Clinical guidelines for managing hearing loss as a complication of drug-resistant tuberculosis treatment: an evaluation of implementation fidelity in Kano, Nigeria.

BACKGROUND: Nigeria has a high burden of Tuberculosis (TB) including Drug-resistant Tuberculosis (DR-TB) and hearing loss. Despite several efforts directed toward its control, many patients fail to respond to treatment, having developed DR-TB. Lack of adherence to the DR-TB guidelines/improper implementation of the guideline has been identified as one of the factors impeding on effective treatment. This study sought to measure the implementation fidelity of health workers to management guidelines for hearing loss resulting from DR-TB treatment and to identify its determinants. METHOD: A questionnaire-based cross-sectional study was conducted at the Infectious Disease Hospital, Kano. Implementation fidelity of the Programmatic Management guidelines for the treatment of Drug-resistant Tuberculosis was measured under the four domains of content, coverage, duration and frequency. The determinants examined are intervention complexity, facilitation strategies, quality of delivery and participant responsiveness as proposed by the Carroll et al. framework. Other determinants used are age, sex, professional cadre and work experience of healthcare providers. RESULTS: The Implementation fidelity score ranged from 40 to 64% with a mean of 47.6%. Quality of delivery, intervention complexity, participants' responsiveness, and being a medical doctor exerted a positive effect on implementation fidelity while facilitation strategy, age and work experience exerted a negative effect on implementation fidelity. CONCLUSION: The implementation fidelity of management guidelines for hearing loss resulting from DR-TB treatment was low. Implementation fidelity should be assessed early and at intervals in the course of implementing the Programmatic Management of Drug-resistant Tuberculosis guideline and indeed, in the implementation of any intervention.

A Cross-Sectional Survey of Doctors in Nigeria Regarding Local Infection Prevention and Control Procedures for Coronavirus Disease 2019 (COVID-19).

Background: Worldwide COVID-19-related mortalities have included healthcare workers in the frontline caring for COVID-19 infected patients. This necessitates the practice of infection prevention and control procedures to protect health professionals from contracting the virus at the workplace. We investigated the knowledge and practice of doctors working in Nigeria regarding infection prevention and control procedures in the workplace. Methodology: This is a cross-sectional study of doctors and dentists working in Nigeria using a semi-structured self-administered questionnaire adapted from the World Health Organization "Perception of health workers regarding local infection prevention and control procedures for the Coronavirus Disease 2019" tool. Data were analyzed using SPSS version 25. Results: 302 doctors participated in this survey. Most were female 195 (64.6%); 80.50% provided direct care to patients; 267 (88.4%) worked in hospitals with suspected or confirmed cases of COVID-19 while 179 (59.3) directly cared for patients with suspected or confirmed cases of COVID-19 infection. 137 (70.6%) had close contact with confirmed cases of COVID-19. Hand hygiene and gloves were the most common procedure/material available for the prevention of infections for the respondents in the healthcare settings, followed by other types of medical facemasks, N95 respirator masks, eye protection like goggles and disposable aprons. Conclusion: In 2020, during the period of the COVID-19 pandemic, doctors in Nigeria were knowledgeable about infection prevention procedures but do not have access to personal protective equipment.

Review of COVID­19 vaccine

Coronavirus disease 2019 (COVID­19) accounts for over 92 million confirmed cases worldwide, with over 2.06 million deaths. In the past year, more than 290 candidate vaccines have been tested; COVID-19 vaccine development was sped up, with shortened timeline, due to the urgent global need in the face of the pandemic. In addition, people with the highest risk of contracting the disease, such as health workers with a high risk of exposure, elderlies, and people with underlying comorbidities, were prioritized with vaccination rollout. The article narratively reviewed original and review articles available on PubMed and Google Scholar related to the theme to provide up­to­date information. The different templates developed and studied for COVID-19 vaccines include the whole-virus vaccine, viral vector vaccine, nucleic acid (deoxyribonucleic acid and ribonucleic acid), and protein subunit vaccine. Myths impede vaccine uptake in this part of the globe. Adopting these myths leads to sharing and spreading, which negatively impacts the prevention of COVID-19 and vaccine uptake. Adverse event following immunizations (AEFIs) is classified based on severity, from minor to severe. The minor ones are common events that pose no potential health risks to the receiver of the vaccine. The type determines the safety profile, severity, and frequency of AEFIs observed with the vaccine administration. Overall, this pandemic has heightened the global level of threat awareness; it has also provided motivation to prepare for future pandemics by developing new vaccines.