Vaccine Safety: Assessing the Prevalence and Severity of Adverse Events Following COVID-19 Vaccination amongst Healthcare Workers in Tertiary Health Facilities in Nigeria.

BACKGROUND: Vaccines, including COVID-19 vaccines, are known to be cost-effective interventions for disease prevention and control. However, adverse events following immunisation (AEFI) may challenge the acceptance of these vaccines. This study assessed the prevalence and severity of COVID-19-related AEFI amongst healthcare workers at tertiary health facilities in Nigeria. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted among healthcare workers who had received the COVID-19 vaccine. A multi-stage sampling technique was used to select participants from six Tertiary Health Facilities in Nigeria. Ethical approval (NHREC/01/01/2007-19/07/2021) was obtained from NHREC. Data were analysed using IBM® SPSS version 25 and categorical variables were presented in tables/charts using frequencies and proportions. RESULTS: A total of 2130 respondents participated in the study, with a mean age of 37.4 ± 9.1 years. Most of the respondents, 1674 (78.6%), had two doses of the vaccine, and the overall prevalence of AEFI was 813 (38.2%). Common among the AEFI reported following the administration of the first dose of the vaccine were fever 649 (30.5%) and pain at the injection site 644 (30.2%), while it was pain at the injection site 216 (10.1%) and fever 173 (8.1%) for second dose. The higher proportions of AEFI were mostly mild to moderate. CONCLUSION: The study observed a relatively low prevalence of AEFI, with the commonly reported ones being fever and injection site pain. It is crucial that countries continuously collect the data on AEFI and establish causality as a way to improve quality and guarantee vaccine safety.

Coronavirus disease 2019 risk assessment of adults and geospatial mapping in selected communities of Southwest Nigeria.

Background: Coronavirus disease 2019 (COVID-19) remained a worldwide public health problem. Risk assessment and mapping can be deployed to assist in the control and management of disease outbreaks. Aim: The aim of this study was to conduct COVID-19 risk assessment and mapping in selected communities of Southwest Nigeria. Methods: This was a cross-sectional study of adults, 18 years and above, involving the use of multi-stage sampling. Data collection was done with a pre-tested, structured, interviewer-administered questionnaire. The Statistical Package for the Social Sciences version 23 and Environmental Systems Research Institute ArcGIS desktop version 10.5 were used for data analysis and spatial mapping, respectively. The threshold for statistical significance was set at P < 0.05. Results: The respondents' mean age was 40.6 ± 14.5 years. Self-reported vulnerability factors identified included hypertension, diabetes mellitus, working in hospital facility, cigarette smoking and age ≥60 years amongst others. About a quarter (20.2%) had a high risk of COVID-19 following risk quantification. The risk cuts across geographical locations and socio-economic status. Education was significantly associated with COVID-19 risk. The spatial interpolation map revealed that the farther a community was from the high-burden area, the lower the risk of COVID-19. Conclusion: There was a high prevalence of self-reported COVID-19 risk. Identified communities with COVID-19 high-risk burden in the risk mapping and those with stratified proximity to these areas need to be targeted by the government for a public health awareness campaign.

Prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido-Ekiti, Southwestern Nigeria.

