Knowledge, attitude and perception of medical students on COVID-19 vaccines: A study carried out in a Nigerian University.

Objective: Vaccine development, distribution, and immunization of large populations have been identified as vital mitigation strategies for curbing the spread of COVID-19. However, vaccine hesitancy is a major barrier to this. The knowledge and perception of COVID-19 vaccines can improve vaccine acceptance. The purpose of this study was to assess medical students' knowledge, attitude, and perception of COVID-19 vaccines. Methods: This study was a cross-sectional web-based survey conducted among undergraduate students from the faculties of Basic medical sciences and Clinical sciences, University of Uyo, Akwa Ibom State, Nigeria. The students' knowledge was ranked as excellent (>70%), good (50-69%) and poor (<50%) while perception was categorized into positive (>50%), and negative (<50%). The difference in knowledge based on demographics was analyzed using the Independent sample t-test. The association between demographics, and students' perception was carried out using the Chi-square and Fisher's Exact tests. Analyses were conducted using SPSS software version 25. Results: A total of 233 students consented to participate in the study out of which 51.1% were female. Forty-eight students (20.6%) had good knowledge while 41.2% of the participants accepted to take the COVID-19 vaccine. Positive perception was reported among 51.1% (119) of the students. Conclusion: There was poor knowledge and positive perception among majority of the students. Educational intervention in form of training should be done to improve medical students' knowledge and perception toward COVID-19 vaccination.

Microbial contamination of packaged drinking water in Nigeria.

OBJECTIVES: About 18% of urban households in Nigeria depend on packaged sachet water as the primary source of drinking water. This review assessed microbial contamination of these products with an emphasis on total coliforms and the faecal indicator bacteria (FIB) - Escherichia coli (E. coli) and thermotolerant coliforms (TTC). METHODS: PubMed/Medline, African Index Medicus, AfroLib, Global Health Library, Embase and the ISI Web of Science databases were searched to identify original research published up to October 2020. The literature findings were synthesised narratively in line with the review objectives. To assess prevalence of microbial contamination, a random effects meta-analysis, was also conducted using the R metafor package in RStudio. The protocol for this review is registered on PROSPERO with reference number CRD 42019128474. RESULTS: Fifty-two of 429 studies were identified for inclusion. At 53.27%, contamination prevalence was higher for total coliforms (95% CI: 39.05-66.98, I2  = 81%, p < 0.01, 42 studies) than FIB (12.38%, 95% CI: 7.92-18.85, I2  = 61%, p < 0.01, 33 studies) suggesting that treatment failure is a major contributor to the poor microbial quality reported in the included studies. Within the FIB group, the prevalence of contamination with E. coli was 13.30% (95% CI: 8.23-20.80, I2  = 65%, p < 0.01, 27 studies) versus 6.24% (95% CI: 1.12-28.06, I2  = 72%, p < 0.01, six studies) for TTCs. Other microbial contaminants reported were Pseudomonas aeruginosa, Klebsiella and Enterococcus faecalis and these showed multidrug antibiotic resistance. CONCLUSIONS: The findings of this review highlight the need for improved regulatory oversight with more stringent monitoring of the microbial quality of sachet water products in Nigeria.

Clinical pharmacy services provided in public sector hospitals in Nigeria: a national survey.

OBJECTIVES: Studies show that clinical pharmacy services are effective in optimizing medicines use and patients' outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria. METHODS: This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively via χ 2 test and multivariate analysis of variance (MANOVA). KEY FINDINGS: Responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary and in only 6% of the PHCs surveyed. Most of the secondary and tertiary care hospitals provided medicines information, patient education and counselling, and in-patient dispensing services [n = 97 (79%), 116 (94%), 88 (72%)], respectively. However, fewer than a third reported involvement in multidisciplinary ward rounds, medication chart review and antibiotic stewardship programmes [n = 18 (15%), 33 (27%), 22 (18%), respectively]. Furthermore, medication error reporting and pharmacovigilance services were each routinely provided in only about half of the secondary and tertiary care hospitals [n = 62 (50%)], and this was not associated with the level of care (P > 0.05). CONCLUSIONS: The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria and emphasize the need to prioritize their integration within the primary care sector.

Consumer and Community Pharmacists' Perceptions of Online Pharmacy Services in Uyo Metropolis, Nigeria.

BACKGROUND: Online pharmacies benefit consumer healthcare experience through affording convenience, efficiency, greater confidentiality, and improved access to medicines. There are several online pharmacies in Nigeria, however, studies about their use as well as consumer and pharmacists' perceptions of the service are lacking. OBJECTIVE: This study aimed to evaluate community pharmacists' and consumer perceptions of online pharmacy services (OPS) in Uyo metropolis, Nigeria. METHOD: This was a cross-sectional survey involving community pharmacists and consumers. The survey instrument was a structured, self-administered questionnaire. Survey data was analysed descriptively using frequencies and percentages while X2 was used to evaluate association between variables. RESULTS: In total, 60 community pharmacists and 500 consumers replied to the survey. Although the majority (>85%) of the survey respondents reported frequent internet use, only about a third (28%) of the consumers and 57% of the pharmacists were aware of the availability of online pharmacy services in Nigeria. In general, majority of the consumers were positive about using online pharmacies with approximately two thirds (67%) indicating that they would consider purchasing medicines from the service in future. Also, 83% of the consumers indicated that access to online drug information and medicine advice via the service will be valuable. There was a significant (P <0.05) association between consumers' online shopping behaviour and their likelihood to use the service. Also, majority (92%) of the community pharmacists in this survey agreed that online pharmacies promote pharmaceutical care and this perceived need was associated with their likelihood to provide the service in future (p=0.002). Consumer concerns about the service included the risk of substandard and counterfeit medicines, internet security, unavailability of prescribed brands, chances of ordering wrong medicines and uncertainty about timely delivery. CONCLUSION: Overall awareness of the availability of online pharmacy services in Nigeria is limited in the survey population despite reported frequent internet use in this cohort. Generally, our findings suggest the potential for future uptake of online pharmacy services and highlight the need for a standardised approach to service provision as well as a regulatory framework to improve consumer confidence and alleviate the concerns raised.