Describing the Epidemiology of COVID-19 in Nigeria: An Analysis of the First Year of the Pandemic.

We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were obtained from Nigerian Centre for Disease Control. By 21 March 2021, 161,737 people were confirmed positive for SARS-COV-2. Overall, testing rates were 0.8% of the population, with positivity rates of 9.6%, complete recovery rates without longterm sequelae of 91.4%, and case fatality rates of 1.3%. Most Nigerian regions contributed to figures for cases and deaths in 2021. The picture may change as testing is scaled up to include community testing. Given so-called "pandemic fatigue" among the general population, various conspiracy theories being prevalent, and the recent introduction of COVID-19 vaccines in Nigeria, we assume that Nigeria is at a pivotal stage of the outbreak. Effort must be made by government to learn successful strategies in other countries to adapt to prevent a rise in case numbers and deaths.

Perceptions and opinions of Nigerians to the management and response to COVID-19 in Nigeria.

INTRODUCTION: we present a qualitative analysis of opinions of the Nigerian general public as to how successful healthcare strategies have been in containing the COVID-19 outbreak. METHODS: an online qualitative survey was conducted, consisting of 30 semi-structured questions. RESULTS: four hundred and ninety-five (495) respondents participated, ranging in age from 18 to 59 years. Over 40% of all respondents were critical of public health information. Participants saw provision of social support measures (n = 83), lack of economic, financial and social support (n = 65), enforcement of restrictions on movement outside the home, availability of face-masks and social distancing (n = 53) and provision of COVID-19 testing (n = 48) as the major things that were handled poorly by the government and health authorities. CONCLUSION: we advocate coordinated forward planning for public safety until vaccines are widely available; while social distancing should continue. Policymakers need to be adaptable to changing conditions, given fluctuating case numbers and fatality rates.

Public perception of COVID-19 management and response in Nigeria: a cross-sectional survey.

OBJECTIVES: A study designed to assess the public perception of the response of government and its institutions to the COVID-19 pandemic in Nigeria. SETTING: Self-selecting participants throughout Nigeria completed a self-administered questionnaire through an online cross-sectional survey. PARTICIPANTS: 495. RESULTS: The majority of respondents were married (76.6%), were males (61.8%), had tertiary level education (91.0%), were public servants (36.8%), Christians (82.6%), and resident either in the Federal Capital Territory (Abuja) (49.1%) or in the South-East Region of Nigeria (36.6%). Over 95% of the respondents had heard of COVID-19 (98.8%) and knew it is a viral disease (95.4%). The government and its institutions response to the pandemic were rated as poor, with the largest rating as poor for Federal President's Office (57.5%). Communication (50.0%) and prevention messages (43.7%) received the highest perception good rating. Female respondents and those less than 40 years generally rated the governmental responses as poor. CONCLUSIONS/RECOMMENDATIONS: It is recommended that as a public-private partnership approached was efficiently used to more effectively disseminate public health communication and prevention messages, the Nigerian Government should expand this collaboration to improve the quality of services provided in other areas of COVID-19 outbreak management.

COVID-19 Experience: Taking the Right Steps at the Right Time to Prevent Avoidable Morbidity and Mortality in Nigeria and Other Nations of the World.

The 2020 Coronavirus pandemic has caused countless governmental and societal challenges around the world. Nigeria, Africa's most populous nation, has been exposed in recent years to a series of epidemics including Ebola and Lassa fever. In this paper, we document our perception of the national response to COVID-19 in Nigeria. The response to the pandemic is with a healthcare system that has changed as a result of previous infectious disease outbreaks but in the context of scarce resources typical of many low-middle income countries. We make recommendations regarding what measures should be in place for future epidemics.

Assessment of the effectiveness of PMTCT program in eight service delivery points in North Central Nigeria.

