Coronavirus Disease 2019 Vaccination Coverage and Seropositivity amongst Nigerians 18 Years Old and Above.

BACKGROUND: This was a cross-sectional community-based survey to study the prevalence of serum antibodies against the severe acute respiratory syndrome coronavirus 1 (SARS-COV-1) and determine possible source of antibodies as to whether from vaccination or from natural infection as well as attempt to compare antibody levels in response to the different four types of vaccines administered in Nigeria. METHODS: A cross-sectional community-based study of the prevalence of serum antibodies against all four vaccine types used in Nigeria amongst a representative sample of people aged 18 years and above in the six geopolitical zones of the country using a multistage sampling technique covering 12 states of the country with two states being randomly selected from each geopolitical zone. High-throughput Roche electrochemiluminescence immunoassay system (Elecsys Anti-SARS-COV-1 Cobas) was used for qualitative and quantitative detection of antibodies to SARS-COV-1 in human plasma. RESULTS: There was no statistically significant difference between the proportions with seropositivity for both the vaccinated and the unvaccinated (P = 0.95). The nucleocapsid antibody (anti-Nc) titres were similar in both the vaccinated and the unvaccinated, whereas the Spike protein antibody (anti-S) titres were significantly higher amongst the vaccinated than amongst the unvaccinated. Antibody levels in subjects who received different vaccines were compared to provide information for policy. CONCLUSION: While only 45.9% of the subjects were reported to have been vaccinated, 98.7% of the subjects had had contact with the SARS-COV-1 as evidenced by the presence of nucleocapsid (NC) antibodies in their plasma. The 1.3% who had not been exposed to the virus, had spike protein antibodies which most likely resulted from vaccination in the absence of NC antibodies. Successive vaccination and booster doses either through heterogeneous or homologous vaccines increased antibody titres, and this stimulation of immune memory may offer greater protection against coronavirus disease 2019.

Adverse Childhood Experiences and Tobacco Use Patterns Among Adults in the United States: Exploring sex differences.

OBJECTIVE: Adverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States. METHODS: This was a cross-sectional analysis of data from adults aged ≥18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes-1 or no/never-0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or ≥4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders. RESULTS: Although we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported ≥4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49-8.63]), cigarette (2.57 [1.72-3.83]) and dual use (3.25 [1.79-5.91]) relative to nonuse. Males with ≥4 ACEs had higher odds of cigarette (1.75 [1.15-2.65]) and dual use (7.64 [3.95-14.79]). CONCLUSION: Our findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults.

High SARS-CoV-2 seroprevalence in Lagos, Nigeria with robust antibody and cellular immune responses.

Background: Early evidence suggested that the impact of the COVID-19 pandemic was less severe in Africa compared to other parts of the world. However, more recent studies indicate higher SARS-CoV-2 infection and COVID-19 mortality rates on the continent than previously documented. Research is needed to better understand SARS-CoV-2 infection and immunity in Africa. Methods: In early 2021, we studied the immune responses in healthcare workers (HCWs) at Lagos University Teaching Hospital (n = 134) and Oxford-AstraZeneca COVID-19 vaccine recipients from the general population (n = 116) across five local government areas (LGAs) in Lagos State, Nigeria. Western blots were used to simultaneously detect SARS-CoV-2 spike and nucleocapsid (N) antibodies (n = 250), and stimulation of peripheral blood mononuclear cells with N followed by an IFN-γ ELISA was used to examine T cell responses (n = 114). Results: Antibody data demonstrated high SARS-CoV-2 seroprevalence of 72·4% (97/134) in HCWs and 60·3% (70/116) in the general population. Antibodies directed to only SARS-CoV-2 N, suggesting pre-existing coronavirus immunity, were seen in 9·7% (13/134) of HCWs and 15·5% (18/116) of the general population. T cell responses against SARS-CoV-2 N (n = 114) were robust in detecting exposure to the virus, demonstrating 87·5% sensitivity and 92·9% specificity in a subset of control samples tested. T cell responses against SARS-CoV-2 N were also observed in 83.3% of individuals with N-only antibodies, further suggesting that prior non-SARS-CoV-2 coronavirus infection may provide cellular immunity to SARS-CoV-2. Conclusions: These results have important implications for understanding the paradoxically high SARS-CoV-2 infection with low mortality rate in Africa and supports the need to better understand the implications of SARS-CoV-2 cellular immunity.

