Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria.

The number of confirmed cases of COVID-19 globally is well over 400 million, however, the number of cases is showing a downward trend especially in developed countries largely as a result of effective vaccination against COVID-19. In developing countries, vaccination coverage is still very low as a result of vaccine hesitancy, which could be attributed to misconceptions about COVID-19 itself and its newly developed vaccines. This study assessed COVID-19 vaccine acceptance and perception amongst the adult population in Sokoto state, Nigeria. A cross-sectional study was conducted in Sokoto state among 854 respondents selected via a multi-stage sampling technique. Data was collected electronically using a set of structured questionnaire and analysis was done using IBM SPSS version 25. Respondents' perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Respondents having a score of 3 and below were graded as having poor perception and those having scores above 3 were graded as having good perception. Respondents' ages ranged from 17 to 76 years, with a mean of 34.8±12.07; more than half [474(53.7%)] of the respondents were males, 667(75.5%) were married and 539(61.0%) had formal education. The majority [839(95.0%)] of the respondents had a good perception of COVID -19 vaccine; 49.9% agreed enough research would be required on the safety of the vaccine. The majority, (72.4%) expressed their willingness to accept the COVID- 19 vaccine (male 38.4% vs. female 34.0%); 410(47.4%) said they can spend more than one hour to get the vaccine. Significant predictors of willingness to accept COVID 19 vaccine include age (p = 0.006; aOR = 0.223; 95% CI = 0.077-0.645), education (p<0.001; aOR = 1.720; 95% CI = 1.274-2.321) and perception of COVID 19 vaccine (p<0.001; aOR = 0.020; 95% CI = 0.009-0.044). The majority of the respondents had a good perception of COVID- 19 vaccine and more than two-thirds were willing to be vaccinated with the vaccine. Government should make the vaccine available for vaccination since a significant proportion of the respondents expressed their willingness to accept the vaccine.

Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial.

OBJECTIVES: The objectives were to compare the efficacy and safety of intravenous hydralazine and labetalol for acutely lowering severe hypertension in pregnancy. STUDY DESIGN: This was a superiority parallel double-blinded randomized controlled trial conducted from October 2018 to June 2019 in two hospitals in Gombe, Nigeria. Pregnant women with a live singleton fetus at gestational age of at least 28 weeks with severe hypertension were randomized (60 per group) to receive incremental doses of either intravenous labetalol (20 mg; 40 mg; 80 mg; 80 mg; and 80 mg) or 10 mg of intravenous hydralazine - up to a maximum of 5 doses - until the target blood pressure was achieved or the study was terminated. MAIN OUTCOME MEASURES: The main outcome measures were the mean reduction in mean arterial blood pressure and occurrence of persistent hypertension. Other endpoints were maternal side-effects, perinatal death, Apgar score at birth and SCBU admission. RESULTS: One hundred and thirteen patients' data were analyzed (fifty-six [56] in the hydralazine group and fifty-seven [57] in the labetalol group). There were no significant differences in the fall of the mean arterial blood pressure (labetalol; 24.19 mmHg/hydralazine; 27.68 mmHg) (p = 0.192), maternal side effects, perinatal deaths, Apgar scores and SCBU admission between the two groups. Hydralazine, however, produced a more marked reduction in diastolic blood pressure than labetalol (p = 0.012). CONCLUSION: Both labetalol and hydralazine are effective for acute blood pressure control in pregnancy with a similar safety profile. This study was self-funded and registered in the Pan African Clinical Trials Registry (www.pactr.orgPACTR202010738538062).

A cross-sectional survey of knowledge, attitude, and practices toward dengue fever among health workers in a tertiary health institution in Sokoto state, Nigeria.

