The role of polio emergency operations centers: perspectives for future disease control initiatives in Nigeria.

The Nigeria Polio Emergency Operations Centre (EOC) was established in October 2012 to strengthen coordination, provide strategic direction based on real-time data analysis, and manage all operational aspects of the polio eradication program. The establishment of seven state-level polio EOCs followed. With success achieved in the interruption of wild poliovirus (WPV) transmission as certified in 2020, the future direction of the polio EOC is under consideration. This paper describes the role of the polio EOC in other emergencies and perspectives on future disease control initiatives. A description of the functionality and operations of the polio EOC and a review of documentation of non-polio activities supported by the EOC was done. Key informant insights of national and state-level stakeholders were collected through an electronic questionnaire to determine their perspectives on the polio EOC's contributions and its future role in other public health interventions. The polio EOC structure is based on an incident management system with clear terms of reference and accountability and with full partner coordination. A decline in WPV1 cases was observed from 122 cases in 2012 to 0 in 2015; previously undetected transmission of WPV1 was confirmed in 2016 and all transmission was interrupted under the coordination of the EOCs at national and state levels. During 2014-2019, the polio EOC infrastructure and staff expertise were used to investigate and respond to outbreaks of Ebola, measles, yellow fever, and meningitis and to oversee maternal and neonatal tetanus elimination campaigns. The EOC structure at the national and state levels has contributed to the positive achievements in the polio eradication program in Nigeria and further in the coordination of other disease control and emergency response activities. The transition of the polio EOCs and their capacities to support other non-polio programs will contribute to harnessing the country's capacity for effective coordination of public health initiatives and disease outbreaks.

Descriptive epidemiology of measles surveillance data, Osun state, Nigeria, 2016-2018.

BACKGROUND: Globally, an estimate of 254,928 measles cases in 2015 and 89,780 deaths in 2016 occur annually. In Nigeria, measles is the fifth leading causes of under-five child mortality with 342 confirmed cases found in the first 9 epidemic weeks in some states including Osun State. We described the distribution, trend and make projection of measles cases in Osun State. METHODS: The Osun State surveillance weekly reporting data on measles cases from all its 30 Local Government Area (LGA) were reviewed, from January 2016 to December 2018 (n = 1205). Data were analyzed using descriptive statistics and a multiplicative time series model (MTSM). The MTSM was used to determine the trend, seasonality in the data and make projections for 2019 and 2020. RESULTS: Cases of measles were reported across the 30 LGAs of the state between January 2016 and December 2018. The rate of reported cases of measles was 20.2, 34.4 and 28.8 per 100,000 populations in 2016, 2017 and 2018 respectively in Ede south LGA where the highest rates were reported in the 3-year period. Out of the three studied years, year 2017, recorded the highest number of reported cases of measles in Osun State. The trend line for the 3-year period showed a positive correlation (r = + 0.4979, p = 0.056). The computed quarterly variation for the studied years was 1.094 for the 1st quarter, 1.162 for the 2nd quarter, 0.861 for the 3rd quarter and 0.888 for the 4th quarter. A quarterly projection for 2019 and 2020 showed an increasing trend with the second quarter of each year likely to have the highest reported cases of measles. CONCLUSIONS: Ede south LGA has the highest proportion of reported measles cases in Osun State. Measles cases may increase in years ahead, but the second quarter of a year has the highest number. Government should strengthen the existing framework on measles reduction and more attention should be given to the second quarter of each year.

Determinants of intermittent preventive treatment of malaria among women attending antenatal clinics in primary health care centers in Ogbomoso, Oyo State, Nigeria.

INTRODUCTION: Despite the effectiveness of intermittent preventive treatment in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), the uptake and coverage in southwest Nigeria are low. We assessed the factors influencing utilisation of IPTp-SP. METHODS: A multistage sampling technique was used to select 400 pregnant women from six primary healthcare centers in Oyo State. Data on socio-demographic characteristics, knowledge, attitude towards IPTp-SP and its utilisation were obtained using a semi-structured questionnaire. Data were analyzed using SPSS software. Focus group discussions (FGD) and key informant interviews (KII) were held for pregnant women and healthcare workers and analysed thematically. RESULTS: Mean age of respondents was 27.2 (SD ± 5.5) years. Mean gestational age was 29.5 weeks (SD ± 5.4). Overall, 320 (80.0%) took SP, of which 152 (47.5%) took 2 doses and 112 (35.0%) took under directly observed therapy (DOT). We found that early booking for ANC, more than two visits to ANC (adjusted odds ratio (aOR) = 5.6; 95% CI: 1.2 - 26.6), good knowledge on IPTp (aOR = 9.3; 95% CI: 5.4 - 16.0), positive attitude towards IPTp (aOR = 2.1; 95% CI: 1.5 - 2.9) and being employed (aOR = 1.4; 95% CI: 1.1 - 1.7) were factors associated with IPTp-SP utilisation. The FGD and KII revealed that IPTp-SP drugs were mostly taken at home due to stock out. CONCLUSION: Late ANC booking with stock out of IPTp-SP drugs was responsible for its low utilisation. There is need to encourage pregnant women to book early for ANC. Adherence to the practice of DOT scheme is recommended to improve IPTp-SP utilisation.