Predictors of exclusive breastfeeding practice among nursing mothers attending a health care facility in a peri-urban setting in Lagos State, Nigeria.

Background: The Nigerian government initiated various national infant and young child feeding programmes (1992-2005) to improve juveniles well-being. Despite these efforts, under-five children feeding related diseases and mortality still escalate. Investigating the drivers of exclusive breastfeeding (EBF) is exigent in tackling this menace. Objective: To investigate maternal socio-demographic and index child variables that serve as predictors of EBF practice among nursing mother attending a healthcare facility in Lagos, western Nigeria. Methods: One hundred and twenty (N=120) consenting nursing mothers (15-49 years) with infants between 0-24 months completed a structured, self-administered questionnaire. Scores of current practice level for EBF was computed and adjusted odd ratios (aORs) generated from a logistic regression model. Results: Respondents mean age was 28.7 ± 2.3 years. Of 120 respondents, 82(68.3%) and 38(31.7%) had good and poor EBF practice respectively. Having an index child <6months age (aOR=5.02, 95% confidence intervalCI=1.28-15.43), being in monogamy (aOR=3.0, 95% CI=1.80-6.73), having tertiary education (aOR=3.12, 95% CI=1.39-8.96), being married (aOR=2.0, 95% CI=0.1-0.8) and vaginal delivery (aOR=2.96, 95% CI=1.75-7.48) increased the odds of EBF practice. Conclusion: Age of index child, marriage type, maternal education, marital status and nature of delivery independently predicted EBF practice.

Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study.

BACKGROUND: Cervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings. OBJECTIVES: This qualitative study was done prior to the introduction of a cervical cancer screening program in two slum areas in Lagos Nigeria and explored women's knowledge about cervical cancer, and their perceived barriers and recommendations for the program. METHOD: Four focus group discussions(FGD) were conducted among 35 women between the ages of 21-65 years residing in two urban slums in Lagos, Nigeria from February to April 2019. Each FGD was limited to 8-10 participants of women of similar ages. Voice recordings were transcribed verbatim and thematic analysis was done. RESULTS: Most of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby primary health center, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women's poorly perceived susceptibility to cervical cancer. CONCLUSION: Interventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge of cervical cancer and address barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered.

Marijuana use modifies the association between heavy alcohol consumption and tobacco use patterns among US adults: Findings from Behavioral Risk Factor Surveillance System, 2020.

OBJECTIVE: This study explored the associations of heavy alcohol consumption with current e-cigarette, cigarette and dual use of e-cigarettes and cigarettes among a nationally representative sample of adults in the United States (US), and if these associations are modified by marijuana use. METHODS: Data from 157,138 adults who participated in the 2020 Behavioral Risk Factor Surveillance System (BRFSS) were included in this cross-sectional analysis. Multinomial logistic regression was used to estimate the strength of the associations between heavy alcohol consumption (independent variable) and the tobacco use patterns (dependent variable, i.e., non-use, current e-cigarette use, current cigarette use and current dual use of e-cigarettes and cigarettes). We also assessed the interaction between past-month marijuana use and heavy alcohol consumption on the primary outcome. RESULTS: After the adjustment for potential confounders, heavy alcohol consumption (relative to no heavy alcohol consumption) was associated with higher odds of current e-cigarette (3.91 [2.25-6.78]), cigarette (3.02 [2.28-3.99]) and dual (4.78 [3.25-7.01]) use. The test for interaction showed that the associations of heavy alcohol consumption with the tobacco use patterns were modified by past-month marijuana use (p < 0.05 for all groups), with associations being much stronger among past-month marijuana non-users. CONCLUSIONS: Heavy alcohol consumption is positively associated with current e-cigarette, cigarette, and dual use among US adults. Further, the findings indicate that these relationships are modified by past-month marijuana use. Longitudinal research is needed to explore the role of marijuana in the association of heavy alcohol consumption with current e-cigarette, cigarette and dual use among adults.