INTRODUCTION: Dengue fever (DF) has become a disease of public health concern. It is a mosquito-borne virus infection caused by one of the four serotypes of the dengue virus, and the disease is prevalent in the tropical and subtropical regions of the world, with a global burden in the Americas. Yearly, about 390 million cases of new infection are estimated to occur. AIMS OF THE STUDY: This study was aimed atdetermining the knowledge, attitude and practices regarding dengue fever amongst health workers in a tertiary health institution in Sokoto state , Nigeria. METHODS: A descriptive cross-sectional study was carried out at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, among 367 health-care workers who had worked in the hospital for at least 1 year before the study were selected using a systematic sampling method. Data were collected by trained resident doctors using a standardized, pretested questionnaire and analyzed using SPSS version 20 with a significance set at P > 0.05. RESULTS: There was high awareness (95.1%) among the respondents, with seminars and lectures in school as the most familiar information sources. A more significant proportion, 87.8%, 93.2%, and 76.6%, of the respondents had adequate knowledge, positive attitude, and appropriate DF practice, respectively. Nurses and laboratory scientists had higher practice scores compared to other health-care workers (P = 0.016). CONCLUSION: Capacity building of health-care workers, especially the primary care physicians on surveillance, proper diagnosis, and treatment, is needed to avoid missing cases or misdiagnosis of cases, especially in developing and underdeveloped countries with limited health resources care service delivery.

Racial Residential Segregation and Colorectal Cancer Mortality in the Mississippi Delta Region.

INTRODUCTION: Few studies have examined the effects of racial segregation on colorectal cancer (CRC) outcomes, and none has determined whether rurality moderates the effect of racial segregation on CRC mortality. We examined whether the effect of segregation on CRC mortality varied by rurality in the Mississippi Delta Region, an economically distressed and historically segregated region of the United States. METHODS: We used data from the US Census Bureau and the 1999-2018 Surveillance, Epidemiology, and End Results (SEER) program to estimate mixed linear regression models in which CRC mortality rates among Black and White residents in Delta Region counties (N = 252) were stratified by rurality and regressed on White-Black residential segregation indices and 4 socioeconomic control variables. RESULTS: Among Black residents, CRC mortality rates in urban counties were a function of a squared segregation term (b = 162.78, P = .01), indicating that the relationship between segregation and CRC mortality was U-shaped. Among White residents, main effects of annual household income (b = 29.01, P = .04) and educational attainment (b = 34.58, P = .03) were associated with CRC mortality rates in urban counties, whereas only annual household income (b = 19.44, P = .04) was associated with CRC mortality rates in rural counties. Racial segregation was not associated with CRC mortality rates among White residents. CONCLUSION: Our county-level analysis suggests that health outcomes related to racial segregation vary by racial, contextual, and community factors. Segregated rural Black communities may feature stronger social bonds among residents than urban communities, thus increasing interpersonal support for cancer prevention and control. Future research should explore the effect of individual-level factors on colorectal cancer mortality.

Progress toward poliomyelitis eradication in Kano State, Nigeria, 2010 - 2017.

Introduction: Kano State in Northern Nigeria was a major source of Wild Polio Virus (WPV) cases in Nigeria up until 2015. In 2009, the State reported 168 WPV cases out of the 388 reported nationally. This paper characterizes the progress made by Kano State in polio eradication. Methods: In December 2017, we conducted a descriptive review of Routine Immunization (RI) from both the District Vaccine Data Management Tool (DVD-MT) and District Health Information System (DHIS2) from 2010 to 2017. Also, we reviewed the Acute Flaccid Paralysis (AFP) and Supplementary Immunization Activities (SIAs) data reported for Kano State from 2010 to 2017. Also, we obtained the number of reported WPV cases by serotypes. Results: From 2010 to 2017, a total of 65 confirmed WPV cases were reported in Kano State. Of these, 58 (89%) were WPV1 and 7 (11%) WPV3. Almost half of these cases were reported in 2012 from 14 LGAs. The number of reported cases fell to 15 (23%) in 10 LGAs in 2013, and further decreased to 5 (8%) in four LGAs in 2014. No new WPV cases have been detected in Kano since 2015. During the same period, 23 circulating Vaccine Derived Polio Viruses (cVDPV2) cases were reported in Kano. Specifically, 10 LGAs reported 10 cases in 2011. Three LGAs reported three cases in 2012, while eight LGAs reported 10 total cases in 2014. During the 2010 to 2017 period 61 SIAs were conducted. Conclusion: Kano State made progress toward polio eradication. Sustained eradication efforts, in form of high quality RI, SIAs and AFP surveillance are necessary to avert possible importation from 2016 polio resurgence in nearby Borno State, Nigeria.

