Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria.

Background: The first case of COVID-19 in Nigeria was reported on February 27, 2020, and over time, spread across the country leading to many healthcare worker infections. The risk of transmission of COVID-19 within healthcare facilities makes it necessary to establish infection prevention and control measures. The World Health Organisation supported the Nigeria Centre for Disease Control to conduct a train-the-trainers workshop on infection prevention and control for key healthcare workers across Nigeria. Aim/Objectives: This study aims to describe the process and results of train-the-trainers as an intervention for national capacity building in infection prevention and control for COVID-19 among healthcare workers in Nigeria. Methods: Eight-hour sessions were held over three days with face-to-face instruction and practical hands-on experience in April 2020. A total of 61 healthcare workers participated across the six geographic zones of Nigeria: North Central, North East, North West, South West, South East, and South South. The training included slide presentations, case-based scenarios, and practical hands-on sessions with plenary discussions. Pre- and post-test assessments were used to evaluate knowledge of COVID-19, triage, and infection prevention and control among healthcare workers. Finding/Results: 69 % (42) of the participants were male 31 % (19) were female, and the majority (67 %) were medical doctors. Others attending were nurses or health administrators. Of the 70 % (26) of the states with existing infection prevention and control structures within the COVID emergency response, only 40 % were functional. The average percentage of pre-test and post-test scores were 60.8 ± 13.4 and 67.8 ± 9 0.3 respectively, showing a statistically significant difference (p > 0.001) in trainee knowledge. Additionally, 70 % of participants evaluated the training workshop as "satisfactory" or higher in training format, relevance for daily clinical work, active participation, learning new concepts, and logistics. Conclusion: Nationwide infection prevention and control training is feasible during a national health crisis. Infection prevention and control is cardinal in the containment of epidemic-prone diseases like COVID-19 and is invaluable in the prevention of healthcare-associated infections in healthcare settings.

One Health epidemic preparedness: Biosafety quality improvement training in Nigeria.

Background and Aim: One of the key components of the One Health approach to epidemic preparedness is raising awareness and increasing the knowledge of emerging infectious diseases, prevention, and risk reduction. However, related research can involve significant risks to biosafety and biosecurity. For this purpose, we organized a multidisciplinary biosafety hands-on workshop to inform and increase the knowledge of infectious diseases and risk mitigation. This study aimed to describe the process and outcome of a hands-on biosafety training program using a One Health approach across a multidisciplinary and multi-specialty group in Nigeria. Materials and Methods: A face-to-face hands-on training for 48 participants was organized by the West African Center for Emerging Infectious Diseases (WAC-EID) at the Jos University Teaching Hospital, serving as a lead institution for the Nigeria project site. Topics covered included (1) an overview of the WAC-EID research; (2) overview of infection prevention and control; (3) safety in animal handling and restraint, sample collection, and processing; (4) safety in field studies including rodent, bird and bat handling; (5) safety practices in the collection of mosquito and other arthropod vectors; (6) personal protective equipment training (disinfection, donning and doffing); and (7) safety in sample collection, labeling, and transportation. The program was executed using a mixed method of slide presentations, practical hands-on sessions, and video demonstrations. Pre- and post-course evaluation assessments and evaluation measures were used to assess training. Results: A total of 48 trainees participated in this training, with 12 (25%), 16 (33.3%), 14 (29.2%), 6 (12.5%) categorized as ornithology, entomology, mammalogy, and clinical interest groups, respectively. The pass rate for the pre-test was 29.4%, while for the post-test, it was 57.1%, or a 28% improvement. 88.6% of the trainees rated the training as relevant to them. Conclusion: Didactic and hands-on biosafety training is relevant in this era of zoonotic epidemics and pandemic preparedness. During this training program, there was a clear demonstration of knowledge transfer that can change the current practices of participants and improve the safety of infectious diseases research.

