First Cases of Sars-cov-2 Reinfection Coinciding with the Covid-19 Second Wave, Benin City, Nigeria.

BACKGROUND: Reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has important public health implications pertaining to herd immunity and durability of protection from vaccines. A small but growing number of cases have been reported globally but none from Africa. This is due, in part, to adherence to definitions based on genetic sequencing, the capabilities of which are in short supply on the continent. METHODS: Based on epidemiological and clinical parameters, we report the first two cases of SARS-CoV-2 reinfection from a Nigerian tertiary hospital managing coronavirus disease 2019 (COVID-19) patients. RESULT: Two cases of SARS-CoV-2 reinfection were seen in December, 2020 and January, 2021. Both were males associated with a healthcare setting and aged 37 and 38 years respectively. The number of days between the first infection and the second ranged from 160-196 days. Symptoms ranged from mild to moderate and they recovered without sequelae. CONCLUSION: Public health action, including risk communication and reinfection surveillance backed by genomic sequencing, is advocated.

CONTEXTE: La réinfection par le coronavirus 2 du syndrome respiratoire aigu sévère (SRAS-CoV-2) a des implications importantes pour la santé publique en ce qui concerne l'immunité du troupeau et la durabilité de la protection contre les vaccins. Un nombre petit mais croissant de cas a été signalé dans le monde, mais aucun en Afrique. Cela est dû, en partie, au respect des définitions basées sur le séquençage génétique, dont les capacités sont rares sur le continent. MÉTHODES: Sur la base de paramètres épidémiologiques et cliniques, nous rapportons les deux premiers cas de réinfection par le SRAS-CoV-2 d'un hôpital tertiaire nigérian prenant en charge des patients atteints de la maladie à coronavirus 2019 (COVID-19). RÉSULTAT: Deux cas de réinfection par le SRAS-CoV-2 ont été observés en décembre 2020 et janvier 2021. Tous deux étaient des hommes associés à un établissement de soins de santé et âgés respectivement de 37 et 38 ans. Le nombre de jours entre la première infection et la seconde variait de 160 à 196 jours. Les symptômes variaient de légers à modérés et ils se sont rétablis sans séquelles. CONCLUSION: Une action de santé publique, y compris la communication des risques et la surveillance des réinfections appuyées par le séquençage génomique, est préconisée. MOTS CLÉS: COVID-19; SRAS-CoV-2; Réinfection; Nigeria; Pandémie.

Healthcare Workers' Preparedness to tackle COVID-19: A Study on Knowledge and Compliance with Standard Precautions in a Tertiary Hospital in Southern Nigeria

AJOL Abstract: Background: Hospitals may serve as amplifiers of infectious disease rates during outbreak situations. The strict implementation of and compliance with standard precautions (SPs) is the primary strategy for preventing healthcare-associated infections. This study was conducted to assess the knowledge and level of compliance with SPs in a tertiary hospital as a measure of preparedness to tackle the COVID-19 pandemic.Methods: This descriptive cross-sectional study was conducted among healthcare workers selected using stratified sampling technique in the University of Benin Teaching Hospital, Benin City, Nigeria during the COVID-19 pandemic. Data was collected using an adapted, self-administered questionnaire and analyzed using IBM SPSS version 25.0. Knowledge and compliance with SPs were assessed using six domains each. Statistical measures for analysis were the odds ratios (OR) and 95% confidence intervals (CI). The level of significance was set at p < 0.05.Results: A total of 524 respondents with mean age 38.1 ± 9.7 years participated in this study. Majority, 432 (84.2%) were female and 467 (89.1%) were clinical staff. Overall, knowledge and compliance of SPs were good in 457 (87.2%) and 293 (60.0%) respondents, respectively. Clinical health workers were 2.5 (95% CI: 1.3 - 5.1) times more likely to have good knowledge while respondents with poor knowledge were 0.5 (95% CI: 0.3 - 0.9) timesless likely to have good compliance with SPs.Conclusion: Knowledge of SPs in the studied population was high and compliance was good. Continued education and behavioural change communication are needed to improve compliance especially in the face of a pandemic

Facility-Based Surveillance Activities for COVID-19 Infection and Outcomes among Healthcare Workers in a Nigerian Tertiary Hospital

WATERLIT Abstract: COVID-19 in healthcare workers (HCWs) can result in nosocomial transmission, depletion in available workforce, and enhanced community transmission. This article describes surveillance for COVID-19 in HCWs at a tertiary healthcare facility, and documents the outcomes. A descriptive cross-sectional study of all HCWs identified from surveillance for COVID-19 from March 31 to August 31, 2020 was conducted. Healthcare workers were categorized as high risk and low risk using an adapted WHO Risk Assessment tool. Nasopharyngeal and oropharyngeal swab specimens obtained from high-risk subjects were tested by a reverse transcriptase PCR method. Data were analyzed with IBM SPSS version 25.0 software (IBM SPSS Statistics for Windows, Version 25.0, Armonk, NY), and results were presented as frequencies and percentages. The level of significance was set at P < 0.05. During 5 months of surveillance, 1,466 HCWs with a mean age of 38.1 ± 9.7 years were identified as contacts. On risk assessment, 328 (22.4%) were adjudged high risk. High risk was associated with increasing age (P < 0.001), male gender (P = 0.001), and nonclinical staff (P = 0.002). Following testing, 78 (5.3%) in the high-risk category were confirmed to have COVID-19. There was no record of COVID-19 in HCWs adjudged low risk. Forty-four (56.4%) cases were epidemiologically linked to the community, 20 (25.7%) to patients, and 14 (17.9%) to another HCW. Surveillance and risk assessment are crucial to COVID-19 response in healthcare facilities and revealed HCW infections with predominantly nonoccupational epidemiological links in this study

An Analysis of COVID-19 Patients Receiving Care in a Tertiary Facility in Southern Nigeria.

BACKGROUND: Information pertaining to the clinical characteristics of COVID-19 in sub-Saharan Africa remains sparse. In Nigeria, it is limited to few isolated reports and case series confined to the early phase of the outbreak. The objective of this study is to describe the presenting characteristics, co-morbidities and outcomes of Nigerian patients managed over a 3-month period in a tertiary hospital. METHODS: This was a descriptive cross-sectional study involving the total population of patients with laboratory confirmed diagnosis of COVID-19 in the University of Benin Teaching Hospital, Edo State, Nigeria from March 31 to June 30, 2020. Data was collected using a review of patients' records. Analysis was by IBM SPSS version 25.0. The level of significance was set at p < 0.05. RESULTS: A total of 173 patients with mean age (SD) 50.7± 20.1 years were managed. One hundred and five (60.7%) were males and the commonest age group was 20-39 years (34.7%). The commonest presenting symptoms were fever, cough and malaise found in 103 (71.5%), 101 (70.1%) and 63 (43.8%) patients respectively. Twenty-five (14.5%) patients had severe disease; 60 (34.7%) had underlying medical conditions mostly hypertension and diabetes mellitus. Outcome analyses showed 117 (67.6%) discharges, 45 (26.0%) deaths, 10 (5.8%) discharges against medical advice, and 1 (0.6%) transfer to another facility. Male sex (p=0.044), increasing age (p<0.001), presence of symptoms (p=0.010), presence of co-morbidities (p=0.010) and non-healthcare worker status (p< 0.001) were significantly associated with mortality. CONCLUSION: The first epidemiological and clinical summary of COVID-19 cases in Edo state, Nigeria over a three-month period is presented showing globally recognized patterns of male predilection and higher mortality with increasing age and co-morbidity.