Sexual activities of pregnant women attending antenatal clinic of a tertiary hospital in North-West Nigeria.

INTRODUCTION: myths about sex during pregnancy harming fetus and leading to preterm labor or miscarriage are very strong factors releasing fear and leading to avoidance of sexual contact during gestation. We therefore evaluated the attitude, sexual experiences and changes in sexual function during pregnancy. METHODS: a cross-sectional study was conducted among 170 pregnant women who were selected using systematic sampling. Data were collected using an interviewer-administered questionnaire. Data was analysed using IBM SPSS® version 22.0. Descriptive statistics, Chi-square test and Cochran´s Q-test were estimated. RESULTS: the mean age of respondents was 27.2 ± 6.2 years. Most of the respondents, 107 (62.7%) had formal education. One-fifth of the respondents, 34 (20.2%) have been married for over 10 years. More than half of them were multiparous, 112 (68.3%) and in the third trimester of pregnancy, 99 (59.6%). Majority of the respondents, 153 (87.9%) thought coitus was safe in pregnancy. More than half 89 (58.2%) had coitus at least thrice a week before pregnancy and 98.8% have engaged in sexual activities during pregnancy. Most of the respondents, 105 (61.1%) enjoyed coitus during pregnancy. The desire for coitus significantly reduced in the third trimester, p=0.001. CONCLUSION: sexual intercourse during pregnancy was universal and respondents engaged in sexual activities during different stages of pregnancy. Although sexual frequency declined in pregnancy compared to pre-pregnancy period, most of the respondents desired and enjoyed it. We recommend that couples are well educated to understand the normal fluctuations in sexual interest and practices during pregnancy.

An Analysis of Associations Between Electronic Nicotine Delivery System Users.

BACKGROUND: Electronic nicotine-delivery systems have been increasing in prevalence among young adults. Although these devices are marketed to aid in quit smoking, young adults who do not smoke traditional cigarettes are using these devices. This study explored associations between individuals' quit type (ie, no plans to quit, plans to quit, or quit > 6 months ago) and perceived health status, perception of harm compared to cigarettes, perception of secondhand vapor harm, and reasons for first use. METHODS: We utilized a cross-sectional study design using a 33-item electronic survey questionnaire. The total sample size was 2,792. Out of these the ENDS users were 1,217. The survey was distributed to university students in 5 areas in 3 countries: the United States (ie, Florida, Alabama, and Illinois), Germany (ie, Hamburg) and South Africa (ie, Potchefstroom). RESULTS: Quantitative data analysis indicated that, regardless of quit status, there was a general lack of knowledge regarding secondhand vapor effects. Additionally, young adults are utilizing these products primarily due to peer influence and stress relief. Harm perception may factor into quit attempts using electronic nicotine-delivery systems. CONCLUSIONS: Education provided by respiratory therapists (and to respiratory therapy students) would be valuable as they inform patients and communities of the scholarly literature on vaping devices.

Descriptive Epidemiology of Childhood Disability Prevalence by Sex in the Mississippi Delta and Appalachian Regions.

BACKGROUND: Evidence suggests a rise in childhood disability rates across the United States with males and those with lower socioeconomic status bearing greater burden. We investigated childhood disability rates in the Mississippi Delta (MDR) and Appalachian regions (AR) in comparison to other parts of the country. METHODS: Using data from the US Census Bureau, we calculated childhood disability rates by type and sex at national, regional, and subregional levels. We used risk ratios (RR) to compare childhood disability rates by sex, type, and region. We generated choropleth maps to represent the geographic distribution of disability. RESULTS: Childhood disability was more prevalent, at the national level, among boys (6.64%) than girls (4.08%). Children in the MDR (boys = 8.60%; girls = 5.08%) and AR (boys = 7.81%; girls = 4.83%) had greater risk of disability than those elsewhere in the country (boys = 6.47%; girls = 3.98%), with rates generally higher in rural compared to urban areas in said regions. CONCLUSIONS: Childhood disability affects rural areas of the country more extensively, with the MDR and AR affected to an even greater extent. School-based health centers, in particular, which are disproportionately located in urban areas, could benefit disabled children living in the MDR and AR.