The Nigerian Military Public Health Response to COVID-19: A 14-Month Appraisal.

The COVID-19 pandemic has caused significant morbidity and mortality since its emergence in December 2019. In Nigeria, the government inaugurated the Presidential Task Force on COVID-19 to coordinate resources while the Nigeria Centre for Disease Control led the public health response. The Nigeria Ministry of Defence Health Implementation Programme (MODHIP), in partnership with the US Army Medical Research Directorate - Africa/Nigeria, responded immediately to the pandemic by establishing a public health emergency operations center to coordinate the military response in support of national efforts. MODHIP has 5 functional units and 6 pillars that coordinate testing, surveillance, case management, risk communication, logistics, research, and infection prevention and control. It developed an incident action plan and each pillar had its own terms of reference to guide specific response activities while preventing duplication of efforts within the military and the Nigeria Centre for Disease Control. In addition, awareness and sensitization sessions were conducted on preventive practices for COVID-19 and infrastructure was provided for hand hygiene and screening at all military facilities. Military laboratories were configured for SARS-CoV-2 testing while selected military health facilities were equipped and designated as COVID-19 treatment centers. Research proposals aimed at better understanding the disease and controlling it were also developed. The traditional combat role of the military was redirected to complement this public health emergency response. In this article, we highlight gaps, opportunities, and lessons to improve military participation in public health emergency response in the future. More funding and multisectoral collaboration with civilian institutions are key to strengthening military public health emergency preparedness and response capabilities.

Reference intervals of common clinical biochemistry analytes in young Nigerian adults.

BACKGROUND: Reference intervals are assessment tools for interpretation of clinical test results. These intervals describe the dispersion of test parameter values of apparently healthy persons in defined populations as health status indicators. Using reference intervals obtained and validated in populations outside the geographical region of derivation for medical decision-making may impact negatively on clinical interpretation and patient management. Many countries have established their reference values, current studies on these data for Nigeria are however scarce. Determination of clinical biochemistry reference intervals for young Nigerian adults which is of particular importance in routine clinical management and conduct of clinical trials in response to existing and emerging diseases will add significantly to the existing body of knowledge. OBJECTIVE: The objective was to establish reference intervals for 24biochemistry analytes among Nigerians aged 18 to 26 years. METHODS: This was a cross-sectional study among 7,797 consenting male and female military applicants aged 18 to 26 years from 37 States of Nigeria. It was a total study among volunteers for military service. Blood samples were collected and subjected to serological testing for HIV-1 and 2, hepatitis-B, malaria, pregnancy and haematuria to restrict our study population to apparently healthy participants. Biochemical assays were performed on 6,169 participant samples that met the inclusion criteria. Generated data was entered into MS Excel® and exported into SPSS® software version 16 for analysis. Statistical tools used were frequencies, median, mid 95th percentile range with 2.5th and 97.5th percentiles as limits. Reference intervals were estimated using nonparametric methods. No intergender statistical comparison was made. RESULTS: Complete records were obtained for 6,169 eligible participants. Median values and associated reference intervals were similar in both genders. CONCLUSION: The findings from this study will help in clinical decision-making and play a significant role in supporting the current global rapid expansion of clinical trials in response to the urgent need for preventive and therapeutic solutions to existing and emerging diseases.

Establishment of reference values for selected haematological parameters in young adult Nigerians.

BACKGROUND: Haematological reference values are necessary for accurate diagnosis of diseases, clinical decision-making, treatment monitoring and clinical research. Due to unavailability of pan-Nigerian reference values, local results interpretation is based on the use of Western values. OBJECTIVE: This study aims to establish national reference values for some haematological parameters in apparently healthy young adult Nigerians. METHODS: Seven Thousand, Seven Hundred and Ninety-Seven (7,797) volunteers aged 18 to 26 years participated in the study. Participants' interviewer-administered questionnaires and blood samples were collected, analyzed and those with confounding factors (HIV infection, Hepatitis B sero-positivity, Malaria and Pregnancy) were excluded from statistical analysis. The 95-percentile reference range was determined for each haematological parameter using SPSS Version 16®. The result obtained was reviewed with reference to already established reference values in two West African and Western countries. RESULTS: Blood specimens from 6153 (78.9%) participants [comprising 5915 (96.1%) males and 238 (3.9%) females] were analyzed after exclusion of 1,644 (21.1%) participants with confounding variables. Reference ranges among males and females varied and these were consistent with findings from two other West African countries. The median platelets count in this study was 218 x 109/l while commonly used Western value is 280 x 109/l. Other haematological parameters in the study were similar to Western values. CONCLUSION: The findings of this study will improve clinical and research decision-making. Considering that this study is limited to young adult participants, there is a need to conduct future pan-Nigerian studies that will include all age groups.

Serum Creatine Kinase-MB Isoenzyme Activity among Subjects with Uncomplicated Essential Hypertension: Any Sex Differences.

Hypertension (high blood pressure) is a major health challenge and more women than men are affected by the condition. Complications as a result of this condition often lead to disabilities and premature death. The objective of this study was to evaluate creatine kinase-MB (CK-MB) activity in uncomplicated hypertension and to know whether sex differences exist in the activity of the enzyme. Serum creatine kinase-MB isoenzyme activity, troponin I, and lipid profile were evaluated in 140 male and 100 female Nigerians with hypertension. The control group was comprised of 100 (50 males and 50 females) normotensive subjects. Measured parameters were assayed using Selectra Pros chemistry analyzer. The means were compared between males and females using Students't-test. The mean CK-MB activity of the female hypertensive subjects was significantly higher (p < 0.001) than the males. Similarly, the mean cardiac troponin I (cTnI) of the female hypertensive subjects was significantly higher (p < 0.001) than the males. Conversely, the mean CK-MB activity of the female normotensive subjects was significantly lower (p < 0.001) than the male counterparts. There was no difference in the levels of cTnI between male and female normotensive subjects. Serum CK-MB activity was higher in female than male hypertensive subjects. In the light of these results, cardiac markers should be routinely done in the evaluation of hypertensive subjects and sex-specific consideration may be recognized in the management of these patients.