Physician-brief advice for promoting smoking cessation among cancer patients on treatment in low and middle-income countries: a scoping review.

INTRODUCTION: Physician-brief advice has been utilized in high-income countries to promote smoking cessation among cancer patients. Empirical evidence on its effectiveness among cancer patients in low and middle-income countries (LMICs) is lacking. The gap could be due to inadequate training, and competing healthcare priorities, leading to insufficient implementation of targeted smoking cessation interventions in oncology settings. We undertook this scoping review to determine if physician-brief advice is effective in promoting smoking cessation among cancer patients in LMICs. METHODS: We conducted a literature search of all relevant articles across five databases: Cochrane Central Register of Controlled Trials, Cochrane Library (Tobacco Addiction Group trials), World Conference on Lung Cancer proceedings, PubMed, and Google Scholar up to November 2023, using pre-defined inclusion criteria and keywords. The study population was cancer survivors in LMICs, the intervention was smoking cessation advice by a physician in a clinic or oncology center during a consultation, and the outcome was the effect of smoking cessation programs in discontinuing smoking among cancer survivors in LMICs. RESULTS: Overall, out of every 10 cancer patients in LMICs, about seven were smokers, and one-half had received physician-brief advice for smoking cessation. Physician-brief advice was more likely to be delivered to patients with smoking-related cancer (Cohen's d = 0.396). This means that there is a noticeable difference between patients with smoking-related cancer compared to those with cancer unrelated to smoking. Smoking cessation failure was due to the inability to cope with the symptoms of withdrawal, missed smoking cessation clinic visits, mental health disorders, limited time and resources, and minimal patient-physician contact. CONCLUSION: There is very little literature on the frequency of use or the efficacy of physician-brief advice on smoking cessation in LMICs. The literature suggests that cancer patients in LMICs have low self-efficacy to quit smoking, and smoking cessation is rarely part of cancer care in LMICs. Physicians in LMICs should be trained to use motivational messages and good counseling techniques to improve smoking cessation among cancer patients. Policymakers should allocate the resources to implement physician-brief advice and design training programs for physicians focusing on physician-brief advice tailored to cancer patients.

Food insecurity and associated factors among households with under-5 children in slum communities in Ibadan, Nigeria.

INTRODUCTION: Food insecurity is a leading cause of childhood morbidity and mortality. This study assessed the prevalence of household food insecurity and its associated factors among under-5 children in Ibadan, Nigeria. METHODS: This was a cross-sectional household survey of 1,027 under-5 children and their caregivers in urban and rural slums in Ibadan. We used an electronic interviewer-administered, semi-structured questionnaire adapted from the Nigeria Demographic Health Survey and Household Food Insecurity Access Scale was used to report sociodemo-economic characteristics, food insecurity, and anthropometric measurement. The household food insecurity scale consisted of nine questions graded from 0 (Never) to 3 (Often) computed to determine the presence of food insecurity. Nutrition indices were computed, and the results were classified according to World Health Organization 2006 cut-off points. Chi-square tests were used to assess associations between food insecurity and the independent variables. Binary logistic regression analyses were conducted to identify the predictors of food insecurity (α = 0.05). RESULTS: The mean ages of the caregivers and under-5 children were 31.7 ± 7.47 years and 34.49 ± 15.8 months respectively. Overall, 530 (51.7%) children were females, and 765 (74.5%) had normal weight for height. In all, 195 (19.0%) households had food insecurity, while 832 (81.0%) households had food security (Chi-square = 103.364, p = < 0.001). Under-5 children living in urban slums were seven times more likely to experience household food insecurity compared to those in rural slums (AOR = 6.859, 95%CI = 4.524-10.509, p = < 0.001). DISCUSSION: Household food insecurity was more prevalent in urban slums. Strengthening of the school health program would help identify children with nutritional deficits, and improve the overall health status of children living in slum communities.

Driving the implementation of the National Health Act of Nigeria to improve the health of her population.

