Knowledge and acceptance of COVID-19 vaccine among healthcare workers in Enugu metropolis, Enugu state, Nigeria.

Background: COVID-19 disease spread at an alarming rate, and was declared a pandemic within 5 months from the first reported case. As vaccines have become available, there was a global effort to attain about 75% herd immunity through vaccination. There is a need to address the issue of vaccine hesitancy to COVID-19 vaccines especially in places such as Sub-Saharan African countries which have a high rate of background vaccine hesitancy. Objective: To determine the knowledge and acceptance of COVID-19 vaccines among healthcare workers (HCWs) in Enugu metropolis. Methods: A cross-sectional descriptive study of 103 HCWs in Enugu metropolis was done. Data was collected using structured online Google forms. Descriptive and inferential statistics was done using SPSS, and results were summarized into percentages and associations. Results: An acceptance rate of 56.2% was obtained among HCWs in Enugu metropolis. Positive predicators of acceptance include older age (p = 0.004, X2 = 13.161), marriage (p = 0.001, X2 = 13.996), and higher average level of income (p = 0.013, X2 = 10.766) as significant correlations were found. No significant association was found between educational level, religion, denomination nor occupation, and acceptance of vaccine. The major factor responsible for refusal was fear of side-effects. Discussion: The acceptance rate of COVID-19 vaccines among HCWs is still less than optimal. This population represents the most enlightened population on health related matters, hence if acceptance rate remains merely average that in the general population is expected to be worse. There is a need to address the fear of vaccine side-effects by inculcating more open and interactive methods of information dissemination, while also addressing the misconceptions or myths surrounding COVID-19 vaccines.

Assessing knowledge, attitude, practice and training related to COVID-19: a cross-sectional survey of frontline healthcare workers in Nigeria.

OBJECTIVES: Healthcare workers (HCWs) are at the frontline of efforts to treat those affected by COVID-19 and prevent its continued spread. This study seeks to assess knowledge, attitude and practice (KAP) as well as training needs and preferences related to COVID-19 among frontline HCWs in Nigeria. SETTING: A cross-sectional survey was carried out among 1852 HCWs in primary, secondary and tertiary care settings across Nigeria using a 33-item questionnaire. PARTICIPANTS: Respondents included doctors, nurses, pharmacy and clinical laboratory professionals who have direct clinical contact with patients at the various healthcare settings. ANALYSIS: Exploratory factor analysis (EFA) was used to establish independent factors related to COVID-19 KAP. Analysis of variance was used to identify any differences in the factors among different categories of HCWs. RESULTS: EFA identified four factors: safety and prevention (factor 1), practice and knowledge (factor 2), control and mitigation (factor 3) and national perceptions (factor 4). Significant group differences were found on three factors: Factor 1 (F(1,1655)=5.79, p=0.0006), factor 3 (F(1,1633)=12.9, p<0.0.0001) and factor 4 (F(1,1655)=7.31, p<0.0001) with doctors scoring higher on these three factors when compared with nurses, pharmaceutical workers and medical laboratory scientist. The most endorsed training need was how to reorganise the workplace to prevent spread of COVID-19. This was chosen by 61.8% of medical laboratory professionals, 55.6% of doctors, 51.7% of nurses and 51.6% of pharmaceutical health workers. The most preferred modes of training were webinars and conferences. CONCLUSION: There were substantial differences in KAP regarding the COVID-19 pandemic among various categories of frontline HCWs surveyed. There were also group differences on COVID-19 training needs and preferences. Tailored health education and training aimed at enhancing and updating COVID-19 KAP are needed, particularly among non-physician HCWs.

The use of the radial recurrent fasciocutaneous flap in interposition arthroplasty of elbow ankylosis case report and review of literature.

Elbow ankylosis and its management remain a challenge in the developing countries like Nigeria because of many factors, including the absence of elbow replacement surgery. Current operative management, which is interposition arthroplasty with fascia lata or arthrodesis in a more functional position, is commonly complicated with donor site morbidity and restricted functionality, respectively. We report the use of the regional radial recurrent fasciocutaneous flap of the arm as an interposition material for an ankylosed elbow after excision of the bone block, with no donor site morbidity and improved range of elbow motion. At 4 years postoperatively, patient is very satisfied with functionality. Additionally, this method of managing elbow ankylosis uses a vascularized and durable flap, is cheap, and has less operation time, and thus is highly recommended.

Complex primary hips for total hip replacement surgery at a tertiary institution in Nigeria.

INTRODUCTION: Total hip replacement (THR) surgery is still evolving in Nigeria with increasing awareness as more cases are being done. This has attraction for individuals who hitherto had no solutions for their hip pathologies. These are mostly complex primary hips which present challenging technical difficulties with increased risk of complications, thus requiring detailed planning to ensure successful operation. This work aims to present the pattern of complex primary hips presenting for THR, the challenges and complications. METHODOLOGY: Data collected over a seven year period, of patients who presented for THR, were analyzed for age, sex, diagnosis, type of hip, complications, duration of surgery, blood loss and transfusions, challenges and outcome. RESULTS: Fifty-nine (43.4%) of the 136 cases of THR done were complex primary hip replacement surgeries. Avascular necrosis of femoral head amongst sickle cell disease patients (23.7%) was the commonest cause of complex primary hips in our series. Most of them had absent/tight medullary canals. This is followed by old unreduced hip dislocation and non-united hip fractures with an incidence of 10.1% each. The major peri operative complication noted was calcar split in 10 patients (16.9%) Discussion: Sickle cell disease patients presented more with complex primary hips and the commonest difficulty was recreating medullary canals. Increased operation time and blood loss alongside technical difficulties should be anticipated and measures put in place to avert complications.

Major Surgery in A Jehovah Witness with Sickle Cell Disease: Case Presentation.

INTRODUCTION: A Jehovah's Witness belongs to the religious group that does not accept blood transfusion in any form, while a sickle cell disease patient has abnormal haemoglobins that do not last in circulation predisposing one to anaemia and other systemic complications. Performing a major surgery in a Jehovah's Witness who has sickle cell disease is tasking for a surgeon. CASE PRESENTATION: This case reports a 28-year-old African female with sickle cell disease who outrightly refused any form of blood transfusion as being a Jehovah's Witness and having a complex primary hip that required total hip replacement. This work highlighted the complexity and difficulty encountered by virtue of the fact that patient had orthopaedic complications of Sickle Cell Disease and measures taken to prevent sickling crisis. CONCLUSION: It is possible to carry out major surgery in a sickler who has durable power of attorney not to receive blood, but optimum preparation, meticulous and fast surgery and adequate monitoring must be instituted to avert morbidity and mortality seen in this group of patients.