Effect of social marketing on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos, Nigeria.

INTRODUCTION: Nigeria has a low uptake of cervical cancer screening and is one of the five countries that represent over half of the global burden of deaths from cervical cancer. Social marketing principles can be used to design and implement interventions to increase uptake of cervical cancer screening. This study assessed the effect of a social marketing intervention on the knowledge, attitude, and uptake of pap smear among women residing in an urban slum in Lagos State, Nigeria. MATERIALS AND METHODS: This was a quasi-experimental study. The intervention arm consisted of 140 women recruited from Ago-Egun Bariga community and the control arm consisted of 175 women recruited from Oto-Ilogbo extension community. Social marketing intervention was instituted in the intervention group. Data analysis was done using IBM SPSS Statistics version 20 and Stata version 16.0. Between groups comparisons and within groups comparisons were done using bivariate analysis with Chisquare, Students t test and Paired t test as appropriate. RESULTS: In both the intervention and control groups, the mean knowledge score of cervical cancer was low at baseline (0.0 ± 0.3 and 0.1 ± 0.9 respectively). In the intervention group, there was a significant increase in mean knowledge score to 15.1 ± 3.7, post-intervention (p < 0.001). In both groups, the mean attitude score of cervical cancer was low at baseline (27.1 ± 0.8 in the intervention group and 27.2 ± 1.4 in the control group). In the intervention group, there was a significant increase in mean attitude score to 36.5 ± 4.8, post-intervention (p < 0.001). In both the intervention and control groups, uptake of pap smear was low at baseline (0.0% and 0.6%, respectively). In the intervention group, there was a significant increase in uptake of pap smear to 84.3%, post-intervention (p < 0.001). There was no statistically significant change in knowledge, attitude or uptake of pap smear in the control group, post-intervention. CONCLUSION: This study demonstrated that social marketing intervention can be successful in improving knowledge, attitude, and also the uptake of pap smear, even in settings where these are abysmally low. It is recommended that social marketing intervention be employed as a strategy for improving cervical cancer screening among women residing in slums.

A qualitative analysis of the COVID-19 vaccination rollout in Lagos, Nigeria: Client and provider perspectives on the plan, the process and the progress.

Mass vaccination has proven useful in the control of COVID-19, though vaccine rollout has met major challenges. The learning curve of this process has been valuable. This qualitative study aimed to assess the plan, the process and the progress of the COVID-19 vaccination rollout in Lagos, Nigeria. This study was conducted at vaccination centers in eight of the 20 Local Government Areas in Lagos State from May to July 2021 among healthcare administrators, health workers and vaccine recipients. Data were collected by conducting three key informant interviews, 24 in-depth interviews and eight focus group discussions to explore the vaccination experiences of participants and the challenges facing the vaccination plan and process. The interviews and discussions were recorded, transcribed verbatim and analyzed using the thematic approach. The four-phased plan for the vaccine rollout was clear to all the key informants because the vaccination process was preceded by training. The process was strengthened by the electronic registration system, though riddled by the frequently unstable electronic and internet data capturing. This was mitigated by a stopgap manual registration and recording of client details. Challenges in the logistics of maintaining supplies of the disposable materials required for the vaccination process were overcome by the creativity of the health professionals. Vaccine hesitancy, fueled by misinformation, myths and misconceptions about the vaccine and its side effects, played a huge role in the community response. The reported vaccine side effects were mild; fever, headaches, pain at the injection site, excessive eating and sleepiness. Though the COVID-19 vaccination process appeared to have largely made progress, the future of vaccination in Nigeria is predicated upon a bottom-up approach to programmatic planning, health education and local vaccine production. Collaborations such as public-private partnerships have the potential of boosting vaccine provision for Nigeria's large population to ensure equitable access to vaccines.