The Nigerian government has previously implemented policies to achieve universal health coverage, however, only few are health-insured. In 2022, the President of the Federal Republic of Nigeria passed the bill for the National Health Insurance Act. As a result of this development and the ensuing target of providing health insurance to all Nigerians by 2030, efforts to combat the high prevalence of poverty caused by out-of-pocket medical expenses while engaging with State Health Insurance Agencies are now more feasible than ever. Health insurance is now required for all Nigerians and legal residents. This article thus aimed to outline strategies to ensure that the National Health Insurance Act contributes positively to the health and well-being of Nigerians.

Knowledge of community members on COVID-19 in Ibadan, Oyo State, Nigeria.

INTRODUCTION: more cases of COVID-19 continue to be reported in Nigeria. The level of knowledge could prompt individuals to take precautionary measures and reduce the spread. This study aimed to assess the knowledge of community members in Ibadan on COVID-19. METHODS: using a descriptive cross-sectional study design, an interviewer-administered semi-structured questionnaire was used to obtain information from adult community members. Multistage sampling methods were used to select respondents from four local government areas (LGAs). Knowledge scores of causes, mode of spread, signs and symptoms and preventive measures were computed. Scores above the mean were categorized as satisfactory. Bivariate chi-square tests and binary logistic regression were performed on respondents' characteristics and knowledge of COVID-19. RESULTS: respondents interviewed were 480 with a median age of 32 years (range: 18-80 years), and 191 (39.8%) aged between 25 and 34 years. Females were 275 (57.3%), 18 (3.8%) had never heard of COVID-19. The main source of information was radio 88.1% and television 54.3%. In all the knowledge domains 200 (43.3%) had satisfactory knowledge of COVID-19. Respondents in Ibadan North-West LGA had five times odds [OR=5.23 (95%CI=2.87-9.54)] of having satisfactory knowledge of COVID-19 while respondents in Ibadan North-East LGA had three times odds [OR=3.35 (95%CI=1.85-6.09)] compared to those in Ibadan South East LGA. CONCLUSION: an even dissemination strategy of COVID-19 information across the communities is required. More sensitization and health education sessions should be broadcast on the radio and television. Regular COVID-19 broadcast is required to improve the knowledge level of community members.

Handling Distrust on Risk Communication in Nigeria: A Strategy to Strengthening the COVID-19 Outbreak Response.

BACKGROUND: This study aimed to assess the level of trust in the Coronavirus disease 2019 (COVID-19) risk communication efforts in Nigeria. METHODS: We conducted a descriptive cross-sectional study among community members aged 15 years and above in Ondo State in October, 2020. Data were collected using an interviewer-administered questionnaire, and analyzed using SPSS version 22. Descriptive statistics were summarized using frequencies. Trust was ranked from "1" suggesting "Low level of trust" to "7" denoting "High level of trust". We conducted Chi-square test between respondents' level of trust in the Nigeria Centre for Disease Control (NCDC) and socio-demographic characteristics. The level of significance was set at p < 0.05. RESULTS: Among the 691 respondents, 244 (35.3%) were aged 21 to 29 years, and 304 (51.4%) accessed COVID-19 information through the NCDC. Overall, 205 (41.8%) had high level of trust in the NCDC, and 51 (51.5%) individuals aged 30-39 years had high level of trust in the NCDC (χ2 = 17.455; p = 0.001). Also, 114 (48.5%) persons who lived with children below 18 years had high level of trust in the NCDC (χ2 = 8.266; p = 0.004). CONCLUSION: Policy-makers should prioritize the involvement of young and educated persons in COVID-19 risk communication strategies.

Dealing with vaccine hesitancy in Africa: the prospective COVID-19 vaccine context.

