The role of Nigerian medical students in the HIV response: lessons from the COVID-19 pandemic.

Background: With the advent of the COVID-19 pandemic, this study seeks to understand how medical students' involvement in the HIV response during the COVID-19 pandemic - as well as before and after it - has influenced their decision to specialise in HIV care and their participation in HIV-related activities in the future.Method: Quantitative and qualitative approaches were utilised among medical students from Ambrose Alli University in their fourth, fifth and sixth years of study respectively. Data from this study was analysed using the SPSS version 21 module for descriptive statistics.Results: Medical students were more involved in community-based HIV awareness campaigns (48.6%) during the pre-COVID era, but then became more involved in online awareness campaigns (55%). Only 8.6% were involved in HIV research and evaluation activities. Over 31.2% of respondents were interested in specialising in HIV-related fields, with 23.6% attributing their decision to the COVID-19 pandemic. 92.3% of the respondents were of the opinion that medical students need to become more involved in HIV-related activities. There was statistical significance between the year of study of respondents and awareness of HIV-related activities (p < 0.007). Focused discussions revealed that all students felt that medical students should be more involved in HIV-related activities.Conclusion: Our results suggest that the COVID-19 pandemic marginally boosted the number of medical students involved in online awareness campaigns for HIV and AIDs, but there was decreased involvement in community campaigns and participation in community HIV testing. The impact of these findings on the lives of people living with HIV needs further investigation.

The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection.

BACKGROUND: Early diagnosis, prompt treatment, and disease containment are vital measures in the management of Lassa fever (LF), a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, the gold standard for diagnosis, is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF. PATIENTS AND METHODS: A prospective case-control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM. RESULTS: Of the 37 confirmed cases of LF infection by RT-PCR, 21 (57%) were IgM positive. Amongst the 35 confirmed negative cases (control group), eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57% and 77% respectively. The negative and positive predictive values of the IgM serological assay were 63% and 72%, respectively, while the efficiency of the test was 67%. CONCLUSION: The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and, hence, the need for a reliable LF "rapid screening kit" since RT-PCR is unavailable in most centers. In the interim, "high clinical index of suspicion," irrespective of IgM status, requires urgent referral to confirmatory centers.

The Sensitivity and Specificity of Lassa Virus IgM by ELISA as Screening Tool at Early Phase of Lassa Fever Infection

"Background: Early diagnosis; prompt treatment; and disease containment are vital measures in the management of Lassa fever (LF); a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test; the gold standard for diagnosis; is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF. Patients and Methods: A prospective case-control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM. Results: Of the 37 confirmed cases of LF infection by RT-PCR; 21 (57) were IgM positive. Amongst the 35 confirmed negative cases (control group); eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57 and 77 respectively. The negative and positive predictive values of the IgM serological assay were 63 and 72 ; respectively; while the efficiency of the test was 67. Conclusion: The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and; hence; the need for a reliable LF ""rapid screening kit"" since RT-PCR is unavailable in most centers. In the interim; ""high clinical index of suspicion;"" irrespective of IgM status; requires urgent referral to confirmatory centers."