Retrospective Comparison of Nigeria's Emergency Response Between the 2014 Ebola Outbreak and 2020 COVID-19 Pandemic.

The 2014 Ebola Virus disease outbreak and the COVID-19 pandemic are prominent among the viral infectious diseases that threatened our existence in the last decade. We did a retrospective review of Nigeria's responses during the two crises using different keywords: pathogenicity, risk communication, data gathering, and vaccine issues. These served as discussion points, and we ended by highlighting a few salient observations that should serve as reflection, learning points, and recommendations for better responses in the future. Based on these keywords, we noticed some differences in the two outbreaks, some of which affected the mode of response. At some point, Nigeria was commended for curtailing the Ebola outbreak. This was not the same with COVID-19 which is still very much with us. Also, the latter received more global attention. We then concluded the review by outlining salient points that should serve as reflection and learning points to serve as a guide for a better approach in future epidemics/disaster outbreaks.

COVID-19 Pandemic: A Survey of its Knowledge and Risk Perception among Nigerians.

Background: The effect of the current COVID-19 pandemic on economies and health systems has been profound. Knowledge of the virus continues to evolve over time. This study aimed to assess the knowledge and the factors associated with the perceived risk of contracting COVID-19 infection during the pandemic. Methodology: This was a cross-sectional study conducted in different parts of Nigeria which were stratified into east, north, and west. A self-administered questionnaire that contained questions related to socio-demographics, medical history, knowledge of COVID-19 (knowledge of viral transmission and infection symptoms), and risk perception of contracting COVID-19 among consenting individuals. The information was extracted and analysed electronically, descriptive variables were summarized in simple proportions and a chi-square test was used to test for association between dependent and non-dependent variables. The level of significance was set at p-value <0.05. Results: The study had 350 participants with 189 (52.8%) females while almost 50% (171) were aged less than 30 Years. Over 90% of participants had good knowledge of viral transmission while 37.7% and 47.2% respectively had good symptom and risk perception scores. The socio-demographic factors - education and geographical location had an association with risk perception (p = 0.02 and 0.04 respectively). Conclusion: Participants had good knowledge of viral transmission but poor symptom and risk perception scores. This could have implications for their health habits. However, proper education remains the most viable tool for bridging the existing gaps.

Determinants of primary healthcare services utilisation in an under-resourced rural community in Enugu State, Nigeria: a cross-sectional study.

Introduction: primary health care (PHC) is essential towards achieving universal health coverage. Improving PHC services require understanding context-specific factors influencing utilisation. We assessed the factors influencing utilisation of PHC services in a rural community in Enugu, Nigeria. Methods: we conducted a cross-sectional community-based survey between May and June, 2017. Information on socio-demographic characteristics, utilisation of PHC services, community- and PHC facility-related factors associated with utilisation of PHC services was obtained from 335 adult residents aged ≥ 18 years using a pre-tested semi-structured interviewer-administered questionnaire. Data were analysed using descriptive and inferential statistics at 5% level of significance. Results: of the 335 respondents, 155 (46.2%) reported utilisation of PHC services the last time they were sick. Of 178 respondents who did not utilise PHC services, 51 (28.7%) reported poor quality health services, 41 (23.0%) unavailability of medical doctors, 31 (17.4%) long patient waiting time and 25 (14.0%) unavailability of drugs as reasons for non-utilisation. Being a female (AOR = 2.3 (95% CI 1.3 - 4.0)), affordability of health services (AOR = 2.4 (95% CI 1.3 - 4.6)), inadequacy of healthcare staff (AOR = 0.3 (95% CI 0.1 - 0.5)), shorter hospital waiting time (AOR = 2.2 (95% CI 1.2 - 4.3)) and satisfaction with PHC services during previous visit (AOR = 2.6 (95% CI 1.1 - 6.3)) influenced utilisation of PHC services. Conclusion: PHC services utilisation was low. Improving utilisation would require addressing cost of health services, adequacy of healthcare staff, patient waiting time and ensuring patient satisfaction with PHC services.