Willingness and motivations towards volunteering during the COVID-19 pandemic: A cross-sectional survey among final year medical students in Lagos, Nigeria.

Introduction: Increasing manpower capacity to meet the demands in the healthcare system is important during health emergencies. Medical students have roles to play during a pandemic but their involvement in these duties should be voluntary. The objective of this study was to assess the willingness and motivations of final year medical students in Lagos, Nigeria towards volunteering during the COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted among medical students in their sixth (final) year of study at the two public Universities in Lagos, Nigeria using total population sampling technique. A web-based questionnaire was used for data collection and data were analysed using SPSS. Logistic regression analysis was used to predict the willingness to volunteer. Results: The mean age of the respondents was 23.4 years ±â€¯2.6SD and 62.6% were female. About 65.9% of the medical students were willing to volunteer. Motivational factors which include self-rated good health status [OR: 2.1(95%CI: 1.16-3.6)], self-rated competence to work as a COVID-19 volunteer [OR: 6.5(95%CI: 3.61-11.54)] and availability of adequate protection and personal protective equipment [OR: 3.3(95%CI: 1.74-6.33)] significantly increased the odds of willingness to volunteer after controlling for other variables. Respondents' opinions on settings where medical students can serve as volunteers during the COVID-19 pandemic include case management (21.7%) and telemedicine (85.8%). Conclusion: Medical students are willing to volunteer during the COVID-19 pandemic. There is a need to prepare and motivate the final year medical students by developing their skills to improve their competence and by providing adequate protection for the willing students to function as volunteers.

Premarital Genotype Screening for Sickle Cell Disease: Knowledge Gaps, Perception and Determinants of Uptake among Final Year Undergraduates of a Tertiary Institution in South-West Nigeria.

Background: Strategies involved in the prevention and management of sickle cell disease include premarital genotype screening and counselling as well as efforts at increasing the knowledge of the population about the condition. Methodology: This is a cross-sectional descriptive study which assessed the knowledge of sickle cell disease and premarital genotype screening, attitudes towards screening and factors associated with uptake of premarital genotype screening among 326 final year students at the University of Ibadan, Oyo State, Nigeria. Results: Respondents were within the age range of 18-24 with a mean age of 23. Majority of the respondents had AA genotype (68.71%). Only 15.95% of the respondents had good knowledge of sickle cell disease. Mean knowledge score was 14 out of 26 with a standard deviation of 4.31. 75.77% of the respondents had good knowledge of premarital genotype screening. 76.07% of the respondents had good attitudes to premarital genotype screening. Mean attitude score was 9.5 out of 12 with a standard deviation of 2.15. Respondents' current level of study (P=0.000) and marital status (P=0.042) were significantly associated with knowledge of sickle cell disease. There was significant association between knowledge of sickle cell disease and knowledge of premarital genotype screening (Fisher's P= 0.000). Knowledge of premarital genotype screening was significantly associated with respondents' current level of study (P=0.004) and attitudes to premarital genotype screening (Fisher's P= 0.000). Conclusion: Significant knowledge gaps were identified in the study population. There is need for continuous assessment of knowledge gaps and educational intervention to decrease the incidence of sickle cell disease.

Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use.

BACKGROUND: Electronic cigarettes (e-cigarettes) have emerged in the Nigerian market, and if used without supervision, may have damaging effects on the physical and mental health of users. Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria. METHOD: An online cross-sectional study among participants aged between 15-35 years. The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a 7-item Generalized Anxiety Disorder (GAD-7) scale. Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. P-values <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS: Data from a total of 949 respondents was analysed. Participants had a mean age of 23.36 years (±3.97) and were predominantly female (55.64%). The prevalence of e-cigarette ever-use was 7.9% (95% CI: 5.8,10.0). Older age and being male were independently associated with higher odds of e-cigarette use. After adjusting for age and sex, alcohol use (p<0.001), friend's use (p<0.001), and other tobacco product or substance use (p:0.05) remained significantly associated with higher odds of e-cigarette use. There was no association between anxiety levels and e-cigarette use. CONCLUSION: These findings suggest a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who use e-cigarettes. Health providers and policy makers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years.

