DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2011
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous publ... more As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a…
DOAJ (DOAJ: Directory of Open Access Journals), 2019
Introduction: To assess the prevalence and causes of premarital sex and condom use among trainee ... more Introduction: To assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified. Methods: We used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis. Results: A total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141 (45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use. Conclusion: There is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology.
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous publ... more As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competencybased training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.
Zenodo (CERN European Organization for Nuclear Research), Jul 26, 2022
This study hinges on the management of biomedical waste with a critique of the waste management p... more This study hinges on the management of biomedical waste with a critique of the waste management practices in Nigeria. The study classified biomedical waste into ten categories based on the World Health Organisation categorization. They include human anatomical waste, animal waste, microbiological waste and biotechnology waste, discarded medicine and cytotoxic waste, soiled wasted, solid waste, liquid waste, incineration ash, and chemical waste. The study identified the dangers of mismanagement of biomedical waste to include: disease-causing microbes, medical sharps, and hazardous substances from biomedical waste can infect healthcare workers, patients, the general public, and the environment, to be more specific. Human and environmental consequences of improperly handled biomedical waste include radiation burns from radioactive waste, sharp-inflicted injuries, poisoning and pollution from pharmaceutical goods, waste water, and toxic elements like as mercury. As such, inadequate management of waste poses major public health risks, ranging from the transmission of endemic parasitic infections to the development and re-emergence of new zoonoses as a result of direct or indirect impacts of poor waste management. The study recommended that the development of integrated policies on waste sorting, reuse, recycling, and disposal should be one essential aspect of the policy and the framework for adequate provision of waste collection, transportation, and disposal facilities. Also, a unified policy on biomedical waste management should be implemented across all states of the federation to ensure the smooth disposal of medical waste across the country.
Funding for health care programs has over the years been an important challenge for health and he... more Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.
Introduction we present a qualitative analysis of opinions of the Nigerian general public as to h... more Introduction we present a qualitative analysis of opinions of the Nigerian general public as to how successful healthcare strategies have been in containing the COVID-19 outbreak. Methods an online qualitative survey was conducted, consisting of 30 semi-structured questions. Results four hundred and ninety-five (495) respondents participated, ranging in age from 18 to 59 years. Over 40% of all respondents were critical of public health information. Participants saw provision of social support measures (n = 83), lack of economic, financial and social support (n = 65), enforcement of restrictions on movement outside the home, availability of face-masks and social distancing (n = 53) and provision of COVID-19 testing (n = 48) as the major things that were handled poorly by the government and health authorities. Conclusion we advocate coordinated forward planning for public safety until vaccines are widely available; while social distancing should continue. Policymakers need to be adaptable to changing conditions, given fluctuating case numbers and fatality rates.
Journal of Health Care for the Poor and Underserved, 2022
We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were... more We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were obtained from Nigerian Centre for Disease Control. By 21 March 2021, 161,737 people were confirmed positive for SARS-COV-2. Overall, testing rates were 0.8% of the population, with positivity rates of 9.6%, complete recovery rates without longterm sequelae of 91.4%, and case fatality rates of 1.3%. Most Nigerian regions contributed to figures for cases and deaths in 2021. The picture may change as testing is scaled up to include community testing. Given so-called "pandemic fatigue" among the general population, various conspiracy theories being prevalent, and the recent introduction of COVID-19 vaccines in Nigeria, we assume that Nigeria is at a pivotal stage of the outbreak. Effort must be made by government to learn successful strategies in other countries to adapt to prevent a rise in case numbers and deaths.
Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Afri... more Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Africa. WHOsponsored World Malaria Day activity has helped to improve education and has contributed to a reduction in mortality globally in the past decade. However, much needs to be done still in Africa. We report on a World Malaria Day scheme in three primary Healthcare Facilities in and around the Abuja Federal Capital Territory in Nigeria in 2017. Activity included educational talks to pregnant women and nursing mothers of young children, with malarial testing, distribution of free mosquito nets and also medical treatment if needed. We found a large clinical over-diagnosis of malaria with simple fevers of any cause being reported as malaria. None of these cases were found to be due to malaria on formal malarial testing. We conclude that efforts should continue into education and prevention of malaria with insecticide-impregnated mosquito nets a key factor. However, over-diagnosis of malaria and the use of unnecessary antimalarial treatment may lead to parasite resistance to antimalarial treatment, morbidity from drug side-effects and potential mortality from not receiving the right treatment for other febrile illnesses. We recommend that malarial testing, particularly with simple blood film microscopy is implemented more widely across Africa, as it is simple to perform and allows effective management plans to be drawn up for individual patients.
