Evaluation of malaria surveillance system in Benue State, Nigeria.

BACKGROUND: Malaria is a priority global health disease with high morbidity and mortality especially among children under-five and pregnant women. Malaria elimination requires an effective surveillance system. The malaria surveillance system in Benue State was evaluated to assess its attributes and performance in line with set objectives. METHODS: The updated United States Centers for Disease Control and Prevention guideline for evaluating surveillance systems was used. The surveillance system's key attributes was quantitatively and qualitatively assessed. Semi-structured questionnaires were administered to all Local Government Area (LGA) Roll Back Malaria (RBM) focal persons and five key informants were interviewed at the State level. The Benue State District Health Information System-2 (DHIS-2) malaria data and monthly summary forms were reviewed from January 2015 to December 2019. RESULTS: A total of 46 RBM focal persons and 5 key-informants participated. About 56.9% were males, the mean-age 43.8 (SD ± 9.3) years and 32 (62.8%) had ≥ 20-year experience on malaria surveillance with mean-year-experience 20.8 (SD ± 7.8) years. All 46 (100%) RBMs understood the case definition; 43 (93.5%) found it easy-to-fill the standardized data tools and understood the data flow channels. The malaria surveillance system in Benue is simple, acceptable and useful to all stakeholders, 36 (70.6%) found switching from the paper-based to the electronic-data tools with ease and 45 (88.2%) stated that analysed data were used for decision-making. Data flow from LGA to State is clearly defined, however majority of the data is collected from public health facilities through the DHIS-2 Platform. The overall timeliness and completeness of reporting was 76.5% and 95.7%, respectively, which were below the ≥ 80% and 100% targets, respectively. CONCLUSIONS: The malaria surveillance system in Benue State is simple, useful, acceptable, and flexible, but it is not representative and timely. Public-private and public-public-partnerships should be strengthened to encourage reporting from both private and tertiary health facilities and improve representativeness, and frequent feedback to improve reporting timeliness.

Stigmatization, psychological and emotional trauma among frontline health care workers treated for COVID-19 in Lagos State, Nigeria: a qualitative study.

BACKGROUND: COVID-19 pandemic has resulted in global health and economic crisis. We investigated the experiences of frontline health care workers recovering from COVID-19 in Lagos State Nigeria. METHODS: We conducted a qualitative study among frontline health workers recovering from COVID-19 in Lagos State, Nigeria. We interviewed 12 respondents before achieving data saturation. We used a checklist to guide the interview according to the phenomenon under study. Data obtained were analyzed using Colaizzi's phenomenological method. RESULTS: The study was summarized under five themes: knowledge of COVID-19, exposure, reactions, challenges and recommendations. The respondents were quite knowledgeable on COVID-19, their reactions when informed of their status were denial, anxiety, distress, disorientation, crying for fear of stigmatization, while some were psychologically prepared. Reactions from colleagues, family and friends were encouraging and provided solace for them with a few colleagues and families that had negative reactions. Challenges include anosmia, movement restriction, loneliness, worries about the state of their families, nondisclosure of status to family members, non-conducive isolation centre with limited space, insomnia, stigmatization by health workers at the isolation centre, extended duration of stay, delay in the release of test results and use of ambulance for evacuation to the isolation centres. Coping strategies were watching movies, phone calls, use of social media, listening to music, attending webinars, working on projects and reading spiritual books. Recommendations were early laboratory testing of samples and conveying of results, increase testing capacity, the need of health care workers to be more compassionate, better method of evacuation of people that tested positive to COVID-19, aside the use of ambulance that increases the likelihood of stigmatization and standard guideline for the case management of people recovering from COVID-19 in Lagos state. CONCLUSIONS: Respondents felt stigmatized and psychologically and morally traumatized. Isolation is a difficult experience and some negative emotions as expressed by previous studies were experienced by the respondents. There is need for increased testing capacity, timely results dissemination, early evacuation and creation of more isolation centres in Lagos State due to the rising number of cases and shortage of bed space.

