Facility-Based Surveillance Activities for COVID-19 Infection and Outcomes among Healthcare Workers in a Nigerian Tertiary Hospital.

COVID-19 in healthcare workers (HCWs) can result in nosocomial transmission, depletion in available workforce, and enhanced community transmission. This article describes surveillance for COVID-19 in HCWs at a tertiary healthcare facility, and documents the outcomes. A descriptive cross-sectional study of all HCWs identified from surveillance for COVID-19 from March 31 to August 31, 2020 was conducted. Healthcare workers were categorized as high risk and low risk using an adapted WHO Risk Assessment tool. Nasopharyngeal and oropharyngeal swab specimens obtained from high-risk subjects were tested by a reverse transcriptase PCR method. Data were analyzed with IBM SPSS version 25.0 software (IBM SPSS Statistics for Windows, Version 25.0, Armonk, NY), and results were presented as frequencies and percentages. The level of significance was set at P < 0.05. During 5 months of surveillance, 1,466 HCWs with a mean age of 38.1 ± 9.7 years were identified as contacts. On risk assessment, 328 (22.4%) were adjudged high risk. High risk was associated with increasing age (P < 0.001), male gender (P = 0.001), and nonclinical staff (P = 0.002). Following testing, 78 (5.3%) in the high-risk category were confirmed to have COVID-19. There was no record of COVID-19 in HCWs adjudged low risk. Forty-four (56.4%) cases were epidemiologically linked to the community, 20 (25.7%) to patients, and 14 (17.9%) to another HCW. Surveillance and risk assessment are crucial to COVID-19 response in healthcare facilities and revealed HCW infections with predominantly nonoccupational epidemiological links in this study.

Mainstreaming the private health sector in the response to COVID-19: facility readinessassessment for screening services in Edo State, Nigeria.

INTRODUCTION: The COVID-19 pandemic presents an opportunity for the Nigerian health system to harness the potentials available in the private sector to augment the capacity within the public health system. This survey was carried out to assess private facility readiness in providing screening services in Edo State. METHODS: This was a descriptive cross-sectional study carried out among private facilities in Edo state. Facilities were selected using stratified sampling technique. Data was collected using adapted questionnaires and an observational checklist. Facility readiness was assessed using the Nigeria Centre for Disease Control recommendations for screening. Parameters were scored and overall scores were converted to proportions. Facilities that scored 70% and above were adjudged to be ready while facilities that scored 69% and below were adjudged to be not ready. RESULTS: A total of 252 health facilities were assessed, comprising 149 (59.1%) hospitals/clinics, 62 (24.6%) pharmacies and 41 (16.3%) laboratories. One hundred and forty-two (95.3%), 60 (96.8%) and 41 (100.0%) hospitals/clinics, pharmacies and laboratories, respectively had hand hygiene facilities. However, overall facility readiness assessment scores for screening services were low with only 51 (34.2%) hospitals/clinics, 2 (3.2%) pharmacies and 2 (4.9%) laboratories achieving high enough scores to be adjudged ready for screening services. CONCLUSION: Overall facility readiness of the private health sector to provide screening services in Edo State was assessed to be low. The government and facility owners will need to ensure that screening services are improved in all facilities to help mitigate community spread of COVID-19.