Coronavirus Disease 2019 Knowledge, Its Vaccine Uptake Intentions, and the Influence of Personality Traits among Undergraduate Pharmacy Students in a University Setting: Findings and Implications.

CONTEXT: Coronavirus disease 2019 (COVID-19) is the greatest global health catastrophe of the century, with its vaccine hesitancy compounding the woes. Relevant stakeholders, including pharmacy students (whose education was disrupted) are important bulwarks against these catastrophes, but their COVID-19-related information are scarce. AIMS: We assessed COVID-19 knowledge, its vaccine uptake intentions, and the influence of personality traits among pharmacy undergraduates in a Nigerian university. SETTINGS AND DESIGN: This was a post-lockdown cross sectional study conducted at the Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto. SUBJECTS AND METHODS: A 61-item questionnaire was used to collect data among pharmacy undergraduates who attended Usmanu Danfodiyo University, Sokoto, Nigeria, in May 2021. STATISTICAL ANALYSIS USED: Summary statistics- mean (±standard deviation), range, frequency, proportion; inferential statistics- Chi square statistics, binary logistic regression. RESULTS: The response rate was 88% (168/191). The average COVID-19 knowledge score, the frequency of acceptance, and hesitancy to take COVID-19 vaccine among study participants were 42.9% (95% confidence interval [CI] = 42.1-43.7), 39.1% (95% CI = 37.3%-41.8%), and 61.9% (95% CI = 58.0%-64.2%), respectively. In addition, of the 168 study participants, 73 (43.5%) considered themselves to have high self-esteem, 67 (39.9%) were highly extroverted, 91 (54.2%) highly privately self-conscious, 96 (57.1%) highly publicly self-conscious, and 60 (35.7%) highly self-restrained, with 57 (34.0%) not believing in the existence of COVID-19. COVID-19 knowledge varied significantly by level of study ( F [2,165] = 5.539; P = 0.005; η 2 = 0.06). Similarly, those with high self-esteem were twice as knowledgeable regarding COVID-19 as those with low self-esteem (odds ratio [OR]: 2.02; 95% CI: 1.08-3.78; P = 0.03) with gleaning COVID-19-related information from social media platforms predicting COVID-19 vaccine hesitancy (CVH) (OR: 0.37; 95% CI: 0.16-0.85; P = 0.02). CONCLUSIONS: The observed suboptimal COVID-19 knowledge was associated with participants' low level of self-esteem, and the prevalent CVH was associated with obtaining COVID-19-related information from social media platform.

Résumé Contexte:La maladie du coronavirus 2019 (COVID-19) est la plus grande catastrophe sanitaire mondiale du siècle, avec ses hésitations à vacciner qui aggravent les fléaux. Les intervenants pertinents, y compris les étudiants en pharmacie (dont l'éducation a été perturbée), sont des gardiens importants contre ces catastrophes, mais leurs informations relatives au COVID-19 sont rares.Objectifs:Nous avons évalué les connaissances sur le COVID-19, ses intentions d'adoption du vaccin et l'influence des traits de personnalité chez les étudiants en pharmacie d'une université nigériane.Configuration et conception:Il s'agit d'une étude transversale.Sujets et méthodes:Un questionnaire de 61 points a été utilisé pour recueillir des données auprès des étudiants en pharmacie qui ont étudié à l'Université Usmanu Danfodiyo, Sokoto, au Nigeria, en mai 2021.Analyse statistique Utilisé:Résumé ­ moyenne (± déviation standard), gamme, fréquence, proportion; inferentiel ­ statistiques Chi-square, régression logistique binaire.Résultats:Le taux de réponse était de 88 % (168/191). Le score moyen de connaissances sur le COVID-19, la fréquence d'acceptation et l'hésitation à prendre le vaccin contre le Covid-19 parmi les participants à l'étude étaient respectivement de 42,9% (intervalle de confiance de 95 % [CI] = 42,1 à 43,7), de 39,1% (IC 95 % = 37,3% à 41,8%) et de 61,9% (IC 95% = 58,0 % à 64,2%). En outre, sur les 168 participants à l'étude, 73 (43,5%) se considéraient comme ayant une haute estime de soi, 67 (39,9%) étaient hautement extrovertis, 91 (54,2%) très conscients de soi en privé, 96 (57,1%) sont hautement conscients d'eux-mêmes en public et 60 (35,7%) sont très restreints, avec 57 (34,0%) qui ne croient pas en l'existence de COVID-19. Les connaissances sur le COVID-19 varient considérablement selon le niveau d'étude (F [2,165] = 5,539; P = 0,005; η2 = 0,06). De même, les personnes ayant une haute estime de soi étaient deux fois plus informées au sujet du COVID-19 que celles ayant une faible estime d'eux-mêmes (ratio de probabilité [OR]: 2,02; 95% CI: 1,08­3,78; P = 0,03) avec la collecte d'informations relatives au Covid-19 provenant des plates-formes de médias sociaux qui prédisaient l'hésitation au vaccin contre le COVid-19 (CVH) (OR: 0,37; 95% IC: 0,16­0,85; P= 0,02).Conclusions:Les connaissances sous-optimales observées sur le COVID-19 ont été associées à un faible niveau d'estime de soi des participants, et la prévalence de la HCV a été associée à l'obtention d'informations relatives au Covid-19 à partir d'une plate-forme de médias sociaux.

