a total of 118,180 residents with a SARS-CoV-2 infection were identified and 24% had an associated antibiotic prescription (N=27,972). The highest prescription rate (30%, 95% Confidence Interval [29%-31%]) was observed in April 2020 and varied by less than 8% from May 2020-November 2021 (Fig.1). The most commonly prescribed antibiotics were azithromycin (53%), doxycycline (13%) and ceftriaxone (10%). Conclusion. An antibiotic prescription was linked to up to a quarter of NH residents with SARS-CoV-2 infection, highlighting potential opportunities for avoiding unnecessary antibiotic prescribing for viral infections in NHs. Appropriate antibiotic prescribing in NH populations is important to reduce potential harm when antibiotics offer no treatment benefit to the resident. Identifying facility-level characteristics that lead to variability in antibiotic prescribing is a next step to inform antibiotic stewardship interventions.

Early childhood education teacher technology usage in emergency times

This study investigated early childhood education teacher technology usage during the COVID-19 pandemic. Descriptive survey design was adopted. The population of the study consisted of all early childhood education teachers in Nigeria. Sample size consisted of 1000 early childhood education teachers that were selected randomly. A self-designed instrument titled Early Childhood Education Teachers ' Technology Usage Questionnaire (ECETTUQ) was administered on the participants for the study. Four research objectives were raised. Data collected were analyzed using frequency counts, simple percentages, mean, standard deviation, and independent t-test. The study indicated that the highest percentage of teachers was not involved in online technology during the COVID-19 pandemic emergency time in Nigeria. Limited internet service is the major weakness of online technology usage. The study recommends that government and private school owners should engage their teachers with regular training on technology usage, and better internet services should be provided by the service providers. © 2022, IGI Global.

Predictors of mortality in hospitalized African American COVID19 cancer patients

Background: Coronavirus disease 2019 (COVID-19) and associated outcomes manifest differently depending on patients' background and pre-existing conditions. It remains unclear how African Americans with and without cancer have been affected. Aim: To determine epidemiological, clinical comorbidities, and laboratory test results to identify markers associated with mortality in COVID-19 cancer patients. Methods: We reviewed all COVID-19 hospitalized patient records from Dec. 2019 to Nov. 2021 at Howard University Hospital. Patients having a history of, or active cancer status were reviewed. All the clinical, treatment, lab values, and pathological data were extracted. Statistical analysis of the COVID-19 cancer patients and comparison with non-cancer COVID-19 patients were performed using univariate and multivariate analyses. Results: Out of 800 COVID-19 infected patients, a total of 49 patients were identified with different types of cancer, with both active and previous history. Females consisted of 26 cancer patients (53%). Cancer patients were older than non-cancer patients (mean age-70.6 vs. 56.3 years) and had an increased length of hospital stay (mean 13.9 vs 9.4 days). Among cancer patients, breast cancer was more prevalent in females and prostate cancer in males, (54% and 52% respectively). In both cases and controls, univariate and multivariate analyses did not show any correlation between individual symptoms or clinical comorbidities and death. Higher reduction in albumin level in cancer cases, from the time of admission to day five, was significantly associated with death during the same hospital stay compared to those who were discharged (p<0.001). In controls, lymphocytes count, AST, and Albumin have shown an association with increased mortality. Comparison of patients with active vs. previous cancer showed no significant difference in the clinical outcome, death vs discharge (P=0.34). Conclusion: Albumin level has shown to have an inverse relationship with clinical outcomes among all COVID infected African American patients. Reduction in Albumin level during the hospital stay, particularly in COVID-19 cancer patients should be considered as a predictor of mortality. No significant difference was noticed in the clinical outcome in patients with previous versus active cancer. Further research with a large cohort size is needed to verify and identify other predictors of outcome in COVID-19 cancer patients and develop appropriate treatment modalities.

