First and Second Waves of Covid-19: A Comparative Study of the Clinical Presentation and Outcome among Hospitalized Patients in Lagos Nigeria.

OBJECTIVE: Nigeria experienced many waves of the COVID-19 pandemic. This study compared the clinical presentations and mortality among hospitalized patients during the first and second waves of the pandemic in Lagos State, Nigeria. METHODS: A retrospective cohort study was conducted. Deidentified medical records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos, Nigeria between February 27, 2020, and September 30, 2020 (first wave) and October 1, 2020, and April 30, 2021 (second wave) were reviewed. IBM Statistics version 25 was used for data analysis. RESULTS: More patients were hospitalized during the first wave of the pandemic. The mean age of patients was higher during the second wave (54.5±15.8 years vs. 42.2±15.5 years, p <0.001). More patients admitted during the second wave had comorbidities (56.0% vs 28.6%, p <0.001), were symptomatic (90.8% vs 52.0%, p <0.001), had severe COVID-19 disease (58.9% vs 25%, p <0.001) and died (14.9% vs 6.4%, p<0.001) compared with the first wave. The odds of death increased with age and severity of COVID-19 disease during the first and second waves. CONCLUSION: A higher proportion of the patients admitted in Lagos, Nigeria during the second wave were older, had comorbidities, and had severe COVID-19 disease than the first wave. Despite the fewer hospitalized patients, there were more deaths during the second wave.

OBJECTIF: Le Nigeria a connu plusieurs vagues de la pandémie de la COVID-19. Cette étude a comparé les présentations cliniques et la mortalité chez les patients hospitalisés lors des première et deuxième vagues de la pandémie dans l'État de Lagos, Nigeria. MÉTHODES: Une étude de cohorte rétrospective a été réalisée. Les dossiers médicaux déidentifiés des patients atteints de la COVID-19 confirmée par laboratoire, admis dans 15 centres d'isolement à Lagos, Nigeria, entre le 27 février 2020 et le 30 septembre 2020 (première vague) et entre le 1er octobre 2020 et le 30 avril 2021 (deuxième vague), ont été examinés. IBM Statistics version 25 a été utilisé pour l'analyse des données. RÉSULTATS: Un plus grand nombre de patients ont été hospitalisés lors de la première vague de la pandémie. L'âge moyen des patients était plus élevé lors de la deuxième vague (54,5±15,8 ans vs. 42,2±15,5 ans, p <0,001). Un plus grand nombre de patients admis lors de la deuxième vague avaient des comorbidités (56,0% vs. 28,6%, p <0,001), étaient symptomatiques (90,8% vs. 52,0%, p <0,001), avaient une forme grave de la maladie à la COVID-19 (58,9% vs. 25%, p <0,001) et sont décédés (14,9% vs. 6,4%, p<0,001) par rapport à la première vague. Les chances de décès ont augmenté avec l'âge et la gravité de la maladie à la COVID-19 lors des première et deuxième vagues. CONCLUSION: Une proportion plus élevée des patients admis à Lagos, Nigeria, lors de la deuxième vague étaient plus âgés, avaient des comorbidités et présentaient une forme grave de la maladie à la COVID-19 par rapport à la première vague. Malgré un nombre moindre de patients hospitalisés, il y a eu plus de décès lors de la deuxième vague. MOTS-CLÉS: Présentation Clinique, Covid-19, Première Vague, Mortalité, Nigeria, Deuxième Vague.

Length of Hospital Stay of COVID-19 Patients managed at the Lagos State Isolation Centres during the First Wave of the Pandemic.

BACKGROUND: Lagos State has the highest number of COVID-19 cases in Nigeria. We assessed the factors predicting the length of hospital stay of COVID-19 patients admitted in 15 isolation centres across the state. METHODS: We reviewed the electronic medical records of all COVID-19 patients admitted and discharged between February 27, 2020, and September 30, 2020. Logistic and linear regressions were used to assess factors predicting the length of hospital stay. RESULTS: A total of 3153 records were reviewed, of which 2623 (83.2%) met the inclusion criteria. The mean age of patients admitted was 40.5 (Sd 14.8) years. The age range was four days-97 years. A total of 1258 (48.0%) were symptomatic, while 2056 (78.4%) and 567 (21.6%) presented with mild and severe disease, respectively. Cough (22.0%), fever (17.3%) and breathlessness (12.3%) were the most common symptoms at presentation. Generally, the median length of hospital stay was 11 (IQR 9, 14) days. A total of 1609 (61.3%) had a prolonged length of hospital stay. The odds for prolonged hospital stay was higher among elderly patients (AOR 12.1 95%CI 7.6-19.4, p<0.001), male (AOR 1.2 95%CI 1.0-1.4, p=0.031) and patients with severe disease (AOR 1.3 95% CI 1.0-1.7, p=0.042). Age, hypertension and shortness of breath made the most significant contribution to predicting the length of hospital stay (P<0.05). CONCLUSION: Age, gender, hypertension and breathlessness predicted the length of hospital stay. Proactive measures should be instituted in managing COVID-19 patients.