Predictors of Viral Suppression among Adults Living with HIV/AIDS in Nigeria: A Retrospective Chart Review.

BACKGROUND INFORMATION: Over 1.6 million Nigerians have succumbed to the ravaging scourge of the acquired immunodeficiency syndrome (AIDS) epidemic since its discovery. Viral suppression (VS) then becomes a critical cost-effective human immunodeficiency virus (HIV) prevention strategy. We assessed the prevalence and predictors of VS. MATERIALS AND METHODS: This retrospective case file review was conducted among adults (aged ≥18 years) living with HIV/AIDS who accessed care at a tertiary health facility in Northwestern Nigeria between January and December 2021. RESULTS: One thousand one hundred and twenty HIV/AIDS-eligible patients accessed care during the study. Their age ranged between 20 and 70 years with a mean of 43.83 ± 10.83 (95% confidence interval [CI]: 43.19-44.46). The patients were mostly female (728; 65.0), residing in urban areas (680; 60.7%), self-employed (440; 39.3%), married (712; 63.6%), receiving antiretroviral therapy (ART) for at most 14 years (916; 81.8%), on first-line ART regimen (812; 72.5%), in HIV clinical stage 1 (964; 86.1%), and with a baseline CD4 count of 199 cells/µl (453; 40.4%). The prevalence of VS of 64.3% (720/1120) was recorded in the study. The predictors of VS were disclosure of HIV status (odds ratio [OR] =2.4; 95% CI = 1.503-3.832), absence of opportunistic infections (OR = 2.6; 95% CI = 1.242-5.406), receiving ART for 15-29 years (OR = 2.1; 95% CI = 1.398-3.292), first-line ART regimen (OR = 3.7; 95% CI = 2.618-5.115), and adequate adherence (OR = 4.7; 95% CI = 3.324-6.766). CONCLUSION: VS was suboptimal among the study cohort with adequate adherence being its strongest predictor.

Résumé Informations générales:Plus de 1,6 million de Nigérians ont succombé au fléau ravageur du syndrome d'immunodéficience acquise (SIDA) depuis sa découverte. La suppression virale (VS) devient alors une stratégie de prévention du virus de l'immunodéficience humaine (VIH) essentielle et rentable du virus de l'immunodéficience humaine (VIH). Nous avons évalué la prévalence et les facteurs prédictifs de la VS.Matériel et méthodes:Cet examen rétrospectif des dossiers a été réalisé parmi adultes (âgés de ≥18 ans) vivant avec le VIH/sida qui ont accédé aux soins dans un établissement de santé tertiaire du nord-ouest du Nigéria entre janvier et décembre 2021.Résultats:Mille cent vingt patients éligibles au VIH/sida ont accédé aux soins au cours de l'étude. Leur âge était compris entre 20 et 70 ans, avec une moyenne de 43,83 ± 10,83 (intervalle de confiance à 95 % [IC] : 43,19-44,46). Les patients étaient majoritairement des femmes (728; 65.0), résidant en zone urbaine (680; 60.7%), indépendants (440; 39,3%), mariés (712; 63,6%), recevant une thérapie antirétrovirale (ART) depuis au plus 14 ans (916; 81,8%), sous traitement antirétroviral de première intention (812; 72,5%), au stade clinique 1 du VIH (964; 86,1%), et avec un taux de CD4 de 199 cellules/µl au départ (453; 40,4%). La prévalence de la VS de 64,3 % (720/1120) a été enregistrée dans l'étude. Les facteurs prédictifs de la VS étaient la divulgation de la séropositivité (odds ratio [OR] = 2,4; IC à 95 % = 1,503-3,832), l'absence d'infections opportunistes (OR = 2,6; IC à 95 % = 1,242-5,406), le fait de recevoir un traitement antirétroviral pendant 15 à 29 ans (OR = 2,1; IC à 95 % = 1,398-3,292), un traitement antirétroviral de première intention (OR = 3,7; IC à 95 % = 2,618-5,115) et une bonne observance (OR = 4,7; IC à 95 % = 3,324-6,766).Conclusion:La VS était sous-optimale dans la cohorte étudiée, l'adhérence adéquate étant son facteur prédictif le plus fort.