LIVER ENZYMES ALTERATION BUT NOT GI SYMPTOMS ARE ASSOCIATED WITH DEATH IN MINORITY COVID-19 PATIENTS WITH CANCER

Background and Aims: Cancers are known to worsen the clinical course of SARS-CoV-2 infection. We aimed to assess health outcome effectors in Coronavirus 19 (COVID-19) cancer patients from different centers in the US. Methods: We retrospectively evaluated medical records of 364 COVID-19 cancer patients from 3 centers in the US (New York, Michigan, and DC) admitted to the hospital between Dec. 2019 to Oct. 2021. Outcomes, symptoms, labs, and comorbidities of cancer patients with COVID 19 (Cases), were analyzed and compared with non-cancer COVID-19 patients (Controls). Results: Among 1934 hospitalized COVID-19 patients, 18.7% (n=364) have an active or previous history of cancer. Cancer patients were older when compared with non-cancer controls (69.7 vs 61.3 years). Among these 364 cancer patients, 222 were African Americans (61.7%) and 121 were Caucasians (33.2%). Cancer patients had an increased length of hospitalization compared to controls (8.24 vs. 6.7 days). The most common types of cancer in cases are prostate cancer (41.5%) and hematological malignancies (10.1%) among males, and breast cancer (41.5%), and head and neck cancers (11.4%) in females. In both genders, lung cancer is associated with high mortality. Patients with a previous history of cancer were more prone to death (p=0.04) than active cancer patients. Cough (23.1%) and fever (19.5%) are the most common symptoms among the cases. In univariate and multivariate analyses, predictors of death among cancer patients were male sex, older age, African American ethnicity/race, asthma, presence or absence of fever, elevated troponin, mechanical ventilation, and previous history of cancer. There is no significant difference in mortality in cancer patients when compared to controls. Abdominal pain (2.2%), diarrhea (3.8%), and vomiting (2%) occurred both in cases and controls but did not associate with death. Albumin is also significantly associated with mortality in cases (p=0.042). AST (54.6%), ALT (12.5%), and Bilirubin (16%) were elevated in the majority of cases. Both AST and ALT alterations have an effect on mortality. Univariate analysis shows that AST is strongly and significantly associated with mortality in cases (p=0.001) but not in controls. ALT is also associated with mortality in cases at the 10% level (p=0.057). Diarrhea is strongly associated with mortality in control (p <0.001) but not in cases. Conclusion: In this retrospective cohort study, we found male sex, and African American race is associated with high mortality. Elevated troponin levels and LFT’s during the hospital stay were significantly associated with poor outcomes. Patients with a previous history of cancer were more prone to death when compared to active cancer COVID-19 patients. Early recognition of cancer COVID-19 patients can help determine appropriate treatment and management plans for better prognosis and outcome.

Understanding Risk Communication Effectiveness From Public Interest, Mobility, and COVID-19 Cases: A Case Study of COVID-19 in Nigeria

Since the emergence of COVID-19 in 2020, various actions have been taken by governments and agencies globally to curtail its spread and devastating effects. Risk communication is an essential component of such actions. Examination of public interest, risk perception and new cases of COVID-19 is vital to understanding the effectiveness of risk communication strategies implemented. With data paucity plaguing policymaking in Nigeria, there is a need to examine new data sources to support the enhancement of risk communication. The study explored Google Trends (GT) and Google Mobility Reports (GMR) in monitoring public restlessness and risk perception, respectively, toward COVID-19 in Nigeria. This is geared toward understanding the effectiveness of the national risk communication strategy. COVID-19 case statistics, stringency index, mobility, and search indices for selected terms were collated (February 28 to June 30, 2020). Temporal dynamics were examined while correlation analysis was carried out to examine the association. Public attention peaked just around the commencement of the nationwide lockdown and declined considerably afterwards despite increasing new cases. Mobility toward most place categories showed a sharp decline at the beginning of the pandemic, except for residential areas. This trend also reversed soon after the lockdown. COVID-19 case statistics were found to be negatively correlated with the public interest. Public interest had a weak but both negative and positive association with the stringency index, while mobility exhibited a weak negative association with the case statistics (except residential area mobility). The results indicated that the risk communication efforts were inadequate in providing a prolonged health behavior change. The initial risk communication and lockdown created a positive outcome, however, the impact soon faded out. The evidence suggests that risk perception may have been poorly targeted by risk communication interventions. It is recommended that continuous monitoring of public interest and risk perception is implemented during an emergency and risk communication adjusted accordingly. Copyright © 2022 Lawal.

COVID-19 PANDEMIC: IMPACT ON GYNAECOLOGICAL ENDOSCOPY AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN

The impact of the COVID-19 pandemic on endoscopic services in a low resource economy is formidable. With the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there has been genuine concerns about the risk of transmission during gynaecological endoscopy via the diffusion of contaminated aerosols generated from CO2 leakage and smoke created by energy devices. A pragmatic step in mitigating transmission at the University College Hospital, Ibadan, resulted in the closure of the Endoscopic unit for 3 months whilst deploying increased hygienic methods coupled with social distancing. This however had its unintended consequences of delay and increased backlog of cases aside the economic losses. Developing a unit-based policy/protocol in response to any future unforeseen occurrence should take front stage in the planning and administration of the unit. Adopting global best practices and guidelines from researched evidence is not only imperative but desirable especially in the context of limited resources.

