Achieving a robust mentoring and research capacity program in a LMIC - the BRAINS faculty development model.

BACKGROUND: A research and training program (RTP) was carried out to build the capacity of faculty and improve the culture of research in the College of Medicine, University of Lagos (CMUL), Nigeria. METHODS: Realist-guided mixed methods evaluation of the BRAINS project was carried out using secondary data generated during the 5-years (2015 - 2020) of project implementation. Capacity building workshops and mentored research activities targeted at faculty in the CMUL were conducted. Overall, 1,418 participants attended the workshops in batches. Among the participants, forty-five faculty received grants and were mentored by senior professionals (local & international) to conduct research. Data were extracted from all project-related documents including coursework biodata, workshop evaluation forms, quarterly project reports, and end- of-project reports, submitted by the mentees, minutes of meetings, and the proposal submitted for funding. It was in the form of continuous variables and prose (sentences & stories). Quantitative data were analysed with IBM SPSS statistics version 20. Mean knowledge score and mean difference was calculated, paired t-test was carried out using p < 0.05 to determine statistical significance. The prose was thematically analysed to generate themes and narratives. Both were subsequently combined for interpretation and used to refine the initial programme theory into an evidence-informed theory. RESULTS: Twelve courses were deployed, and 1,418 participants (47.8% males and 52.2% females) from medical, nursing, and allied medical departments were trained. Eighty participants were trained in Responsible Conduct of Research and eighty-one on Manuscript Writing over three years. A comparison of the pre/post-test knowledge scores showed a positive mean difference. Thematic analysis of workshop data produced three thematic domains representing effectiveness and gains namely: cognitive, reward, and behavioural. 45 trainees were awarded grants and mentored, and analysis of mentee's data generated 4 themes: Achieving a robust mentoring program; Benefits of the mentoring program; Resilience in research; Improving the mentoring program. CONCLUSION: By contributing to the body of knowledge available on RTPs, this evaluation identified key components that contributed to the success of the project and developed a model for achieving a robust training and mentoring program which can be replicated in other LMICs.

Targeted faith-based and faith-placed interventions for noncommunicable disease prevention and control in low- and middle-income countries: a systematic review protocol.

BACKGROUND: Low- and middle-income countries (LMICs) bear a disproportionately high burden of noncommunicable diseases (NCDs) with severe socioeconomic consequences. Targeted interventions that are faith-based or take place in faith-based settings are historically viable for health promotion and disease prevention programmes. However, evidence of their effectiveness often comes from high-income countries. This paper outlines the protocol for the systematic review of faith-based and faith-placed interventions for NCDs in low- and middle-income countries. OBJECTIVE: To determine the effectiveness of faith-based and faith-placed interventions or interventions within faith-based settings targeted at NCDs and/or their risk factors in LMICs. METHODS: We will conduct a systematic search of PubMed, Embase, Scopus, WHO Library, and grey literature to locate published and unpublished studies. We will consider quantitative studies that report on interventions (a) with faith-based components or that take place in faith-based settings (b) for the prevention and control of one or more of the top ten NCDs listed in the Global Burden of Disease or their known risk factors (c) occurring among adults aged 18 and above (d) that take place in one or more LMICs. We will screen the titles, abstracts, and full text of articles for eligibility. Included articles will be critically appraised for quality and the inclusion of faith-based components by at least two independent reviewers. Data extraction will be performed for study characteristics and findings. A meta-analysis will be used to synthesize the results; if impossible, a narrative synthesis will be performed. DISCUSSION: This review will attempt to synthesize up-to-date evidence to guide effective decision-making, allocation of health resources, and the design of future trials to test the efficacy of NCD interventions in faith-based settings. The study will increase the understanding of the existing evidence, highlight the need for additional evidence, and guide possible directions for future collaborations between public health professionals and faith-based health service providers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020186299.

Implementing a smoking cessation intervention for people experiencing homelessness: Participants' preferences, feedback, and satisfaction with the 'power to quit' program.

