Molecular epidemiology and genetic evolution of avian influenza H5N1 subtype in Nigeria, 2006 to 2021.

Nigeria recorded one of the earliest outbreaks of the Highly Pathogenic Avian Influenza (HPAI) virus H5N1 in 2006, which spread to other African countries. In 2023, 18 countries reported outbreaks of H5N1 in poultry, with human cases documented in Egypt, Nigeria, and Djibouti. There is limited information on the molecular epidemiology of HPAI H5N1 in Nigeria. We determined the molecular epidemiology and genetic evolution of the virus from 2006 to 2021. We investigated the trend and geographical distribution across Nigeria. The evolutionary history of 61 full-length genomes was performed from 13 countries worldwide, and compared with sequences obtained from the early outbreaks in Nigeria up to 2021. MEGA 11 was used to determine the phylogenetic relationships of H5N1 strains, which revealed close ancestry between sequences in Nigeria and those from other African countries. Clade classification was performed using the subspecies classification tool for Bacterial and Viral Bioinformatics Research Center (BV-BRC) version 3.35.5. H5N1 Clade 2.2 was observed in 2006, with 2.3.2, 2.3.2.1f clades observed afterwards and 2.3.4.4b in 2021. Our findings underscore the need for genomics surveillance to track antigenic variation and clades switching to monitor the epidemiological of the virus and safeguard human and animal health.Impacts Specific variations in the hemagglutinin (HA) and neuraminidase (NA) genes of Avian influenza virus are consistent in different geographical regions. H5N1 Clade 2.2 was reported in 2006, with 2.3.2, 2.3.2.1f afterwards and 2.3.4.4b in 2021. Nigeria is an epicentre for avian influenza with three major migratory routes for wild birds transversing the country. It is plausible that the Avian influenza in Northern Nigeria may be linked to wild bird sanctuaries in the region.

Revisiting the blind spot of substandard and fake drugs as drivers of antimicrobial resistance in LMICs.

One of the most significant risks to public health is ongoing antimicrobial resistance (AMR). Substandard and fraudulent medications, particularly in low- and middle-income countries (LMICs), are thought to have a role in the genesis and spread of AMR. There are numerous reports concerning the availability of subpar pharmaceuticals in developing countries, with no scientific evidence as to what exactly is included in some of the prescriptions supplied there. These counterfeit and inferior pharmaceuticals are a financial burden of up to US$200 billion, causing thousands of patient deaths, endangering both individual and public health,and undermining patient trust in the healthcare system. Poor quality and counterfeit antibiotics are often disregarded as possible causes of AMR in AMR studies. Therefore, we examined the issue of fake drugs in LMICs and its possible links to the emergence and spread of AMR.

Public health concerns surrounding the cVDPV2 outbreak in Africa: Strategies for prevention and control with a special focus on Nigeria.

Background and Aim: Poliovirus is a global health issue that affects children in different parts of the world. Despite the efforts of national, international, and nongovernmental organizations to eradicate the disease, it is re-emerging in Africa due to poor sanitation, vaccine hesitancy, new ways of transmission, and poor surveillance among others. Circulating vaccine-derived poliovirus type 2 (cVDPV2) is a major step in eradicating poliovirus and preventing outbreaks in developing countries. Strengthening African healthcare systems, increasing surveillance, hygiene and sanitation, and proper mass vaccination to achieve herd immunity are required in the fight against polio disease. This paper discusses the outbreak of cVDPV2, public health challenges, and recommendations in Africa with a special emphasis on Nigeria. Methods: We searched for articles documenting the incidence of cVDPV2 in Nigeria and other African countries on Pubmed, Google Scholar, and Scopus. Results: A total of 68 distinct cVDPV2 genetic emergences were found across 34 nations between April 2016 to December 2020, and in Nigeria, three cVDPV2 emergences were found. Also, 1596 instances of acute flaccid paralysis linked to cVDPV2 outbreaks were reported in four areas of the World Health Organization where Africa contributed 962 cases out of 1596 cases. Available data indicate that Africa has the most cVDPV2 cases and is associated with various challenges like the unidentified virus source, poor sanitation system, and inability to achieve herd immunity of the cVDPV2 vaccine. Conclusion: Collaborative efforts of stakeholders are crucial in combating infectious diseases, especially those transmitted via environments such as water and air, like poliovirus. Therefore, a collaboration between environmental health workers, veterinarians, community health workers, laboratory scientists, policymakers, and other professionals is required.