Association between anxiety, alcohol, poly-tobacco use and waterpipe smoking: A cross-sectional study in Lagos, Nigeria.

BACKGROUND: Waterpipe smoking (WPS) has been reported to have a wide range of damaging health effects on pulmonary and cardiovascular systems. Studies suggest that waterpipe tobacco smoking is associated with reduced harm perceptions, mental health problems and the use of psychoactive substances. We investigate the patterns of use and the association of WPS with anxiety, poly-tobacco and alcohol use in Lagos, Nigeria. MATERIALS AND METHODS: A cross-sectional study design was used to assess the data from 818 adolescents and adults in Lagos State, Nigeria. An online questionnaire obtained demographic information, waterpipe, e-cigarette, alcohol and other tobacco product use from respondents. Anxiety was assessed using the validated Generalised Anxiety Disorder 7-point scale. Bivariate and multivariate logistic regression analysis was used to identify the factors associated with waterpipe ever-use. P < 0.05 was considered statistically significant. RESULTS: The mean (standard deviation) age of respondents was 23.43 (±3.96), over half were female (55.2%) and a majority had a college diploma or more (88.59%). Among study participants, 18.58% reported waterpipe ever-use. Among ever waterpipe users, 17.33% reported current use (past 30-days), with a majority having smoked waterpipe in a bar or pub. Alcohol use (P < 0.001), e-cigarette ever-use (P: 0.010) and poly-tobacco ever-use (P: 0.030) were significantly associated with higher odds of waterpipe use in the multivariate regression model. Further, there was a lower likelihood of waterpipe ever-use in the bivariate regression model among respondents with mild and moderate to severe anxiety levels than those with normal anxiety levels (P: 0.030); however, this association was no longer significant in the adjusted model. CONCLUSIONS: Our findings suggest a relatively high prevalence of WPS in Lagos, Nigeria. Concurrent alcohol consumption, e-cigarette and poly-tobacco use are associated with WPS, and most waterpipe smokers have normal anxiety levels. The Nigerian Government should consider surveillance measures for WPS and a more comprehensive smoke-free policy.

From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria.

BACKGROUND: Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. DISCUSSION: Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment. CONCLUSION: Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.

Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: a retrospective cohort study.

BACKGROUND: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described. METHODS: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 62,020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher's exact tests were used in determining associations between variables. Kaplan-Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant. RESULTS: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P < 0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR = 2.41, P = 0.001, 95%CI = 1.4-4.0, death: HR = 2.30, P = 0.001, 95%CI = 1.2-4.6, for those with hypertension only} {severe/critical illness: HR = 3.76, P = 0.001, 95%CI = 2.1-6.4, death: crude HR = 6.63, P = 0.001, 95%CI = 3.4-1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. CONCLUSION: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

Psychosocial health effects of Covid-19 infection on persons in treatment centers in Lagos, Nigeria.

INTRODUCTION: Prior research has highlighted the psychosocial impact of infectious diseases on individuals and the community at large. However, little is known about the psychosocial implications of COVID-19. This study set out to determine the rate as well as correlates of anxiety and depressive symptoms among persons managed as in-patients for COVID-19 in Lagos, Nigeria. MATERIALS AND METHODS: We conducted an online survey between April to June ending 2020 using a consecutive sampling technique of persons positive for COVID-19 and who were managed as in-patients across five (5) treatment centres in Lagos, Nigeria. The survey collected information on demographic as well as clinical data including suicidality. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: There were one hundred and sixty participants in total. The mean age of respondents was 36.4 (±9.7) years with a higher proportion (56.9%) being males. With regards to diagnosis, 28.1% and 27.5% of the respondents were categorised as probable cases of depression and anxiety respectively, while 3.8% respondents reported suicidal ideation. Majority of the respondents (61.9%) reported the fear of infecting their loved ones. The variables that showed association with psychiatric morbidity were a past history of an emotional concern, employment status, guilt about infecting others and boredom. CONCLUSION: This study revealed a high burden of psychological/psychiatric morbidity among persons treated for COVID-19, particularly persons who have had prior emotional concerns. The findings from this study reiterate the need to pay attention to the mental health of people during disease outbreaks and to incorporate psychosocial interventions as part of the management package.