Modelling potential economic impact of covid-19 in nigeria: Evidence from graph analysis

COVID-19 pandemic created a shockwave that can be felt across every sphere of society and the environment. The disease grew from a local event to a pandemic and the impacts are not the same everywhere. Therefore, there is a need to characterise the impact at different levels to ensure that initiatives to cushion the impacts are well-targeted. This study utilised graph analysis to examine the network attributes of Facebook Users’ mobility during the pandemic in comparison with the baseline period before the pandemic to characterise the economic impact. Movement data were collated from the Facebook Data for Good platform while economic output and census data were collated from the National Bureau of Statistics. The result shows that economic output and baseline network attributes have a positive and highly significant relationship (P<0.01). Nodal efficiency was statistically different across the crisis and baseline periods while betweenness showed no difference. The sum of the difference from baseline values identified two extremes – Lagos State (most negatively impacted) and Kwara State (most positively impacted). The States adopted varying measures to combat the disease, these variations also emerged in the graph analysis results. Economic output from each State is related to its centrality and efficiency. It is therefore plausible that changes in network attributes will bring commensurate changes in the economic output of each State. States with high centrality and betweenness values had a greater decline in their network attributes. The study provided an insight into one aspect of the extent of the economic impact of the COVID-19 on each State. We recommend more investigations into the inclusion of local interactions in capturing intra-state movements and changes in modelling economic output. © 2021, Comenius University in Bratislava. All rights reserved.

SPATIAL STRUCTURE AND CLIMATIC ASSOCIATIONS WITH COVID-19 CASES ACROSS THE GLOBE

The study examined the spatial structure and the association between COVID-19 cases and selected climatic variables. Data on cases, deaths, recovery were obtained from the COVID-19 Resources website of the Environmental Systems Research Institute (ESRI). The climatic variables were selected included Land Surface Temperature (LST) and Water Vapour (WV) and collated from the NASA Earth Observations (NEO). Spatial and inferential statistics were used to examine spatial autocorrelation and associations with these variables. Results show that China, Italy, and Iran have the largest number of confirmed cases, the highest recovery (81%) was recorded in China. Confirmed cases have 7 clusters and 2 outlier locations. There are 21 and 17 spatial outliers for recoveries and deaths respectively. There are 2 natural clusters of the incidences and 98.7% of the locations belong to one of the groups. A weak but statistically significant (P<0.05) associations were observed for the incidence and the climatic variables. The analysis of spatial structure revealed more insight into the distribution of the disease, shedding more light on areas with needs for more investigation (outlier locations) and providing opportunities for mitigating spread and re-emergence.

The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning.

INTRODUCTION: Worldwide, reports and experiences indicate that there has been extensive re-organisation within diagnostic imaging and radiotherapy departments in response to the COVID-19 pandemic. This was necessary due to changes in workload and working practice guidelines that have evolved during the pandemic. This review provides a comprehensive summary of the global impact of the COVID-19 pandemic on radiography practice, service delivery and workforce wellbeing. METHODS: A systematic review methodology was adopted to obtain data from primary studies of qualitative, quantitative, and mixed methods designs from databases (PubMed, Science Direct, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and SCOPUS: all 2020 to present). The included articles were subjected to information extraction and results-based convergent synthesis. RESULTS: The electronic database search yielded 10,420 articles after removal of duplicates. Of these, 31 articles met the final inclusion criteria with some (n = 8) fully focussed on radiotherapy workforce and service delivery. The pandemic impact on radiography practice is broadly themed around: training, communication, and information dissemination; infrastructure, technology, and clinical workflow; and workforce mental health and well-being. CONCLUSION: Globally, most radiographers received inadequate training for managing COVID-19 patients during the initial acute phase of the pandemic. Additionally, there were significant changes to clinical practice, working patterns and perceived increase in workload due to surges in COVID-19 patients and the consequent strict adherence to new infection protocols. These changes, coupled with fear emanating from the increased risk of the workforce to contracting the infection, contributed to anxiety and workplace-related stress during the pandemic. IMPLICATIONS FOR PRACTICE: Local pandemic response strategies must be appropriately developed from standard protocols in readiness for safe clinical practice and well-being management training of practitioners.

The use of UVC-LED in the disinfection of wastewater effluent

The growth of UltravioletC Light Emitting Diode (UVC-LED) systems in the water and wastewater market has been occurring at a geometric. Based on a recent survey (Cosman 2019) the number of vendors providing UVC-LED system has increased from 3 in 2017 to over 18 in 2019. While not all the companies provide systems for water and wastewater applications, the interest and growth of the UVC-LED vendors is occurring at a very rapid pace. The Electric Power Research Institute (EPRI) (2019) estimated the UVC-LED systems would reduce the capital cost of UV systems by 75 percent and the power use by 50 percent in the wastewater industry. Aqua-Aerobic Systems Inc. (Aqua-Aerobic) installed the METWATER UVC-LED unit at its Rockford, Ill test facility. Validation test runs were completed using filtered effluent as well as secondary treated effluent to determine the effectiveness of the unit in treating wastewater. A combination of various test runs were completed to determine the conditions under which the unit could be used to treat wastewater. Based on these results, computational fluid dynamic (CFD) and light intensity modeling was recommended to develop a plan to increase the treatment capacity of the test unit. The procedures for the models have been completed, however the actual runs have not been completed due to issues related to COVID-19. It is anticipated that the results of the model will show that a change to inlet conditions as well as baffling may need to be incorporated into the design of the existing unit to improve its overall effectiveness. Copyright © 2020 Water Environment Federation.