CONTEXTE: L'État de Lagos a le plus grand nombre de cas de COVID-19 au Nigeria. Nous avons évalué les facteurs predisan la durée du séjour à l'hôpital des patients atteints de la COVID-19 admis en 15 centres d'isolement à travers l'État. MÉTHODES: Nous avons examiné les dossiers médicaux électroniques de tous les Patients atteints de la COVID-19 admis et sortis de l'hôpital entre février27, 2020 et 30 septembre 2020. Régressions logistiques et linéaire sont été utilisés pour évaluer les facteurs prédisant la durée de l'hôpital rester. RÉSULTATS: Un total de 3153 dossiers ont été examinés, don't 2623 (83,2 %) répondaient aux critères d'inclusion. L'âge moyen des patients admis était de 40,5 ans (Sd 14,8). La gamme d'âge était de quatre jours­97 ans. Au total, 1258 (48,0 %) étaient symptomatiques, tandis qu'en 2056(78,4 %) et 567 (21,6 %) ont présenté une maladie bénigne et grave,respectivement. Toux (22,0 %), fièvre (17,3 %) et essoufflement(12,3 %) étaient les symptômes les plus courants à la présentation.En général, la durée médiane du séjour à l'hôpital était de 11 (IQR 9, 14)Jours. Au total, 1609 (61,3 %) ont eu une durée prolongée d'hospitalisation rester. Les chances de séjour prolongé à l'hôpital étaient plus élevées chezpatients âgés (AOR 12,1 IC à 95 % 7,6­19,4, p<0,001), hommes (AOR1,2 IC à 95 % 1,0 à 1,4, p = 0,031) et patients atteints d'une maladie grave(AOR 1,3 IC à 95 % 1,0­1,7, p = 0,042). Âge, hypertension et l'essoufflement a apporté la contribution la plus significative à prédire la durée du séjour à l'hôpital (P<0,05). CONCLUSION: Âge, sexe, hypertension et essoufflement prédit la durée du séjour à l'hôpital. Des mesures proactives devraient être institués dans la prise en charge des patients atteints de LA COVID-19. Mots-clés: COVID-19, présentation clinique, durée de l'hôpitalrester, Lagos.

EXPERIENCE OF INTIMATE PARTNER VIOLENCE AS A PREDICTOR OF SEXUALLY TRANSMITTED INFECTIONS AMONG MARRIED WOMEN IN NIGERIA.

BACKGROUND: Intimate partner violence (IPV) is an important public health issue that is associated with adverse sexual and reproductive health outcomes including sexually transmitted infections (STIs). STIs have recently gained more recognition worldwide because they increase the risk for HIVinfection. However, there is dearth of information on the association between IPV and STIs particularly among married women in Nigeria. OBJECTIVE: To determine the association between IPV and STIs among married women in Nigeria. METHOD: This was a secondary data analysis of the 2008 Nigeria Demographic and Health Survey (NDHS) dataset. A total of 18,402 married women aged between 15 and 49 years were included. Questions about intimate partner violence were adapted from the Conflict Tactic Scale (CTS). Multiple logistic regression models were used to determine relationship between IPV and self-reported STIs. RESULTS: The prevalence of IPV among married women in Nigeria was 29.3%. Majority of the women experienced emotional violence (22.1%), 17.3% of the women experienced physical violence while the least experienced form of violence was sexual IPV (4.4%). Majority (60.1%) of the women experienced just one type of IPV, 30.0% two types, 9.9% all three types. The prevalence of self-reported sexually transmitted infections was 7.2%. Logistic regression demonstrated that after controlling for other covariates, women who experienced any form of IPV were found to be more likely to report STI than women who did not [OR 1.357 (95% CI 1.188-1.551)]. In addition, experience of physical and sexual IPV was significantly associated with history of STIs [OR 1.699 (95% CI 1.420-2.034); OR 1.414 (95% CI 1.085-1.843) respectively]. Experiencing two or more types of IPV was significantly associated with history of STIs [OR 1.759 (95% CI 1.446-2.139); OR 2.193 (95% CI 1.636-2.941) respectively]. CONCLUSION: There is a need to incorporate IPV screening and services in STI clinics. Also, it is important to screen for STIs among women who present with IPV particularly those with multiple types of violence.

Making a case for community screening services: findings from a medical outreach in ibadan, Nigeria.

BACKGROUND: Currently, population based medical check up is yet to be explored as a veritable tool for assessing the burden of non-communicable diseases in Nigeria. OBJECTIVES: This study aimed to assess the prevalence of selected lifestyle related diseases during a free medical rally in an urban community. METHODS: General medical examinations of all participants at a free medical rally in a middle class community in Ibadan, Oyo State was conducted. Body Mass Index (BMI), blood pressure and random blood sugar measurements were done using standardised instruments. BMI classification for children was done using the CDC guidelines for males and females aged 2-20 years. RESULTS: Of the 302 participants examined, 33.1% were males and 32.1% were less than 18 years. Of those aged 2 to 20 years, 22.9% were underweight, while 5.2% were overweight/ obese. In adults 3.6% were underweight and 43.2% were overweight/ obese. Adults were significantly more likely to be overweight/obese (P<0.001). Prevalence of high blood pressure was 29.3% and 9.4% of adults had elevated random blood glucose levels. A higher proportion of obese people (P=0.259), males (P= 0.327) and those older than 40 years (P<0.001) had elevated blood pressure. A weak correlation (spearman rho= 0.3) was found between blood pressure and BMI (P<0.001) and also between BMI and blood sugar level (spearman rho= 0.2) P=0.05. CONCLUSION: There is a need for greater emphasis on community based screening programmes to aid early diagnosis and treatment of non communicable diseases in the country.