Knowledge, attitude and adherence to COVID-19 prevention among community health workers in Nigeria.

Introduction: community health workers play important roles in curtailing the spread of COVID-19. This study therefore investigated the knowledge, attitude and adherence to practice of COVID-19 prevention-protocols among community health workers in selected States of Nigeria. Methods: purposive sampling method was adopted. A cohort of community health workers testing and enrolling human immunodeficiency virus (HIV) positive-clients into care were involved in the study. Questionnaire on Microsoft forms was completed by 366 participants. Data were analyzed using descriptive and inferential statistical methods. Results: key findings revealed that 87.80% have good knowledge of COVID-19; 96.10% positive attitude towards COVID-19 prevention-protocols and 97.20% adhere to the protocols. Demographics variables have significant positive effect on adherence to COVID-19 prevention-protocol among the respondents as follows: marital status (X2: 21.91; p: <0.05), gender (X2: 9.01; p: 0.003), ethnic group (X2: 17.45; p: <0.05), State of residence (X2: 32.51; p: <0.05), education status (X2: 18.44; p: 0.005). Findings revealed there is no significant relationship between knowledge of COVID-19 and the anxiety status of community health workers (p=0.90). There is positive relationship between knowledge of COVID-19 and attitude to guidelines and adherence to COVID-19 prevention-protocols. R=0.20 (<0.05) and 0.195 (<0.05) respectively. Conclusion: the high knowledge of COVID-19, positive attitude and adherence to the prevention-protocols among community health workers provides assurance of their ability to provide factual information to the community and their ability to promote good attitude and adherence to the prevention-protocols. Key sociodemographic variable like marital status, gender, ethnic groups, educational status and State of residents play significant roles in adherence to COVID-19 prevention-protocols.

Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children.

Paediatric HIV-infected patients have higher risk of developing resistance to antiretroviral drugs, and from public health perspective, drug resistance remains a limiting factor for effective management of HIV infection in children. We reviewed the current evidences available on the antiretroviral treatment and resistance patterns in HIV-infected children. Prevalence of HIV drug resistance varied among the three main classes of antiretroviral drugs, namely nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors in both treatment naïve and treatment-experienced children in different countries. Most of the patients with extensive triple-class drug-resistant mutations were found to be considerably exposed to the three main classes of antiretroviral agents. Identification of genetic factors linked with susceptibility to perinatal transmission of HIV may be key in understanding the development of resistance due to waning antiviral effectiveness. Children who were less likely to achieve viral re-suppression were more likely to have resistance mutations. Newer drugs such as etravirine can be used as alternatives in case of resistance to efavirenz while newly developed diagnostic method such as next-generation sequencing is a platform for improving quality of detections especially minor variant drug resistance mutations.