BACKGROUND: Asymptomatic malaria infections have received less attention than symptomatic malaria infections in major studies. Few epidemiological studies on asymptomatic malaria infections have often focused on pregnant women and children under-five years of age as the most vulnerable groups. However, there is limitation on data regarding asymptomatic infections among the old adult populations, particularly in the study area. Therefore, this study determined the prevalence of asymptomatic malaria infection by microscopy and its determinants among residents of Ido- Ekiti, Southwestern Nigeria. METHODS: A hospital-based cross-sectional study was conducted between July and September 2021 among 232 consenting apparently healthy individuals aged 40 years and above who were recruited during a free health screening program using a standardised interviewer-administered questionnaire. The questionnaire sought information on respondents' socio-demographics, presence and types of co-morbidity, and the prevention methods being adopted against malaria infection. Venous blood samples were collected and processed for asymptomatic infections using Giemsa-stained blood smear microscopy. Data were analysed using SPSS version 21. Multivariate logistic regression was used to identify factors associated with asymptomatic infections. RESULTS: Of the total 232 respondents, 19.0% (48/232) were confirmed to be infected with Plasmodium falciparum (95% confidence interval (CI): 14.1% - 24.6%). Lack of formal education (Adjusted odds ratio (AOR): 5.298, 95% (CI): 2.184-13.997), being diabetic (AOR: 4.681, 95% CI: 1.669-16.105), and not sleeping under Long Lasting Insecticide Net (LLINs) (AOR: 4.594, 95% CI: 1.194-14.091), were the determinants of asymptomatic Plasmodium falciparum infection. CONCLUSION: The prevalence of asymptomatic Plasmodium falciparum was 19%. Lack of formal education, being diabetic, and not sleeping under LLINs were the determinants of asymptomatic infections.

Perception and willingness to the uptake of COVID-19 vaccine among household-heads in a rural community of South-Western Nigeria

Background:The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria.Materials and Methods:A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaireusing the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval.Results:The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19vaccine.Conclusion:There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19vaccine.

Profile and determinants of intention to migrate by early career doctors in Nigeria: A report from CHARTING study.

INTRODUCTION: Recently, there has been an upsurge in the migration of medical personnel, especially early career doctors (ECDs) from low- and middle-income countries, Nigeria inclusive, to high-income countries with wide-ranging consequences on the social and economic systems of the donor countries. This study assessed the profile and determinants of intention to emigrate by ECDs in Nigeria. METHODS: A cross-sectional study conducted among Nigerian ECDs from nine tertiary hospitals. Socio-demographic characteristics, intention & reasons to emigrate and willingness to return were collected using a self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) version 23. RESULTS: A total number of 763 ECDs participated in the study. The majority (88.2%) were less than 40 years of age and the male to female ratio was 2:1. Majority of the participants (69.4%) received monthly income ≤833 US Dollar. About two-thirds of ECDs had plans to emigrate and most to developed countries. Common reasons for intention to migrate were better quality of postgraduate training, improved quality of life and better remuneration. CONCLUSION: High proportion of Nigerian ECDs has intention to emigrate out with potential adverse effect on the fragile health system in the country.

Exploring Issues and Challenges of Leadership among Early Career Doctors in Nigeria Using a Mixed-Method Approach: CHARTING Study.

(1) Background: leadership behaviour is a poorly explored phenomenon among early-career doctors (ECDs). Good leadership is vital in maximising the effective management of patients in a clinical setting. While a good number of studies, though with small sample surveys, have researched the role of leadership in clinical setting quantitatively, qualitative investigations are yet to be done in Nigeria. This study aims to explore the attitudes, skills, and experience of ECDs in Nigeria on issues pertaining to leadership in a medical setting, using a mixed-method approach. (2) Methods: we conducted two sessions of key informant focus group discussion (FGD) that involved 14 ECD leaders in Nigeria, exploring their leadership experience in a clinical setting. Furthermore, we used a self-administered questionnaire to quantitatively survey 474 ECDs from seven Nigerian teaching hospitals to explore their attitudes, skills, and experience on issues pertaining to medical leadership. (3) Results: taking on leadership roles is a common phenomenon (52.7%) among the surveyed ECDs; however, the medical leadership position can be very challenging for ECDs in Nigeria. Despite the fact that many (91.1%) of the surveyed ECDs perceived leadership skills as essential skills needed by a doctr, many (44.1%) of them were yet to be formally trained on medical leadership. About three out of every 10 (23.6%) of surveyed ECDs that have ever held leadership positions in a medical setting experienced major leadership challenges while in such office due to their lack of training on leadership skills. Leadership skill acquisition programmes are highly recommended to become an integral part of medical training programmes in Nigeria. (4) Conclusion: there is a need for a structured leadership skill acquisition programme for ECDs in Nigeria. This programme will help in the robust delivery of highly effective healthcare services in Nigeria, as effective leadership is crucial to patient care services.