BACKGROUND: Mother-to-child transmission (MTCT) of HIV is one of the commonest avenues through which infants are infected with HIV. To achieve an HIV-free generation, MTCT of HIV should be eliminated. Nigeria began prevention of mother-to-child transmission (PMTCT) services 13 years ago, but it still contributes to over one-third of global MTCT burden. We set out to explore and define the effectiveness of PMTCT in selected sites in North Central Nigeria. METHODS: We conducted a retrospective secondary data analysis at eight service delivery points in two states. One thousand four hundred and fifty-four mother-infant pair data sets from 2012 to 2016 were extracted and analyzed. Maternal/infant antiretroviral (ARV) services, early infant diagnosis (EID), and final outcomes were reviewed to examine the predictors of MTCT of HIV in these centers. RESULTS: We retrieved 1,454 mother-infant pair data sets. While 89.5% (1,302) of positive pregnant women (PPW) and 92.2% (1,340) of HIV-exposed infants (HEIs) received ARV prophylaxis/ARV treatment (ART), 88.4% (1,285) infants were breastfed with 32.5% still receiving breast milk at the time of dry blood spot (DBS) collection. EID PCR positivity rate was 3.5% (range, 0.0%-11.1%). Facility of delivery (χ2=24.99, P<0.00), mother on ARV (χ2=48.8, P<0.00), mother having received ARV prophylaxis (χ2=89.59, P<0.00), infant having received ARV prophylaxis (χ2=58.56, P<0.00), and baby having received cotrimoxazole (χ2=55.24, P<0.00) all significantly prevented positive EID results. However, mode of delivery and breastfeeding were not significantly associated with positive EID results. CONCLUSION: This study supports PMTCT services as it minimizes the transfer of HIV from infected mothers to HEIs. To eliminate HIV and achieve zero new HIV infections, every HIV-positive pregnant woman should receive ARV prophylaxis and should be supported postdelivery to prevent transfer of infection to the newborn. Also, HEIs should receive timely ARV and cotrimoxazole prophylaxis.

Is malaria over-diagnosed? A world malaria day 2017 experience by Excellence and Friends Management Care Centre (EFMC) and partners, Abuja Nigeria.

Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Africa. WHO-sponsored World Malaria Day activity has helped to improve education and has contributed to a reduction in mortality globally in the past decade. However, much needs to be done still in Africa. We report on a World Malaria Day scheme in three primary Healthcare Facilities in and around the Abuja Federal Capital Territory in Nigeria in 2017. Activity included educational talks to pregnant women and nursing mothers of young children, with malarial testing, distribution of free mosquito nets and also medical treatment if needed. We found a large clinical over-diagnosis of malaria with simple fevers of any cause being reported as malaria. None of these cases were found to be due to malaria on formal malarial testing. We conclude that efforts should continue into education and prevention of malaria with insecticide-impregnated mosquito nets a key factor. However, over-diagnosis of malaria and the use of unnecessary antimalarial treatment may lead to parasite resistance to antimalarial treatment, morbidity from drug side-effects and potential mortality from not receiving the right treatment for other febrile illnesses. We recommend that malarial testing, particularly with simple blood film microscopy is implemented more widely across Africa, as it is simple to perform and allows effective management plans to be drawn up for individual patients.

Commonization of HIV/AIDS services in Nigeria: the need, the processes and the prospects.

INTRODUCTION: With the first case of Human Immunodeficiency Virus infection/Acquired Immunodeficiency Syndrome (HIV/AIDS) identified in 1986, the management of HIV/AIDS in Nigeria has evolved through the years. The emergency phase of the HIV/AIDS program, aimed at containing the HIV/AIDS epidemic within a short time frame, was carried out by international agencies that built structures separate from hospitals' programs. It is imperative that Nigeria shifts from the previous paradigm to the concept of Commonization of HIV to achieve sustainability. Commonization ensures that HIV/AIDS is seen as a health condition like others. It involves making HIV services available at all levels of healthcare. METHODS: Excellence & Friends Management Consult (EFMC) undertook this process by conducting HIV tests in people's homes and work places, referring infected persons for treatment and follow up, establishing multiple HIV testing points and HIV services in private and public primary healthcare facilities. EFMC integrated HIV services within existing hospital care structures and trained all healthcare workers at all supported sites on HIV/AIDS prevention, care and treatment modalities. RESULTS: Commonization has improved the uptake of HIV testing and counseling and enrolment into HIV care as more people are aware that HIV services are available. It has integrated HIV services into general hospital services and minimized the cost of HIV programming as the existing structures and personnel in healthcare facilities are utilized for HIV services. CONCLUSION: Commonization of HIV services i.e. integrating HIV care into the existing fabric of the healthcare system, is highly recommended for a sustainable and efficient healthcare system as it makes HIV services acceptable by all.