Outbreak of Multidrug-resistant Acinetobacter baumannii in a Tertiary Health Center from Northwestern Nigeria.

Background: In spite of its global notoriety and WHO alarm, Acinetobacter baumannii is still an understudied critical-priority pathobiont in Nigeria. We characterized its antimicrobial susceptibility profile and resistance genes during an outbreak. Materials and Methods: This cross-sectional study involved collection of patients' urine samples and swabs from unit staff's hands and ward environments for the identification of A. baumannii strains using standard morphologic and biochemical methods. The disk diffusion method was used to assess the antimicrobial susceptibility profile of the isolates with the production of extended-spectrum beta-lactamases (ESBLs) confirmed by the combined disk test screening method. Characterization of the resistance genes of the ESBL producers was carried out using polymerase chain reaction polymerase chain reaction technique. Results: A.total of eight (six clinical and two nonclinical) A. baumannii isolates were identified. The overall isolate susceptibility and resistance rates to all the antimicrobial agents was 56.3% (27/48) and 35.4% (17/48), respectively. Similarly, all (8/8; 100.00%) isolates were susceptible to meropenem and 75.0% (6/8) to ampicillin-sulbactam while 62.5% (5/8) were resistant to trimethoprim-sulfamethoxazole and 50.0% (4/8) to each of ciprofloxacin and ceftazidime. In addition, 37.5% (3/8) of the isolates were multidrug resistant (MDR) with nonclinical isolates exhibiting more antimicrobial resistance than their clinical counterparts (9/12%-75.0% vs. 8/36%-22.2%). Phenotypic detection and molecular characterization revealed three ESBL-producing isolates that each harbored blaSHV and blaTEM genes with blaCTX-M gene being absent. Conclusion: MDR strains of A. baumannii harboring blaSHV and blaTEM genes were recovered from clinical and environmental sources during the outbreak, which was contained with preventive measures recommended.

Résumé En dépit des alertes faites par l'organisation mondiale de la Santé (OMS), Acinetobacter baumannii demeure un pathobiont sous-étudié et très peu priorisé au Nigeria. Nous avons procedé à sa caractérisation phénotypique et génotypique en dressant son profil de sensibilité aux antimicrobiens et ainsi que les gènes de résistance impliqués au cours d'une épidémie. Matériel et méthodes: Cette étude transversale a consisté à collecter des échantillons d'urine de patients et des écouvillons des mains du personnel des soins et de l'environnement hospitalier. L'identification des souches d' A. baumannii était faite par des méthodes bactériologiques standard. le profil de sensibilité aux antimicrobiens des isolats a été faite par la méthode de diffusion de disque , les bêta-lactamases à spectre étendu (BLSE) étaient recherchée par la méthode de dépistage combinée de disque ainsi que leur caractérisation moléculaire par la mise en évidence des gènes de résistance BLSE à l'aide d'une PCR (réaction en chaîne par polymérase). Résultats: Au total, huit isolats d'A. baumannii (6 cliniques et 2 de l'environnement) ont été identifiés. Les taux globaux de sensibilité et de résistance des isolats à tous les agents antimicrobiens étaient respectivement de 56,3 % (27/48) et de 35,4 % (17/48). De même, tous les isolats (8/8 ; 100,00 %) étaient sensibles au méropénème et 75,0 % (6/8) à l'ampicilline-sulbactam, tandis que 62,5 % (5/8) étaient résistants au triméthoprime-sulfaméthoxazole et 50,0 % (4/8) à la ciprofloxacine et à la ceftazidime. En outre, 37,5 % (3/8) des isolats étaient multirésistants (MDR), les isolats non cliniques présentant une plus grande résistance aux antimicrobiens que leurs homologues cliniques (9/12 %-75,0 % contre 8/36 %-22,2 %). La détection phénotypique et la caractérisation moléculaire ont révélé trois isolats producteurs de BLSE qui hébergeaient chacun les gènes blaSHV et blaTEM, le gène blaCTX-M étant absent. Conclusion: Des souches multirésistantes d'A. baumannii portant les gènes blaSHV et blaTEM ont été identifiées sur des prélevements cliniques et environnementaux au cours de l'épidémie, qui a été gerée grâce aux mesures préventives recommandées. Mots-clés: Surveillance de la résistance aux antimicrobiens, blaSHV carbapénème, pathogène ESKAPE, infections associées aux soins de santé, pratiques de prévention et de contrôle des infections, one health, uropathogènes.