BACKGROUND: Smoking rates among populations experiencing homelessness are three times higher than in the general population. Developing smoking cessation interventions for people experiencing homelessness is often challenging. Understanding participant perceptions of such interventions may provide valuable insights for intervention development and implementation. We assessed participants' satisfaction and preferences for the Power to Quit (PTQ) program. METHODS: PTQ was a 26-week community-based smoking-cessation RCT among people experiencing homelessness. A total of 315 of the 430 enrolled participants completed the 26 week-study feedback survey. Overall program satisfaction was measured on a 5-point Likert scale by asking the question "Overall, how satisfied were you with the Power to Quit Program?" Analyses were conducted to identify factors associated with overall program satisfaction. RESULTS: Participants were mostly male (74.9%), African American (59.0%), 40 years and older (78.2%), and not married or living with a partner (94.9%). Visa gift cards were the most preferred incentive followed by bus tokens and Subway restaurant coupons. The patch and counseling were the top-ranked intervention component, 55.3% rated the patch as very helpful; 59.4% felt counseling sessions was very helpful; 48.6% found reminder phone calls or messages most helpful for appointment reminders. Majority (78.7%) said they were very satisfied overall, 80.0% were very satisfied with the program schedule, and 85.4% were very satisfied with program staff. Race and age at smoking initiation were predictors of overall program satisfaction. African American/Black participants were 1.9 times more likely to be satisfied with the program compared to White participants. CONCLUSION: Majority of the participants of PTQ were satisfied with the program. This study supports the acceptability of a smoking cessation program implemented in a population experiencing homelessness. The high rate of satisfaction among African American participants may be in part because of race concordance between participants, study staff, and community advisory board. Including staff that have a shared lived experience with participants in a smoking cessation study may improve the participant satisfaction within such studies.

Epidemiological trends of coronavirus disease 2019 in Nigeria: From 1 to 10,000.

BACKGROUND: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th February 2020 and 95 days after, it had spread to 35 states and the Federal Capital Territory (FCT) with 10,162 confirmed cases. We reviewed the trends of the epidemic from the 27th February to the 31st May 2020, when it reached the 10,000th mark vis-à-vis government policies to contain the spread of the disease. METHODS: We used publicly available data from the Nigeria Center for Disease Control from 27th February 2020, when Nigeria recorded her first coronavirus disease 2019 case to the 31st May 2020. We used line graphs to describe the trends of the daily course of cumulative cases, discharges and deaths in states and nationally. The doubling time, transmission rates were inferred from these trends and the epidemiological curve generated was reviewed vis-a-vis the instituted government policies over the specified period. RESULTS: The epidemic curve in Nigeria has been on an upward trajectory as the number of cases crossed the 10,000 marks, 3 months after the first case was recorded. The first spike in the number of new cases was observed on the 21st April 2020, with 117 cases. The number of daily deaths within the study period was highest on the 2nd May 2020 (17 new deaths). Geo-political zone variations were also observed. Of the 63,882 screening tests conducted during the study period, 15.9% tested positive; the doubling time and transmission rates were 23.5 days and 1.0%, respectively, as at 31st May 2020. Since the lockdown measures were lifted in Lagos and the FCT on the 4th May 2020, the number of cases has been on a steady increase each week. CONCLUSION AND RECOMMENDATIONS: In Nigeria, the epidemic curve has been on an upward direction since the first reported case and it took 3 months to reach 10,000 cases. We recommend a sustained drive in the enforcement of physical and social distancing and increase in testing capacity to flatten the epidemic curve.

A preprogram appraisal of factors influencing research productivity among faculty at college of medicine, University of Lagos.

Background: A defining feature of any university is its dedication to scholarly activities, leading to the generation of knowledge and ideas Research productivity is a measure of achievement of a scholar. The number of research publications in peer-reviewed journals is an important criterion for assessing productivity and prestige in the academia. Aims and Objectives: This cross-sectional descriptive study assessed the level of research productivity (RP) among junior faculty at the College of Medicine, University of Lagos, and investigated factors affecting their research output prior to the implementation of a 5-year training grant funded by the National Institutes of Health. Methods: Seventy junior faculty members attended a pre-program training, and the self-reported number of peer-reviewed publications (PRPs) was used as an indicator. Intrinsic and extrinsic factors influencing RP among the attendees were assessed and ranked. Results: The majority (42/70, 60%) of the respondents had <10 PRPs. The median (interquartile range) number of PRPs was 7 (3-18). A desire for the development of their personal skills, contribution to society, and personal research interests topped the list of intrinsic factors influencing RP. Work flexibility, research autonomy, and scholarly pursuits were the bottom three. A desire for promotion, respect from peers, and increased social standing were the top three extrinsic factors, while monetary incentives, employment opportunities, and the need to attend conferences were the lowest three. The top barriers to RP were lack of resources and lack of mentoring. Perceived older age, lack of time, and motivation were the lowest three barriers. Older age and professional cadre were associated with increased RP (P < 0.05). Conclusion: Among the participants, research output appears to be motivated primarily by a desire for personal development,promotion, and respect from peers. Lack of access to resources was the main barrier to increased RP. These factors may need to be considered when developing programs designed to promote RP.

