Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study.

BACKGROUND: COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. AIM: This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. SUBJECTS AND METHODS: Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. RESULTS: The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. CONCLUSION: There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.

Impact of some low-cost interventions on students' performance in a Nigerian medical school.

BACKGROUND: Students' poor performance in physiology examinations has been worrisome to the university community. Reported preference of peer-tutoring to didactic lectures at the University of Nigeria Medical School has not been investigated. AIM: The aim of this work is to design/implement low-cost interventions to improve teaching and learning of physiology. MATERIALS AND METHODS: This is a postintervention retrospective review of medical Student's performance in 2 nd Bachelor of Medicine and Bachelor of Surgery examinations physiology. Data were collected and analyzed by descriptive and inferential statistics using the MedCalc Statistical software (Turkey). The odds ratio (OR) was used to determine the chances of passing before and after the intervention. The level of significance was set at P < 0.05. RESULTS: A total of 2152 students sat for the professional examination over the study period, and 1485 students passed the examination at first attempt giving an overall pass rate of 69%. The pass rate from 2008 when our interventions started was significantly higher than the pass rate before this reform (OR: 0.53; 95% confidence interval: 0.43-0.64; P < 0.0001). CONCLUSION: Results support the engagement of teachers with strong translational interests and clinicians to augment existing faculty in basic sciences, innovative alternatives to passive lecture formats and students involvement in program evaluation.

Benefit incidence analysis of free insecticide treated nets distribution in urban and rural communities of Enugu state, South East Nigeria.

BACKGROUND: Malaria is a leading cause of mortality as well as a barrier to economic and social development in developing countries. The use of insecticide-treated nets (ITNs) for malaria vector control is effective in controlling malaria attacks in pregnant women and under-5 children. The Nigerian government, in its bid to achieve the Millennium Development Goal (MDG) 4 and 5 distributes free ITNs to pregnant mothers and under-five children in the Roll Back Malaria programme (RBM). AIM: This study compared the benefit incidence analysis of this government program between urban and rural areas. MATERIALS AND METHODS: Pretested, semi-structured questionnaires were administered to 150 pregnant women and also 150 mothers of under-5 children, who were randomly selected from each of the two communities (rural and urban) from a local government area (LGA) in Enugu state, Nigeria. The study was conducted within the rainy season periods (March-August) of 2008. The information obtained included some socio-economic variables, accessibility, usage and benefits of usage of ITNs. Data entry and analyses were done using the Statistical Package for Social Sciences (SPSS) version 15.0(Chicago IL, USA). Student's t-test and Chi-square were used for comparison where appropriate. Significant values were taken as P value. Value of less than 0.05 was considered significant. RESULTS: The respondents' mean monthly expenditures on food utilities and anti-malarials in the rural area and urban areas were N266.1 (74.02), range (143.3-395) and N473 (90) range (380-495.7) respectively (P < 0.001). Within each socio-economic stratum (SES), the average monthly expenditure in the urban community was higher than that of the rural community except for least poor SES (P < 0.05). For the urban community, 106 (71.6%) respondents used ITNs as against 99 (66.9%) in the rural community [P = 0.778, OR = 1.3 (95% CI: 0.76, 2.05)]. Also, ITNs were always accessible to 112 (75.7%) and 54 (36.5%) respondents in the urban and rural communities respectively [P < 0.001, OR = 5.4 (95% CI: 3.28, 8.96)]. In the urban community, 130 (87.7%) respondents expressed some benefit from ITNs as against 123 (83.1%) respondents from the rural community [P = 0.258, OR = 1.5 (95% CI: 0.76, 2.28)]. CONCLUSION: Most pregnant women and mothers of under-five children in the rural study area belong to the poorest socio-economic classes and they spend less on anti-malarial treatment. Majority of the free ITN's beneficiaries in both urban and rural study areas have used and benefitted from them.

Evaluation of some anthropometric indices for the diagnosis of obesity in pregnancy in Nigeria: a cross-sectional study.

BACKGROUND: Obesity in pregnancy is a global health problem which is associated with poor pregnancy outcomes. The use of weight and height, measured at about ten weeks of gestation, to produce pre-gestational body mass index is recommended for the diagnoses of the condition but limitations abound in under resourced settings. OBJECTIVES: To measure anthropometric indices such as mid upper arm circumference, calf circumference, waist circumference and waist to hip ratio, for identification of obesity in pregnancy. METHODS: Anthropometric measurements were carried out on cohorts of pregnant women from 4 hospitals in Enugu, South-eastern Nigeria. RESULTS: There were no significant difference in the mean mid upper arm circumference (MUAC) and calf circumference (CC) across the trimester groups. The mean values of waist circumferences, hip circumference and waist to hip ratios changed significantly across the trimesters. The 75(th) percentile of MUAC (33 cm) and CC (39 cm) in all trimesters, had sensitivity and specificity of more than 70% for identifying obesity in pregnancy. CONCLUSION: MUAC and CC values of 33cm and 39cm respectively might be reliable cut off points for diagnoses of obesity throughout pregnancy in Enugu, Nigeria.

Students performance and perception of neurophysiology: feedback for innovative curricular reform in a Nigerian medical school.

This study aimed at ascertaining the status of students' performances and their perception of the learning of neurophysiology in a Nigerian medical school. The goal of the study was to determine ways of addressing identified negative perceptions for the purpose of improving upon the overall learning and use neurophysiology knowledge by structured curricular reform. We analyzed and compared the performances of students in three areas of physiology at the second professional examinations over a three-year period [n=300]. We also surveyed learning experience of a batch of graduating doctors in neurosciences [n=50] and surveyed the staff and students' perception of the teaching of neurophysiology. The students performances in neurophysiology was comparatively poorer than in cardiovascular and endocrinology aspects of the subject over a three year period at the second professional examinations. The reported students perception of their neurophysiology learning included uninteresting, abstract concepts, lack of real examples and conflicting facts with their prior basic knowledge. Over 50% of the graduates rated their learning experiences as poor or very poor or below average for the neuroscience courses. The analyses of the curricular contents of neurophysiology in the preclinical departments indicted asynchrony and redundancy in topics that may reduce the learning and reduce teaching time efficiency of the neuroscience courses. It is suggested that learning experiences of medical students should be routinely monitored and structured to ensure that the graduate doctor is able to understand and transfer learned experiences into clinical studies and practice. A horizontally integrated curriculum may be one way of raising students knowledge, attitude and skills in neuroscience courses as taught in the preclinical departments and is suggested.