Practice, Perceptions, and Prospects of Mammography Screening in Nigeria: Insights From a National Survey of Female Health Workers.

BACKGROUND: Mammography, the most preferred tool for breast cancer screening, has very poor uptake in Nigeria, even among health workers. No nationwide study has been done to ascertain this. This study sought to determine the current perceptions and practices of Nigerian female health care practitioners on mammography screening across different types and levels of health care institutions in the country's 6 geopolitical zones. METHODS: This cross-sectional online survey was conducted using Google Forms distributed among Nigerian female health workers via online professional associations and networks. Descriptive and inferential statistics were done using SPSS version 20. RESULTS: A total of 562 respondents, with mean age of 41.30 ± 9.8 years, were surveyed. About half (50.3%) were doctors, with majority practicing in southern Nigeria. A mammography screening utilization rate of 15.4% was found, with majority having their first mammography long after attaining the age of eligibility. As of the time of the survey, only 24.8% of tertiary health workers had access to functional mammography machines at their place of work. Majority of female doctors (78%) never refer eligible patients for mammography, although nearly all (98.6%) were willing to do so. About 54% of those who have had a previous mammography screening vs. 17% who have not had 1 would recommend it to others. Majority of respondents recommended annual mammography from the age of forty at a subsidized cost. CONCLUSION: Nigerian female health workers have limited access to mammography and consequently do not screen often. Efforts must be made to make 'charity begin at home'.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among health care workers in Nasarawa State, Nigeria: implications for infection prevention and control measures.

INTRODUCTION: health care workers (HCWs) are on the frontline, waging war against SARS-CoV-2 and have a higher risk of infection with exposure to an infected person with SARS-CoV-2. There is a paucity of information on clinical characteristics and infection risk gradient of HCWs with SARS-CoV-2 with the view to marshal preventive measures. METHODS: we conducted a multi-center case series analysis of 648 HCWs who were randomly selected in private and public hospitals across Nasarawa State, managing cases of SARS-CoV-2. Demographic and epidemiological information, were abstracted from electronic medical records of cases from February to July 2020. Throat and Nasopharyngeal swabs and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 nucleic acid were performed. RESULTS: overall, 134 of 648 HCWs across health centers in Nasarawa State tested positive for SARS-CoV-2. Eighty male HCWs constituted 30.9% of respondents with a median (interquartile range) age of 36.7 (30.0-47.0) years. Overall, 50 of 134 HCWs (67.5%) with SAR-COV-2 had mild disease. The five most common symptoms amongst cases were fever (67 [90.5%]), myalgia or fatigue (60 [81.1%]), cough (50[67.6%]), sore throat (50 [67.6%]), and muscle ache (50 [67.6%]). Contact with index patients (65 [59.1%]) and colleagues with infection (10 [13.9%]) as well as community-acquired infection (14 [18.9%]) were the main routes of exposure for HCWs. CONCLUSION: HCWs in Nasarawa State face an unprecedented occupational risk of morbidity and mortality as a result of SARS-CoV-2. There is need for rapid development of sustainable infection prevention control measures that protect HCWs from the SARS-CoV-2 ongoing pandemic.

Measles outbreaks and Supplemental Immunization Activities (SIAs): the Gwagwalada experience, Abuja 2015.

INTRODUCTION: In November 2015 a measles outbreak was detected in several clustered settlements during the Northern Measles Supplementary Immunization Activities (SIAs) campaign in Gwagwalada, Nigeria, a measles outbreak was detected. Six weeks later another outbreak with 17 cases was reported in a different settlement in the same area council in December 2015 and January 2016. An outbreak investigation was initiated to characterize the outbreak in terms of time and person and implement prevention and control measures. METHODS: Suspected cases were defined as any person in Gwagwalada with onset of fever and rash between 1st November 2015 and 12th January 2016. Probable cases were defined as suspected cases with 3 days of rash or known exposure to someone with laboratory-confirmed measles. Confirmed case patients were defined as suspected or probable cases with Koplik spots or positive titer for immunoglobulin (Ig) M antibody. We conducted house to house case search, contact tracing and reviewed hospital records at the health facilities to determine the socio-demographic characteristics, clinical presentation and vaccination status of the cases. RESULTS: Active case search between November 2015 and January 2016 as well as record review from January 2015 to January 2016 showed that there were 109 suspected and 10 confirmed case patients. We identified 66 cases during the first reported outbreak with a case fatality rate of 6% (4 deaths) while 17 cases were identified 6 weeks later. The epidemic curve indicated a person-to-person transmission. CONCLUSION: There had been cases of measles from January 2015 to November 2015 prior to the reported measles outbreak. However there was an unusual increase in the number of measles cases during the measles SIAs in communities where children were missed. Vaccination of all eligible children in the affected wards was carried out. The area council authorities and primary healthcare team need to create awareness on the importance of measles vaccination and ensure that these communities are targeted and covered during subsequent SIAs.

Socio-demographic and regional disparities in utilization of intermittent preventive treatment for malaria in pregnancy - Nigeria demographic health survey 2013.

INTRODUCTION: malaria in pregnancy can lead to medical emergencies. Utilization of intermittent preventive treatment for prevention of malaria in pregnancy with Sulphadoxine- Pyrimethamine (IPTp-SP) has remained low in developing countries in sub-Saharan Africa. This study aimed to identify the factors determining uptake of IPTp-SP in Nigeria using the 2013 Nigeria Demographic Health Survey. METHODS: we conducted a secondary analysis of data extracted from the National Demographic Health Survey 2013 which used a three stage stratified sampling method to select respondents. Independent variables considered were age, marital status, the level of education of respondents and their spouses, region, location of residence, wealth-index and birth order. The dependent variable was the use of two or more doses of SP for IPTp in the two years before the survey. Descriptive statistics for socio-demographic and selected characteristics was done. Chi-square test was used to test associations between sociodemographic characteristics and IPTp-SP uptake. Multiple logistic regressions at 95% confidence interval were used to determine predictors of IPTp utilization using STATA version14 software. RESULTS: of the 38,948 women interviewed 12,473 (32%) had given birth two years preceding the survey and 15% used at least two doses of SP for IPTp. Women aged 30 years and above [aOR 1.4, C.I:1.1-1.7], in the middle class or higher wealth index [aOR 1.5, CI: 1.1-2.0], with two or more ANC visits [aOR 4.2, CI: 1.4 - 12.5], were more likely to use IPTp. CONCLUSION: late initiation of IPTp after the second trimester was a contributory factor for poor SP utilization. Interventions targeted at ensuring pregnant women attend ANC and use of IPTp-SP after quickening should be promoted.