RésuméContexte: Une caractéristique déterminante de toute université est son dévouement aux activités savantes, menant à la génération de connaissances et d'idées La productivité de la recherche est une mesure du rendement d'un chercheur. Le nombre de publications de recherche dans des revues à comité de lecture est un critère important pour évaluer la productivité et le prestige de l'académie. Buts et objectifs: Cette étude descriptive transversale a évalué le niveau de productivité de la recherche (RP) parmi les professeurs débutants du Collège de médecine de l'Université de Lagos et a examiné les facteurs affectant leurs résultats de recherche avant la mise en œuvre d'une subvention de formation de 5 ans. financé par les National Institutes of Health. Méthodes: Soixante-dix facultés juniors ont suivi une formation préalable au programme et le nombre autodéclaré de publications évaluées par des pairs a été utilisé comme indicateur. Les facteurs intrinsèques et extrinsèques influençant la RP chez les participants ont été évalués et classés. Résultats: La majorité (42/70, 60%) des répondants ont utilisé moins de 10 publications évaluées par des pairs. Le nombre médian (intervalle interquartile) de PRP était de 7 (3­18). Le désir de développer leurs compétences personnelles, leur contribution à la société et leurs intérêts personnels en recherche figuraient en tête de liste des facteurs intrinsèques influençant la productivité de la recherche. La flexibilité du travail, l'autonomie de recherche et les activités universitaires étaient les trois derniers. Un désir de promotion, le respect des pairs et une position sociale accrue étaient les trois principaux facteurs extrinsèques, tandis que les incitations monétaires, les possibilités d'emploi et la nécessité d'assister à des conférences étaient les trois plus faibles. Les principaux obstacles à la productivité de la recherche étaient le manque de ressources et le manque de mentorat. L'âge avancé perçu, le manque de temps et la motivation étaient les trois obstacles les plus bas. L'âge avancé et les cadres professionnels étaient associés à une augmentation de la RP (P <0,05). Conclusion: parmi les participants, les résultats de la recherche semblent être principalement motivés par un désir de développement personnel, de promotion et de respect de la part des pairs. Le manque d'accès aux ressources était le principal obstacle à l'augmentation de la productivité de la recherche. Ces facteurs peuvent devoir être pris en compte lors de l'élaboration de programmes conçus pour promouvoir la productivité de la recherche.

A preprogram appraisal of factors influencing research productivity among faculty at college of medicine, University of Lagos

A defining feature of any university is its dedication to scholarly activities, leading to the generation of knowledge and ideas Research productivity is a measure of achievement of a scholar. The number of research publications in peer-reviewed journals is an important criterion for assessing productivity and prestige in the academia. Aims and Objectives: This cross-sectional descriptive study assessed the level of research productivity (RP) among junior faculty at the College of Medicine, University of Lagos, and investigated factors affecting their research output prior to the implementation of a 5-year training grant funded by the National Institutes of Health. Methods: Seventy junior faculty members attended a pre-program training, and the self-reported number of peer-reviewed publications (PRPs) was used as an indicator. Intrinsic and extrinsic factors influencing RP among the attendees were assessed and ranked. Results: The majority (42/70, 60%) of the respondents had <10 PRPs. The median (interquartile range) number of PRPs was 7 (3­18). A desire for the development of their personal skills, contribution to society, and personal research interests topped the list of intrinsic factors influencing RP. Work flexibility, research autonomy, and scholarly pursuits were the bottom three. A desire for promotion, respect from peers, and increased social standing were the top three extrinsic factors, while monetary incentives, employment opportunities, and the need to attend conferences were the lowest three. The top barriers to RP were lack of resources and lack of mentoring. Perceived older age, lack of time, and motivation were the lowest three barriers. Older age and professional cadre were associated with increased RP (P < 0.05). Conclusion: Among the participants, research output appears to be motivated primarily by a desire for personal development,promotion, and respect from peers. Lack of access to resources was the main barrier to increased RP. These factors may need to be considered when developing programs designed to promote RP

Predictors of tuberculosis knowledge, attitudes and practices in urban slums in Nigeria: a cross-sectional study.