'Long COVID': persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria.

BACKGROUND: Coronavirus disease once thought to be a respiratory infection is now recognised as a multi-system disease affecting the respiratory, cardiovascular, gastrointestinal, neurological, immune, and hematopoietic systems. An emerging body of evidence suggests the persistence of COVID-19 symptoms of varying patterns among some survivors. This study aimed to describe persistent symptoms in COVID-19 survivors and investigate possible risk factors for these persistent symptoms. METHODS: The study used a retrospective study design. The study population comprised of discharged COVID-19 patients. Demographic information, days since discharge, comorbidities, and persistent COVID-19 like symptoms were assessed in patients attending the COVID-19 outpatient clinic in Lagos State. Statistical analysis was done using STATA 15.0 software (StataCorp Texas) with significance placed at p-value < 0.05. RESULTS: A total of 274 patients were enrolled in the study. A majority were within the age group > 35 to ≤49 years (38.3%), and male (66.1%). More than one-third (40.9%) had persistent COVID-19 symptoms after discharge, and 19.7% had more than three persistent COVID-like symptoms. The most persistent COVID-like symptoms experienced were easy fatigability (12.8%), headaches (12.8%), and chest pain (9.8%). Symptomatic COVID-19 disease with moderate severity compared to mild severity was a predictor of persistent COVID-like symptoms after discharge (p < 0.05). CONCLUSION: Findings from this study suggests that patients who recovered from COVID-19 disease may still experience COVID-19 like symptoms, particularly fatigue and headaches. Therefore, careful monitoring should be in place after discharge to help mitigate the effects of these symptoms and improve the quality of life of COVID-19 survivors.

Outcomes of COVID-19 patients with comorbidities in southwest Nigeria.

BACKGROUND: Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. METHODS: This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. RESULTS: Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33-55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22-4.01), diabetes (OR: 3.69, 95% CI: 1.99-6.85), renal disease (OR: 12.53, 95%CI: 1.97-79.56), cancer (OR: 14.12, 95% CI: 2.03-98.19) and HIV (OR: 1.77-84.15]. CONCLUSION: Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.

Volunteering during the COVID-19 pandemic: Attitudes and perceptions of clinical medical and dental students in Lagos, Nigeria.

BACKGROUND: Volunteering within the health-care sector is crucial during pandemics. This study aimed to assess the attitudes and perceptions of clinical medical and dental students in Lagos, Nigeria, about volunteering during the coronavirus disease 2019 (COVID-19) pandemic. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted amongst medical and dental students undergoing clinical postings at the two public universities in Lagos, Nigeria, using total population sampling. Data were collected using a web-based questionnaire and analysed using Statistical Package for the Social Sciences. Chi-square test and logistic regression analysis were used to test for association at the level of significance of 5%. RESULTS: The mean age of the respondents was 23.3 years ± 2.6 standard deviation and 62.5% were females. The majority (82.9%) of the respondents agreed to volunteer if provided with adequate personal protective equipment (PPE) and if adequately trained to do so (79.3%). Although perceived as dangerous, the majority (91.2%) of the respondents considered volunteering during the COVID-19 pandemic as a form of educational experience. Compared to the final-year students, penultimate year students were more likely to volunteer in the event of a health manpower shortage. The final-year students were more likely to volunteer if government made the request. Female students were more likely than male students to volunteer even if they were not compensated but would require parental approval. CONCLUSION: Medical and dental students perceived their involvement during the COVID-19 pandemic as a form of educational experience but would require adequate training and PPE. There is a need to train and provide adequate PPE for them to function as volunteers.