Determinants for Acceptance of COVID-19 Vaccine in Nigeria.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic heralded an unprecedented race to the development of several vaccine candidates at record speeds never seen in global health. Within nine months, Pfizer-BioNTech's COVID-19 vaccine was approved by the United States FDA. Unfortunately, while these advances were ongoing, there was a burgeoning epidemic of disinformation about the virus and the vaccines that affected the willingness of people, especially minority groups, to get vaccinated. In Nigeria, this wave of vaccine hesitancy was happening against the backdrop of landmark pharmaceutical litigations such as the 2007 Pfizer trovafloxacin lawsuit in the country. AIM: To assess the determinants of the COVID-19 vaccine's acceptability among Nigerians. MATERIALS AND METHODS: Following ethical approval, a population-based cross-sectional study was conducted from November 2020 to January 2021 using an adapted pretested, self-administered questionnaire originally designed by Amyn Malik and colleagues who conducted a similar study at Yale University School of Public Health. The participants were recruited through simple random sampling using a list of community and corporate sites obtained from Google Maps in the three regional zones of Nigeria (north, east, and west) in diverse occupational and residential settings. Information obtained includes socio-demographics, medical history related to COVID-19, level of knowledge, risk perception, and attitudes toward COVID-19 and the vaccines. Descriptive and inferential statistics were done, and results were summarized into percentages and associations. The level of statistical significance was set at a p-value of <0.05. Using the open EpiR package (Emory), we determined a minimum of 340 participants for a statistical power of 80%. RESULTS: A total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions, of which 189 (53%) were females. The mean age of respondents was 32 years (±11.2 SD). About 75% of the participants had at least a college education. The majority (66.2%) of the participants were willing to accept the approved vaccine. The mean risk perception score for COVID-19 was 5.1 (±2.2 SD) out of 10, while the mean COVID-19 symptom knowledge score was 8.6 (±4.1 SD) out of 19. Variables such as being male, identifying as Christian, Hausa ethnicity, and living in northern Nigeria had a statistically significant relationship with the willingness to get vaccinated. CONCLUSION: Over 60% of Nigerians are willing to take the COVID-19 vaccines if recommended by health workers. We found male gender, religion, ethnicity, and geographical location to positively influence the willingness of Nigerians to get vaccinated against COVID-19. Health workers should be supported to go beyond the confines of the hospital to educate the general public in schools, marketplaces, churches, and corporate organizations on the efficacy and safety of the approved vaccines.

Water, sanitation and hygiene risk factors associated with diarrhoea morbidity in a rural community of Enugu, South East Nigeria.

INTRODUCTION: diarrhoea remains a public health problem globally with majority of diarrhoea morbidity and mortality occurring in low resource settings. This study assessed the prevalence of diarrhoea and factors associated with diarrhoea in a rural community in Enugu, South East Nigeria. METHODS: a community-based cross-sectional survey was conducted between May and June, 2017. Information on socio-demographic characteristics, water, sanitation, hand washing practices and diarrhoea history was obtained from 534 community residents using a structured interviewer administered questionnaire. Data were analyzed using descriptive statistics, Chi-square and logistic regression tests at 5% level of significance. RESULTS: prevalence of diarrhoea in the two weeks preceding the study was 7.47% and 10.77% among all ages and children younger than five years respectively. Of 469 residents aged five years and above, 206 (43.92%) accessed source of drinking water within 30 minutes round trip walking distance from their households, 275 (58.64%) practiced open defecation while 456 (97.23%) and 455 (97.01%) reported washing hands with soap or ash and water before eating and after using the toilet respectively. Two or more households sharing a toilet facility [AOR = 4.78 (95% CI 2.03-11.24)] was a risk factor for diarrhoea while washing hands with soap or ash and water before eating [AOR = 0.23 (95% CI 0.06-0.90)] and after using the toilet [0.16 (95% CI 0.04-0.55)] protected against diarrhoea. CONCLUSION: increasing access to improved sanitary sewage disposal methods and promoting hand washing with soap and water at critical moments would improve diarrhoeal disease control.