Prevalence of Post COVID-19 Vaccination Side Effects amongst Corp Members in an NYSC Orientation Camp in North Central Nigeria.

BACKGROUND: Covid-19 vaccination is recommended for the prevention of Covid-19 infection. However, there is paucity of studies assessing post-vaccination side effects, especially in Africa, and thus, the need for this study. OBJECTIVES: To determine the prevalence of post-covid-19 vaccination side effects; the frequency of occurrence of each side effect and the willingness to receive the second dose of the vaccine. METHODS: A descriptive cross-sectional study was conducted among Corp members undergoing the three-week compulsory orientation course in a National Youth Service Corps (NYSC) orientation camp in Keffi, North-Central Nigeria. A total of 552 Corp members received the Covid-19 vaccine (AstraZeneca), 268 consented and were enrolled in the study. Data were obtained through online Google forms and were analyzed using SPSS version 26. RESULTS: The mean age of the respondents was 25 years (SD = 2.5). The prevalence of post-covid-19 vaccination side effects was 90.7%, 95% CI (86.8 - 93.8). The most common side effects were weakness (53.5%), pain at the injection site (52.7%), and headache (52.7%). There was a weak association between the duration of symptoms and intake of medications (Cramer's V = 0.148) which was not statistically significant. About a quarter, 62 (24.0%), of the respondents who received the first dose of the vaccine, were unwilling to accept the second dose, mainly due to their fear of the side effects - 53 (85.5%). CONCLUSION: Our study population had a high prevalence of post-covid-19 vaccination side effects. Thus, the need to educate recipients on possible side effects and remedies.

CONTEXTE: La vaccination contre le Covid-19 est recommandée pour la prévention de l'infection par le Covid-19. Cependant, il existe peu d'études évaluant les effets secondaires post-vaccinaux, en particulier en Afrique, d'où la nécessité de cette étude. OBJECTIFS: Déterminer la prévalence des effets secondaires post-vaccination contre le Covid-19, la fréquence d'apparition de chaque effet secondaire et la volonté de recevoir la deuxième dose du vaccin. MÉTHODES: Une étude descriptive transversale a été menée parmi les membres du Corps qui suivaient le cours d'orientation obligatoire de trois semaines dans un camp d'orientation du National Youth Service Corps (NYSC) à Keffi, dans le centrenord du Nigeria. Au total, 552 membres du Corps ont reçu le vaccin Covid-19 (AstraZeneca), 268 ont consenti à participer à l'étude. Les données ont été obtenues à l'aide de formulaires Google en ligne et ont été analysées à l'aide de SPSS version 26. RÉSULTATS: L'âge moyen des personnes interrogées était de 25 ans (écart-type = 2,5). La prévalence des effets secondaires post-vaccination était de 90,7 %, IC à 95 % (86,8 - 93,8). Les effets secondaires les plus fréquents étaient la faiblesse (53,5%), la douleur au point d'injection (52,7 %) et les maux de tête (52,7 %). Il y avait une faible association entre la durée des symptômes et la prise de médicaments (V de Cramer = 0,148) qui n'était pas statistiquement significative. Environ un quart, 62 (24,0%), des répondants ayant reçu la première dose du vaccin, n'ont pas voulu accepter la seconde dose, principalement en raison de leur crainte des effets secondaires - 53 (85,5%). CONCLUSION: Notre population étudiée présentait une prévalence élevée d'effets secondaires post-vaccination. D'où la nécessité d'informer les bénéficiaires sur les effets secondaires possibles et les remèdes. Mot-clés: COVID-19, Vaccination, Effets secondaires.

Hand hygiene knowledge, training and practice: A cross-sectional study in a tertiary health institution, North-central Nigeria.