Factors affecting access to information on routine immunization among mothers of under 5 children in Kaduna State Nigeria, 2015.

INTRODUCTION: Immunization is one of the most effective interventions to prevent disease and early child death. A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities. Knowledge and perception of mothers/caregivers regarding VPDs influence demand and utilization of immunization services. We examined the associations between knowledge, perception and information on routine immunization received by mothers/caregivers in Kaduna State. METHODS: We enrolled 379 eligible caregivers in a community-based cross-sectional study. We sampled respondents using multistage sampling technique. We collected data on socio-demographic characteristics; knowledge and perception on routine immunization using semi-structured interviewer-administered questionnaire. We conducted bivariate analysis and logistic regression using Epi-InfoTM version 7 at 5% level of significance. RESULTS: Mean age of respondents was 28.6 years (standard deviation=±6.6 years), 34% completed secondary school, 65% were unemployed, 49% lived in rural settlements. Among respondents' children 53.3% were females and 62.8% fell within 2nd-5th birth order. Only 15.6% of these children were fully immunized. Seventy-five percent of respondent did not obtain information on routine immunization within 12 months prior to the study. About 64% had unsatisfactory knowledge while 55.4% exhibited poor perceptions regarding routine immunization. Commonest source of information was radio (61.61%). On logistic regression educated participants (Adjusted odds ratio (AOR)=1.9, 95% CI: 1.1-3.3), mothers' perception (AOR=2.6, 95% CI: 1.5-4.5) and monogamous family setting (AOR=2.4, 95% CI: 0.2-0.6) were likely to have obtained information on routine immunization. CONCLUSION: There is low access to information, poor maternal knowledge on routine immunization with low vaccination coverage in this community. Efforts should be made by the Governments to scale up sensitization of mothers/caregivers to improve their knowledge on routine immunization through radio jingles.

Prevalence and risk factors of Mycobacterium tuberculosis complex infection in slaughtered cattle at Jos South Abattoir, Plateau State, Nigeria.

INTRODUCTION: Bovine tuberculosis (BTB) is widespread yet poorly controlled in Nigeria hence posing a public health threat. This study determined the prevalence of Mycobacterium tuberculosis complex (MTC) and factors associated with MTC among slaughtered cattle at Jos South Abattoir in Plateau State, Nigeria. METHODS: We conducted a cross sectional study in which we collected 168 lung samples systematically from 485 slaughtered cattle from May-June, 2012, and tested for acid fast bacilli (AFB) using Ziehl-Neelsen test and a duplex polymerase chain reaction technique (PCR) for MTC detection. Data on cattle socio-demographic characteristics and risk factors for zoonotic BTB infection was obtained and analyzed using Epi info version 3.5.3 to determine frequency, proportions, and prevalence odds ratios. Multiple logistic regression was done at 95% Confidence Interval (CI). RESULTS: The mean age of the cattle was 5.6 ± 1.3 years and (108) 64.3% were females. Majority were indigenous White Fulani breed of cattle (58.5%) and about half (54.8%) were slightly emaciated. Prevalence of MTB complex was 21.4% by AFB test and 16.7% by duplex PCR. Of 33 (19.6%) lungs with lesions, 27 (81.8%) were positive for AFB; while of 135 (80.4%) lungs without lesions, 9 (6.7%) were positive for AFB. Lungs with lesions were 52 times more likely to test positive to AFB test compared to tissues without lesions (AOR=52.3; 95% CI: 16.4-191.8). CONCLUSION: The presence of MTC in cattle signifies its potential risk to public health. Presence of lesions on lungs is a reliable indicator of MTC infection that meat inspectors should look out for.