Annals of Medical and Health Sciences Research, 2017
Context: The Royal College of Physicians of London and the West African College of Physicians hav... more Context: The Royal College of Physicians of London and the West African College of Physicians have a long history of collaboration with a focus on postgraduate education. The Millennium Development Goal 6 Partnership for African Clinical Training (M-PACT) Clinical Course project was undertaken to improve the theoretical and practical knowledge base in the pertinent diseases of the Millennium Developments Goals (MDG 6): Tuberculosis, HIV/AIDS, Malaria, and medical leadership. Aim: To assess the impact of the training on everyday practice of the participants at least six months’ post training. Material and methods: A cross-sectional descriptive survey was used to execute this study between April to May 2016. A self-administered questionnaire was used for this study. Questionnaires were distributed using SurveyMonkey®. Data were analyzed using SurveyMonkey® Analysis Tool and Microsoft Excel Sheet. Results: A total of 73 trainees from six different courses responded to the survey. Major...
While the Millennium Development Goal 6 has concentrated on malaria elimination strategies with s... more While the Millennium Development Goal 6 has concentrated on malaria elimination strategies with some degree of success, reflected in falling morbidity and mortality over the past 15 years, the situation in Africa is not as promising as the rest of the world. We wondered how effective the message to use insecticide-treated mosquito nets was and with this in mind, in September 2016, we undertook a survey of highly-trained doctors from Nigeria and Ghana, attending Millennium Development Goal 6 postgraduate training courses in Ibadan and Accra to assess whether they practiced antimalarial personal protection policies themselves. Surprisingly, over 40% of the doctors in the Accra survey did not even own a mosquito net with 20% in Ibadan. Only 7% of those in Ghana used their nets daily, rising to 20% in the Nigerian respondents. We conclude that further public health measures are needed to bring home the message that mosquito nets should be used on a daily basis in endemic areas and that ...
Access to quality care is essential for improved health outcomes. Decentralization improves acces... more Access to quality care is essential for improved health outcomes. Decentralization improves access to healthcare services at lower levels of care, but it does not dismantle structural, funding and programming restrictions to access, resulting in inequity and inequality in population health. Unlike decentralization, Commonization Model of care reduces health inequalities and inequity, dismantles structural, funding and other program related obstacles to population health. Excellence and Friends Management Care Center (EFMC) using Commonization Model (CM), fully integrated HIV services into core health services in 121 supported facilities.This initiative improved access to care, treatment, support services, reduced stigmatization/discrimination, and improved uptake of HTC. We call on governments to adequately finance CM for health systems restructuring towards better health outcomes.
International Journal of Infectious Diseases, 2010
e432 14th International Congress on Infectious Diseases (ICID) Abstracts vaccination clinics. Vac... more e432 14th International Congress on Infectious Diseases (ICID) Abstracts vaccination clinics. Vaccination clinics were successful both years, increasing the number of vaccines administered from approximately 604,000 to 1,053,388. The WRD website has currently received over 180,000 visitors from more than 200 countries/territories; the majority (81%) of which are new visitors and remain on the site for an average of 2 minutes. Conclusion: The success of WRD is promising, and web traffic demonstrates interest from a broader scope of potential participants. The evaluation metrics serve as a continuous feedback loop into the yearly campaign design and global outreach plan.
International Journal of Infectious Diseases, 2010
e103 members, were followed up with home visits to determine secondary infections in the househol... more e103 members, were followed up with home visits to determine secondary infections in the household. Serum samples taken at baseline and convalescence were tested for HAI specific to pandemic H1N1, seasonal H1N1 and seasonal H3N2. Nasal and throat swabs (NTS) were collected from each individual and tested by RTPCR to confirm active infections. Results: There were 18 pandemic H1N1, 5 seasonal H1N1, and 24 seasonal H3N2 virus positive cases confirmed by RT-PCR. Among those positive for influenza virus, 39 were adults (''16 years) and 8 were children. The proportion of individuals with a homologous antibody titer of ≥1:40 rose from 17%, 20% and 4% to 78%, 100% and 38% after infection with the pandemic H1N1, seasonal H1N1 and seasonal H3N2 viruses respectively. Heterologous responses were strongest between pandemic H1N1 and seasonal H1N1. In individuals with RT-PCR confirmed seasonal H1N1 infection, the proportion with an antibody titer ''1:40 for pandemic H1N1 increased from 20% to 40%. In the opposite direction, the proportion of those confirmed with pandemic H1N1 with an antibody titer ≥1:40 for seasonal H1N1 increased from 33% to 44%. Low levels of cross-strain HAI titer rise to ≥1:40 were detected in other variations. Conclusion: We identified low baseline immunity prior to naturally-acquired infection with seasonal or pandemic strains of influenza in the 2009 summer season in Hong Kong. This suggests that a proportion of those infected with either seasonal H1N1 or H3N2 viruses could gain protection against the novel pandemic H1N1 strain and vice-versa.