The outbreak of the novel coronavirus disease (COVID-19) has resulted in many cases of morbidity and mortality across the globe, and the lack of the COVID-19 vaccine has contributed greatly to this experience. COVID-19 vaccines have currently been rolled out, and are available in some countries. However, strategies need to be put in place to prevent COVID-19 vaccine hesitancy (VH) especially in Africa; a continent where VH has been previously reported following the introduction of new vaccines. For this cause, we, therefore, recommend optimal community involvement in the structure and modalities for the delivery of the prospective COVID-19 vaccine. Also, feedback mechanisms for the acknowledgement of community efforts in previous health interventions should be improved upon to encourage the acceptance of the prospective COVID-19 vaccine. In addition, improved multi-sectoral collaboration should be initiated and promoted to enhance the acceptance of COVID-19 vaccines through the provision of more resources required to address COVID-19 VH. Furthermore, integration of the COVID-19 vaccine into the routine immunization schedule would strengthen the health system, improve uptake of the COVID-19 vaccine, and improve the health of all persons living on the African continent.

Coping with the third wave of the COVID-19 pandemic in Africa: implications for an improved outbreak response.

The third wave of the COVID-19 pandemic has commenced. To avert increase in cases and avert preventable deaths, community engagement strategies such as the promotion of vaccination, voluntary testing and debunking of COVID-19-related rumors need to be undertaken.

Addressing COVID-19 vaccine hesitancy: Lessons from the role of community participation in previous vaccination programs.

The acceptance of the coronavirus disease 2019 (COVID-19) vaccine has been described as a gateway to attaining herd immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The critical role of community participation (CP) has been successfully demonstrated in previous vaccination programs globally. This perspective therefore aimed to describe how CP could be used to promote COVID-19 vaccination acceptance. To promote COVID-19 vaccine acceptance, it is required that a mapping of community assets, resources, civil-based organizations, and stakeholders is done to gain insight into the community culture and value in relation to COVID-19 vaccine. This will help to address the misconceptions while prompting COVID-19 vaccination sensitization activities that are relevant to each community. It is required that policy makers understand that the adoption of a comprehensive grassroots approach lends a voice to the community and helps to utilize community-initiated and community-driven ideas on promoting COVID-19 vaccine acceptance.

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.

The experiences of healthcare workers during the COVID-19 crisis in Lagos, Nigeria: A qualitative study.

INTRODUCTION: The novel coronavirus (COVID-19) pandemic has overwhelmed health systems globally. Healthcare workers (HCWs) are faced with numerous challenges during the COVID-19 response. In this study, we aimed to describe the experiences of HCWs during the COVID-19 outbreak in Lagos, Nigeria. METHODS: We conducted a qualitative study on the experiences of frontline HCWs at the COVID-19 isolation centers in Lagos, Nigeria using purposive and snowballing sampling techniques. An in-depth interview which lasted for 25-40 minutes for each respondent was conducted among ten medical officers and four nurses between 15th June and 13th July 2020. We analyzed data using Colaizzi's phenomenological method. RESULTS: Respondents' age ranged between 29 and 51 years with a median age of 36.5 years. Four themes were identified from data analysis. In the first theme, "COVID-19 care: A call to responsibility", HCWs expressed optimism regarding COVID-19 care, and described the work conditions at COVID-19 isolation centers. In the second theme, "Challenges encountered while caring for COVID-19 patients - coping strategies", HCWs experienced difficulties working in a new environment and with limited resources. They however coped through the available support systems. Regarding the "Experiences in COVID-19 care", the feelings of HCWs varied from pleasure on patients' recovery to distress following patients' demise. On the "Necessities in COVID-19 care", HCWs identified the need for increased psychosocial support, and adequate provision of material and financial support. CONCLUSIONS: HCWs at COVID-19 isolation centers need to be assured of a safe working environment while providing them with a strengthened support system.

COVID-19 pandemic response fatigue in Africa: causes, consequences, and counter-measures.

A notable decline in adherence to COVID-19 preventive measures has been observed despite the increasing number of cases following the suspension of lockdown measures. The African governments have positively responded to the COVID-19 pandemic in previous times, however presently the COVID-19 response on the African continent is in a state of fatigue. Therefore, public vigilance on COVID-19 needs to be reinvigorated through behavioral change communication via different channels of disseminating information. In addition, support systems and social protection should be established to address the COVID-19 pandemic fatigue. Also, increased funding should be made available for enhancing the COVID-19 outbreak response.