INTRODUCTION: Nigeria is among six countries responsible for the majority of tuberculosis (TB) cases in the world. The Nigerian government has emphasized community-based case finding to increase detection of TB. This process requires efforts to improve knowledge, attitudes and practices (KAP) of TB, particularly in the poorest of communities. This study presents data from a KAP survey administered in two underserved Nigerian communities. METHODS: a structured survey was administered by trained interviewers among adult residents in two slum communities in Lagos, Nigeria. Participants were selected through multistage random sampling. KAP scores were computed and the predictors of higher scores were assessed. RESULTS: a total of 504 respondents were surveyed. The mean KAP scores were relatively low: 9.8 ± 7.1 for knowledge (out of a maximum 34), 5.3 ± 3.4 for attitude (maximum = 10), and 5.2 ± 1.5 for practice (maximum = 7). The predictors of good knowledge were increasing age, post secondary education and professional occupation. The predictors of positive attitude were post secondary education and good TB knowledge. Good knowledge was a predictor of good practice. CONCLUSION: our findings underscore the need to improve the education about TB in underserved communities. Improving KAP scores will ultimately lead to higher rates of TB detection and treatment.

High group B streptococcus carriage rates in pregnant women in a tertiary institution in Nigeria.

INTRODUCTION: In contrast to industrialized countries, until recently Group B Streptococcus (GBS) was infrequently reported in the developing world. This study was aimed at investigating the prevalence of GBS maternal colonization and to analyze the serotype distribution among the isolates. METHODS: Vagino-rectal swabs collected from pregnant women were cultured for GBS using conventional media. Swabs were also taken from the mouths, ears and umbilical stumps of the neonates born to colonized mothers. Multiplex PCR and a conventional PCR to discern the gbs2018-ST-17 gene (specific for sequence type(ST)-17 clone) was performed to characterize the Group B streptococcus isolates. RESULTS: A total of 300 pregnant women and 53 neonates were studied by culture but only 175 mothers by PCR. GBS was identified in four (6.8%) of 59 (19.7%) neonates of colonized mothers. Out of 175 mothers investigated by PCR, 112 (64%) were colonized. Serotype Ia (23.9%) was the most common among vagino-rectal isolates. Serotype II (71.4%) predominates among colonizing strain in newborns. A significant association between frequency of intercourse of > 2 per week and GBS carriage was found (t-test= 2.2; P value < 0.05). CONCLUSION: GBS carriage is high with low transmission. Strains that have been associated with GBS neonatal disease were reported, though in very low rates. Though none of the babies studied had invasive GBS disease, a more expansive study in the future will be required to establish if invasive GBS neonatal disease is uncommon in Nigeria.

Predictors of surgical site infections of the abdomen in Lagos, Nigeria.

BACKGROUND: The issue of nosocomial infection constitute a significant burden on any health care facility particularly in resource constrained centers of many developing countries. OBJECTIVES: A prospective cross sectional study was designed to determine the baseline surgical site infection rate following abdominal surgeries, determine the influence of various factors on infection rates, evaluate the predictive value of the ASA, SENIC, NNIS indices on infection rates and identify the common aerobic and anaerobic organisms responsible for such infections. METHODS: One hundred and forty four consecutive patients who had abdominal surgeries were studied at the Lagos University, Teaching Hospital over a one year period. Demographic, clinical and other parameters were obtained with aid of a proforma. Those who developed surgical site infection had swabs taken for aerobic, anaerobic cultures and antimicrobial sensitivity. RESULTS: Wound infection rate was 17.4%. Surgeries involving the small bowels and the colon made up 75% of all infected cases. The predominant organisms isolated were Pseudomonas, enterobacter, proteus species Bacteroides was the most frequently isolated anaerobic organism. The predictive factors for infection were long surgeries, surgical procedures classified as contaminated or dirty, high ASA (American Society of Anaesthesilogist) scores, SENIC (Study of Efficacy of Nosocomial Infection Control), NNIS (National Nosocomial Infection Surveillance Index) scores. CONCLUSION: The predictive scores can be utilized to identify high risk surgeries and institute appropriate measures to reduce surgical site infections.