BACKGROUND: Hand hygiene (HH) is the single most important means of preventing hospital-acquired infections. We set out to determine the knowledge, training gaps, and practice of HH in a tertiary health institution in a resource constrained setting. METHODS: This cross-sectional study was conducted among health care workers in a 600-bed capacity tertiary health centre. The study was conducted between April and November 2013. A multi-stage randomized sampling method was used to self-administer 322 WHO HH knowledge questionnaires. Information on HH training in the past 3 years, knowledge and practice of HH were obtained, and data were analysed using Epi-Info version 3.5.1. RESULTS: A response rate of 98.5% was obtained for the HH knowledge assessment. Mean age of the study population was 39 ± 9.8. About 64% were females. Of all the respondents, only 16% had good knowledge of HH, 52% had moderate knowledge while 32% had poor knowledge. About 24% had formal training on HH. In terms of practice, only about 22% of the respondents self-reported routine practice of HH. CONCLUSIONS: The findings in this study suggest that there is sub-optimal HH knowledge, practice and training. It is imperative to improve the HH training and retraining of health care workers with a focus on attendants. Administrative controls and bold signage in healthcare institutions are also recommended.

Lassa fever outbreak in adolescents in North Central Nigeria: report of cases.

BACKGROUND: Lassa fever (LF) is a viral haemorrhagic fever endemic to West Africa. The clinical presentation and course is variable, making diagnosis difficult. AIM: To report the outbreak and identify the common clinical presentations of LF in paediatric patients in Jos, Plateau State, North Central, Nigeria. METHODS: This was a retrospective review of patients managed for LF during the June-August 2017 outbreak. LF was suspected in cases with: fever of less than 3 weeks' duration that had not responded to antimalarials or antibiotics, myalgia, abdominal pain, prostration and history of contact with any person diagnosed with LF. LF was confirmed by a positive reverse transcriptase polymerase chain reaction test (RT-PCR). RESULTS: Ten adolescents were studied. The common presenting complaints were fever (100%), prostration (90%) and headache (70%) while the commonest clinical signs were pyrexia (temperature >38.0oC; 90%), prostration (80%) and abdominal tenderness (80%). Leukocytes were present in urine in 60%. Eight individuals recovered fully, one adolescent died and one developed intestinal perforation necessitating laparotomy. CONCLUSION: In settings such as North Central Nigeria, LF should be suspected in any patient with fever that is unresponsive to antimalarials and antibiotics, especially in the presence of prostration, tachypnoea, tachycardia or abdominal tenderness. Early diagnosis and treatment is needed to reduce mortality from the disease and protect against transmission to health personnel.

REVIEW OF CONTROL OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN NIGERIA.

The global scourge of human immunodeficiency virus (HIV) infection is inundating, especially in sub-Saharan Africa and in particular Nigeria which is home to 10% of the world's HIV-infected persons. The target of the millennium development goal 6 is to halt and reverse the spread of HIV/AIDS by 2015. HIV control in Nigeria was initially shrouded in denial and apathy. Subsequently, a more pragmatic approach was launched during the tenure of President Olusegun Obasanjo. Several policies were formulated. The national prevalence of HIV witnessed some progressive decline and is currently 4.1%. There is now improvement in both HIV awareness and counselling and testing. Greater access to antiretroviral therapy and other support services have also been witnessed with over 300,000 persons currently on drugs. Notable achievements have been recorded in prevention of mother to child transmission (PMTC). However, with increased access to antiretroviral therapy, antiretroviral drug resistance has become inevitable. Acquired drug resistance is high-82% and transmitted drug resistance ranges between 0.7 and 4.5%. The achievements were largely facilitated by international partnerships which have become more streamlined in recent years. A sustained shift to indigenously sourced financial and manpower resource has become imperative. It is also important to integrate HIV facilities with other existing health care facilities for sustainability and cost-effectiveness. In an attempt to strengthen the national response, President Goodluck Ebele Jonathan launched the President's Comprehensive Response Plan for HIV/AIDS in Nigeria. It is hoped that this well-articulated policy would be well implemented to significantly reverse the epidemic.