An evaluation of the impact of anti-rabies programs in Nigeria.

Rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria, the most populous country in Africa, rabies causes a significant public health burden partly due to uncoordinated efforts and the ineffectiveness of available anti-rabies programs. We aim to address the current efforts, and challenges associated with the available anti-rabies programs in Nigeria and provide recommendations to tackle these challenges. Results: The anti-rabies programs available in Nigeria are highlighted. They are sponsored by different bodies such as government parastatals, veterinary teaching hospitals, professional associations, nongovernmental associations, and students. These programs provide support to eradicate rabies but are not devoid of challenges. Recommendations are provided to the Nigerian government, bodies anchoring the anti-rabies programs, and health professionals to tackle the challenges hindering the effective impact of the programs. Conclusion: Anti-rabies programs in Nigeria are supported by individual and collaborative bodies. It is pertinent to hold on to these programs and create a comprehensive national program to achieve effective rabies eradication in Nigeria.

Rural-urban variation in willingness to donate blood in Ibadan Region, Nigeria.

BACKGROUND: Although there are ongoing blood donation campaigns in Nigeria, the prevalence of voluntary blood donation is about 10% and there is limited information about the determinants of blood donation behavior, especially across rural-urban geographic areas. This study examines the rural-urban differences in willingness to donate blood. METHOD: A cross-sectional study addressing adults from three rural and three urban communities was performed in 2021 to evaluate willingness, knowledge, attitude and practice of blood donation. RESULTS: A total of 287 individuals were surveyed. Most of the respondents across all communities have never donated blood (72%). Females aged 18-25, highly educated, and from urban communities were more incline to donate blood compared to their counterparts. The main reasons for not donating blood for rural dwellers were: never thought of it (39% vs 34.7%) and no one asked (34.4% vs 17%); fear of needles was declared mostly by urban dwellers (21.8% vs 12.5%) (p=0.02). CONCLUSIONS: Willingness to donate blood varies across rural and urban communities and is influenced by socio-demographic characteristics. The gap between willingness to donate and actual blood donation has consequences for the establishment of blood transfusion services. Targeted public health interventions are required to enhance awareness and knowledge and modify attitudes towards blood donation.

Changing Ecotypes of Dengue Virus 2 Serotype in Nigeria and the Emergence of Cosmopolitan and Asian I Lineages, 1966-2019.

Dengue virus (DENV) is a leading mosquito-borne virus with a wide geographical spread and a major public health concern. DENV serotype 1 (DENV-1) and serotype 2 (DENV-2) were first reported in Africa in 1964 in Ibadan, Nigeria. Although the burden of dengue is unknown in many African countries, DENV-2 is responsible for major epidemics. In this study, we investigated the activities of DENV-2 to determine the circulating strains and to appraise the changing dynamics in the epidemiology of the virus in Nigeria. Nineteen DENV-2 sequences from 1966-2019 in Nigeria were retrieved from the GenBank of the National Center of Biotechnology Information (NCBI). A DENV genotyping tool was used to identify the specific genotypes. The evolutionary history procedure was performed on 54 DENV-2 sequences using MEGA 7. There is a deviation from Sylvatic DENV-2 to other genotypes in Nigeria. In 2019, the Asian I genotype of DENV-2 was predominant in southern Edo State, located in the tropical rainforest region, with the first report of the DENV-2 Cosmopolitan strain. We confirmed the circulation of other non-assigned genotypes of DENV-2 in Nigeria. Collectively, this shows that DENV-2 dynamics have changed from Sylvatic transmission reported in the 1960s with the identification of the Cosmopolitan strain and Asian lineages. Sustained surveillance, including vectorial studies, is required to fully establish the trend and determine the role of these vectors.

The re-emergence and transmission of Monkeypox virus in Nigeria: the role of one health.

The Monkeypox virus, commonly abbreviated as mpox, is a viral zoonosis that is experiencing a resurgence in prevalence. It is endemic to regions of West and Central Africa that are characterized by dense forested areas. Various measures pertaining to animals, humans, and the environment have been recognized as potential factors and catalysts for the spread of the disease throughout the impacted regions of Africa. This study examines the various factors contributing to the transmission of the virus in Nigeria, with a particular focus on the animal-human and inter-human modes of transmission in rural communities and healthcare facilities. The One Health approach was emphasized as crucial in the prevention and management of this issue. Literature suggests that preventing repeated zoonotic introductions could potentially halt the transmission of the mpox virus from animal to human hosts, leading to a potential decrease in human infections.