Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020-October 2021: a retrospective analysis of national surveillance data.

OBJECTIVES: Nigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic. DESIGN: A retrospective analysis of national surveillance data. SETTING: 33 of 37 states (including the Federal Capital Territory) in Nigeria. PARTICIPANTS: Persons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data. OUTCOME MEASURES: Attack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs. RESULTS: Overall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5-14 years and women aged 25-44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96). CONCLUSIONS: Cholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country.

COVID-19 Pandemic Lockdown Discourse: A Review of Some Contending Human Rights Issues (preprint)

The paper examined the human rights issues associated with COVID-19 pandemic lockdown restriction in Nigeria. With the aid of secondary data obtained from official documents, reports and other literature on the subject matter, the paper found that there were reports of human rights violations at different levels which were encapsulated in three concentric circles namely right to life and duty to protect, right to health and access to healthcare and freedom to movement. The paper discussed the issues associated with these rights during the COVID-19 pandemic lockdown. It was found that there was little or no considerations for the necessary parameters of necessity and proportionality when national lockdown restrictions were made. This subsequently raised the call for review of the national emergency laws and setting up of monitoring committee during national emergencies. Other recommendations included taking necessary actions to guarantee freedom of expression during national emergencies and provision of stimulus packages and other palliatives to the most vulnerable in the society.

Media Systems and the Coverage of COVID-19 Pandemic: Assessment of Emerging Issues (preprint)

The COVID-19 pandemic received enormous media coverage from the very beginning when it was first noticed in Wahan, China in December 2019. The media system which was usually defined by existing state political system radically changed during the COVID-19 period due to the rise of digital media. A new media system emerged with robust communicative power. The paper used secondary data (document analysis) to descriptively analyzed issues that arose from media systems coverage of the COVID-19 pandemic. These issues included emergence of a new media/medicine relations, the change in pattern of health news consumption and persistent public fear and panic. The paper recommended for a regulatory framework for telehealth service delivery, governments engagement of the public using social media platform and development of real-time alerts system for public health officials to respond quickly to misinformation during pandemics.