Epidemiology of coronavirus disease 2019 (COVD-19) outbreak cases in Oyo State South West Nigeria, March-April 2020.

INTRODUCTION: On March 17th, 2020, Oyo State recorded her first case of COVID-19 through a United Kingdom returnee. Oyo State Ministry of Health with the support of technical and development partners responded quickly and effectively to contain the outbreak. The outbreak was characterized by place, person and time. METHODS: Field investigations were conducted and contact tracing and follow up done, all confirmed cases were identified, line-listed and analyzed using Epi-info version 7. RESULTS: A total of 34 confirmed cases were identified all within the capital city of Oyo State and two transferred from other states. The mean age was 49.1 ± 2.0 years with over 40% within the age group 50-59 years. There were 11(35.5%) health care workers infection. The case-fatality was 6.5%. The epidemic curve initially shows a typical propagated pattern, followed by a point source; though atypical. CONCLUSION: Outbreak of COVID-19 was confirmed in Oyo State. Field investigation provided information on the characteristics of persons, time and place. Intensified surveillance activities such as contact tracing and follow- up, drive through testing and active case search were useful in early case detection and control of the outbreak.

Maternal complication prevention: evidence from a case-control study in southwest Nigeria.

BACKGROUND: The importance of strengthening maternal health services as a preventive intervention for morbidities and complications during pregnancy and delivery in developing countries cannot be over-emphasised, since use of prenatal health services improves maternal health outcomes. AIM: This study investigated differences in risk factors for maternal complications in booked and unbooked pregnant women in Nigeria, and provided evidence for their prevention. SETTING: The study was carried out in a postnatal ward in a secondary health facility. METHODS: This was a case-control study involving booked and unbooked pregnant women who had delivered. Consecutive enrolment of all unbooked pregnant women (cases) was done, and one booked pregnant woman (control) was enrolled and matched for age with each of these. Both groups were interviewed using a questionnaire, whilst records of delivery were extracted from the hospital files. Findings were subjected to logistical regression at a significance level of p < 0.05. RESULTS: Booked women had a lower median length of labour (10 hours) compared to unbooked women (13 hours). More women in the booked control group (139; 35.1%) than in the unbooked case group (96; 23.6%) reported at least one type of morbidity during the index pregnancy (p = 0.0004). Booking status was associated with a likelihood of spontaneous vaginal delivery. Young maternal age, low education, rural residence and low socio-economic status were associated with less likelihood of using prenatal services. Young maternal age, low education and intervention in the delivery were associated with a likelihood of experiencing a complication of delivery. CONCLUSION: Strengthening antenatal and secondary healthcare services as short- and medium term measures might be cost-effective as a preventive strategy in complications of pregnancy,whilst socio-economic dimensions of health are accorded priority in the long term.

Birth outcomes among booked and unbooked women at a secondary health facility in southwest Nigeria: implications for strengthening perinatal health services.

A case-controlled analytic study involving 406 singleton unbooked and 396 singleton booked births was conducted. Unbooked births constituted 16.6% of all births during the study. Booked births were half as likely to preterm than unbooked births (43, 10.9% vs 81, 20.0%; p<0.001). Unbooked births were seven times more likely to be stillbirth than booked births (80, 17.7% vs 13, 3.3%; p< 0.001). Booked births were a third as likely to have a low birth weight as unbooked births (36, 9.1% vs 104, 25.6%; p< 0.001). Unbooked births had a significantly lower mean birth weight of 2.95 ± 0.53 kg than 3.08 ± 0.45 kg of booked births (p< 0.001). Unbooked births had a significantly lower mean Apgar score at 1 minute and 5 minutes than booked births (6.64 ± 1.42 vs 7.08 ± 1.12 and 9.16 ± 1.40 vs 9.64 ± 1.00; p< 0.001) respectively. Unbooked births are common and their birth outcomes may result in high morbidity and disability, thereby contributing to the high child mortality in developing countries. Strengthening perinatal health services through professional skilled care at birth and providing quality services for all unbooked births may lead to improved birth outcomes.