Knowledge of Lassa fever, its prevention and control practices and their predictors among healthcare workers during an outbreak in Northern Nigeria: A multi-centre cross-sectional assessment.

BACKGROUND: The year 2020 Lassa fever (LF) outbreak had the greatest disease burden and this can place an enormous strain on the already overstretched healthcare system and can potentially increase morbidity and mortality due to infectious diseases. Therefore, having a knowledgeable healthcare workforce with appropriate skills and competencies to prevent and manage outbreaks of a neglected infectious disease such as LF in Nigeria will potentially enhance public health. Thus, this survey assessed the level of knowledge of LF and its prevention and control (PC) measures amongst the healthcare workers (HCWs) during a LF outbreak in Katsina state, Nigeria. METHODOLOGY/PRINCIPAL FINDINGS: During this cross-sectional survey, HCWs complete a validated 29-item questionnaire comprising 18 items on the knowledge of LF and its PC measures and an item on global self-evaluation of their LF knowledge. Psychometric properties of the questionnaire were evaluated. Chi-square and binary logistic regression analyses were conducted. Out of 435 HCWs invited, a total of 400 participated in the study (92% response rate). The majority of participants (51.8%) demonstrated inadequate LF knowledge, with 62.9% of those scoring low having a high self-perception of their LF knowledge with the global scale. This LF knowledge over-estimation was predicted by LF training status (odds ratio (OR) 2.53; 95% CI: 1.49-4.30; p = 0.001). The level of LF knowledge and its PC measures among the study participants was low (11.60±8.14, 64.4%) and predicted by participants' LF training status (OR 2.06; 95% CI: 1.19-3.57; p = 0.009), place of work (OR 1.82; 95% CI: 1.07-3.08; p = 0.03) and their designations (OR 2.40; 95% CI: 1.10-5.22; p = 0.03). CONCLUSION: The level of knowledge of LF and its PC measures among the HCWs surveyed was suboptimal and participants' LF training status, place of work and occupational category were the significant predictors. In addition, LF knowledge overestimation on a global scale was observed among a majority of HCWs and this was also predicted by LF training status. Therefore, there is a critical need for health authorities in Nigeria to prioritize continuous on-the-job training of HCWs on priority neglected tropical diseases such as Lassa fever.

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines.