HIV and AIDS-related knowledge, HIV risk perception, uptake of HIV testing and its predictors among prison inmates in Bauchi State, Nigeria: a cross-sectional study.

Introduction: globally, HIV infection among prison inmates is significantly higher than in the general population. Therefore, it is important to identify inmates-living-with-HIV, through HIV-testing, in keeping with the target of UNAIDS vision 90-90-90. We assessed HIV/AIDS-related knowledge, HIV-risk perception and predictors of HIV-testing-uptake in Bauchi Prison. Methods: we conducted a cross-sectional study among 310 inmates selected with 2 stage sampling. Data was collected using a pretested, structured, interviewer-administered questionnaire. Inmates that consented to HIV-test were tested. We estimated inmates' knowledge about HIV/AIDS, the level of HIV testing uptake and predictors of HIV testing-uptake using multiple logistic regression at 5% significant level. Results: the mean age (SD) was 32.3 (±9.4) years and 94.8% were males, 47.1% (95% CI: 41.6-52.7) of the respondents had good knowledge of HIV/AIDS. Fifty-five percent (95% CI: 49.9-60.9) felt they were not at risk of contracting HIV. Uptake of HIV-testing was 58.1% (95% CI: 52.5-63.4). Independent predictors for the uptake of HIV-testing were age 35-44 years (aOR= 3.3; 95% CI: 1.4-7.7), positive risk perception (aOR= 3.3; 95% CI: 1.8-6.2), good knowledge of HIV (aOR= 9.6; CI: 5.1-18.0) and knowing someone who had died of AIDS (aOR= 4.1; 95% CI: 1.9-6.4). Conclusion: good knowledge of HIV/AIDS and HIV-testing-uptake was low among the inmates. We recommended the development and implementation of targeted HIV-testing interventions that cater to the specific needs of different age-groups within the prison population. The prison authority should develop prison-specific health education programme and awareness campaigns aimed at promoting accurate HIV-risk perception, improving their knowledge and help inmates make informed decisions that will prevent them from contracting HIV.

Drug-susceptible tuberculosis treatment outcomes and its associated factors among inmates in prison settings in Bauchi State, Nigeria, 2014-2018.

Tuberculosis (TB) is a contagious disease and its transmissibility is increased in congregate settings. TB incidence rates are five-to-fifty times higher among inmates in prison settings than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its associated factors in Nigerian prison settings. We therefore assessed TB treatment outcomes among inmates in prison settings in Bauchi State, Nigeria. We conducted a retrospective data analysis of inmates with TB in the five-main prison settings in Bauchi State. We extracted socio-demographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a checklist. We calculated the TB treatment success rate (TSR) and explored the relationship between the TSR and socio-demographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify factors associated with TSR at 5% level of significance. All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 65 (30.1%) were transferred-out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Factors associated with successful-treatment-outcome were age, weight, imprisonment duration and HIV status. The results indicate that inmates who are 20-29 years are at least ten times more likely to be successful (aOR = 10.5; 95%CI: 3.2-35.1) than inmates who are 55 years or older. Inmates who are 30-39 years are about four times more likely to be successful than inmates who are 55 years or older (aOR = 4.2; 95% CI: 1.3-13.1). In general, the younger an inmate, the more successful he is. Inmates with pretreatment-weight; 55kg or more are 13 times more likely to be successful (aOR = 13.3; 95%CI: 6.0-29.6) than inmates with weight below 55kg. Inmates who were imprisoned for 2 years or less are about three times more likely to be successful (aOR = 2.6; 95%CI: 1.3-5.4) than inmates who were imprisoned for more than 2 years and HIV negative inmates were three times more likely to succeed (aOR = 3.3; 95%CI:1.4-7.8) than inmates who were HIV positive. We recommended that to improve TB treatment outcome among inmates; age, duration-of-imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking-system be developed by the authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.