BACKGROUND: Adequate management of childhood acute asthma exacerbation requires optimal non-pharmacotherapy and pharmacotherapy. Global asthma guidelines provide critical information and serves as a quick reference decision-support material for clinicians. OBJECTIVES: We aimed at evaluating hospital management of childhood acute asthma exacerbation to ascertain its conformity to the global treatment guidelines, and to identify factors that predict short or prolonged observation in the hospital. METHOD: This was a retrospective audit of the management of acute asthma exacerbation in children seen between 01 January 2017 and 31 December 2018 at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Relevant data on demography, asthma triggers and severity, functional and clinical diagnoses, types of controller medications used before and after presentation, non-pharmacotherapy and pharmacotherapy instituted during presentation, duration of observation in the hospital, and treatment outcomes were extracted from the case file of each eligible patient. RESULTS: A total of 119 children presented with features of suspected acute asthma exacerbations during the study period but only 63 (52.9%) that met the inclusion criteria for the study were included for analysis. The 63 children that were evaluated had mild (47; 74.6%) and moderate (16; 25.4%) acute asthma exacerbations. Their median (interquartile range) age was 8 (5-15) years. More males (36; 57.1%) than females (27; 42.9%) presented with features of the condition. Majority (50; 79.8%) of the patients had at least one trigger factor and of the 73 trigger factors reported, cold weather (19; 26.0%) was the commonest. Nebulized salbutamol (48; 76.5%), in addition to intravenous (23; 57.9%) and oral (17; 42.5%) corticosteroids, was used during hospital treatment. Patients were discharged mostly on short course of oral corticosteroid only (37; 58.8%). Of the 17 major recommendations in the Global Initiative for Asthma (GINA) guidelines, good (5; 29.4%), moderate (7; 41.2%), and poor (5; 29.4%) levels of adherence were observed. Specifically, moderate and poor levels of adherence were observed in the management of 61(96.8%) and 2(3.2%) patients, respectively. The odds of admission for ≤12 h were higher for female children and patients with mild cases. CONCLUSION: Good and moderate adherence levels to 12 of the 17 GINA recommendations were observed in our center. Nonetheless, reinforcement of institutional guidelines for acute asthma management is suggested to further improve the quality of care of childhood acute asthma exacerbations.

Severe cutaneous adverse drug reactions manifesting as Stevens-Johnson syndrome and toxic epidermal necrolysis reported to the national pharmacovigilance center in Nigeria: a database review from 2004 to 2017.

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions (SCARs). There is scant literature on the characteristics and causes of these conditions among the Nigerian population. Here, we describe the epidemiology, associated morbidity and mortality, and culpable drugs in SJS and TEN cases using the National Pharmacovigilance (NPC) database in Nigeria. METHODS: A retrospective review of the NPC database was done to analyze SJS and TEN cases reported over a period of 14 years. Annual reports, age and sex of patients, type of reporter, suspects and concomitant drugs, time to onset (TTO) of the reactions, and outcome of SJS and TEN were evaluated. RESULTS: The NPC received a total of 24,015 adverse drug reaction (ADR) reports. SJS and TEN accounted for 284 (0.1%) of the total reports, of which 254 (89.4%) were SJS and the remainder were TEN. Females (n = 184, 64.8%) and individuals aged 19-40 years (n = 181, 63.7%) were the most affected by SJS and TEN. Antiretrovirals, followed by antibiotics, were the most common drug classes reported to cause SJS and TEN, with nevirapine (n = 174, 40.7%) and co-trimoxazole (n = 143, 33.5%) being the most widely implicated drugs. Among patients with reported outcomes, 73 (28.7%) SJS and 3 (10.0%) TEN cases recovered without sequelae, at the time of reporting. Severity of the SCAR was reported for only 171 (69.0%) cases, of which 12 (4.7%) and 8 (26.7%) resulted in death (Grade 5) among SJS and TEN cases, respectively. CONCLUSIONS: Antiretroviral and antibiotics were the commonly reported offending group of drugs for SJS and TEN cases. Nevirapine and co-trimoxazole were the commonly reported suspect drugs. SJS and TEN were reported most frequently in females and in patients aged 19-40 years, indicating that drug surveillance and counseling in these groups of patients may be beneficial.

Surgical antimicrobial prophylaxis and its dose appropriateness among paediatric patients in a Nigerian teaching hospital.

Surgical antimicrobial prophylaxis (SAP) prevents incision site infection. We assessed SAP compliance with existing international guidelines, evaluated the appropriateness of the antimicrobial doses, and determined the risk factors for antimicrobial under-dosing. A retrospective chart review was performed for patients who under-went surgery and administered antimicrobial prophylaxis. Compliance with SAP guidelines was evaluated. Antimicrobial doses were categorized as under-, normal-, or over-dose. Of the 303 surgical patients, 97.7% received SAP and complete compliance was achieved in 5.6%. Of the 550 antimicrobial prescriptions, metronidazole (42.7%) and cefuroxime (34.7%) were the most prescribed. Over- (31.5%), under- (44.5%), and normal- dosing (24.0%) were recorded, respectively. None of the factors evaluated predicted the risk of antimicrobial under-dosing. Full compliance with international SAP guidelines was poor in our study. Correct timing, re-dosing, and duration of antimicrobial use were the most violated. Most antimicrobials were under-dosed, suggesting a need for national and institutional SAP guidelines.