International Journal of Infectious Diseases, 2010
e28 14th International Congress on Infectious Diseases (ICID) Abstracts sis and meningitis were d... more e28 14th International Congress on Infectious Diseases (ICID) Abstracts sis and meningitis were detected. Age-specific proportions of those <5 years with suspected disease were 43% (n = 530) 2-11 months, 32% (n = 387) 1 year, and 25% (n = 308) 2-4 years. Of those aged ''5 years, 42% (n = 100) were <15 years and 58% (n = 138) were ≥15.7% (95/1385) of blood cultures grew pathogens; 38% (36/95) pneumococcus and 20% (19/95) Staphylococcus aureus. 80% (76/95) of invasive bacterial disease occurred <5 years of age. 86% (25/29) of IPD <5 years of age was associated with pneumonia and there were seven cases of bacterial meningitis. All cases of IPD ''5 years of age were associated with pneumonia and there were two cases of bacterial meningitis. The estimated incidence of IPD per 100000 person years was 362 (2-11 months), 295 (1 year), 56 (2-4 years), 4 (5-14 years) and 9 (≥15 years).
ObjectivesA study designed to assess the public perception of the response of government and its ... more ObjectivesA study designed to assess the public perception of the response of government and its institutions to the COVID-19 pandemic in Nigeria.SettingSelf-selecting participants throughout Nigeria completed a self-administered questionnaire through an online cross-sectional survey.Participants495.ResultsThe majority of respondents were married (76.6%), were males (61.8%), had tertiary level education (91.0%), were public servants (36.8%), Christians (82.6%), and resident either in the Federal Capital Territory (Abuja) (49.1%) or in the South-East Region of Nigeria (36.6%). Over 95% of the respondents had heard of COVID-19 (98.8%) and knew it is a viral disease (95.4%). The government and its institutions response to the pandemic were rated as poor, with the largest rating as poor for Federal President’s Office (57.5%). Communication (50.0%) and prevention messages (43.7%) received the highest perception good rating. Female respondents and those less than 40 years generally rated ...
International Journal of Research Publications, 2022
Nigeria is a country with over 190 million people spread across 36 states including the federal c... more Nigeria is a country with over 190 million people spread across 36 states including the federal capital territory of the country. Although significant progress has been made towards strengthening the health system, the quality of Water Sanitation and Hygiene (WASH) services that results in Infection Prevention and Control (IPC) advancement efforts are lacking in most Primary Health Care (PHC) facilities in the country. For this reason, there are still gaps in attaining sustainable development goals (SDG-6). This pilot proposal if implemented will bring sustainable and improved WASH services that will improve IPC effort in Primary Health Care facilities. It will address bottleneck issues in leadership and governance and the health workforce which are major health system building blocks. Our target population is about 20 million vulnerable people living in and accessing PHC facilities in South-South, Nigeria. The proposal seeks to bridge the identified system gaps by strengthening leadership, governance, and workforce. This will be achieved by appointing WASH and IPC focal persons from the facilities and communities to improve community participation, accountability, and responsiveness. The pilot program will be scalable to the rest of the country. Liberia and Ethiopia are used as benchmarks references.
DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2011
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous publ... more As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Emergency Plan for AIDS Relief and the US President&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a…
DOAJ (DOAJ: Directory of Open Access Journals), 2019
Introduction: To assess the prevalence and causes of premarital sex and condom use among trainee ... more Introduction: To assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified. Methods: We used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis. Results: A total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141 (45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use. Conclusion: There is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology.
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous publ... more As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competencybased training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.
Zenodo (CERN European Organization for Nuclear Research), Jul 26, 2022
This study hinges on the management of biomedical waste with a critique of the waste management p... more This study hinges on the management of biomedical waste with a critique of the waste management practices in Nigeria. The study classified biomedical waste into ten categories based on the World Health Organisation categorization. They include human anatomical waste, animal waste, microbiological waste and biotechnology waste, discarded medicine and cytotoxic waste, soiled wasted, solid waste, liquid waste, incineration ash, and chemical waste. The study identified the dangers of mismanagement of biomedical waste to include: disease-causing microbes, medical sharps, and hazardous substances from biomedical waste can infect healthcare workers, patients, the general public, and the environment, to be more specific. Human and environmental consequences of improperly handled biomedical waste include radiation burns from radioactive waste, sharp-inflicted injuries, poisoning and pollution from pharmaceutical goods, waste water, and toxic elements like as mercury. As such, inadequate management of waste poses major public health risks, ranging from the transmission of endemic parasitic infections to the development and re-emergence of new zoonoses as a result of direct or indirect impacts of poor waste management. The study recommended that the development of integrated policies on waste sorting, reuse, recycling, and disposal should be one essential aspect of the policy and the framework for adequate provision of waste collection, transportation, and disposal facilities. Also, a unified policy on biomedical waste management should be implemented across all states of the federation to ensure the smooth disposal of medical waste across the country.
Funding for health care programs has over the years been an important challenge for health and he... more Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.
Introduction we present a qualitative analysis of opinions of the Nigerian general public as to h... more Introduction we present a qualitative analysis of opinions of the Nigerian general public as to how successful healthcare strategies have been in containing the COVID-19 outbreak. Methods an online qualitative survey was conducted, consisting of 30 semi-structured questions. Results four hundred and ninety-five (495) respondents participated, ranging in age from 18 to 59 years. Over 40% of all respondents were critical of public health information. Participants saw provision of social support measures (n = 83), lack of economic, financial and social support (n = 65), enforcement of restrictions on movement outside the home, availability of face-masks and social distancing (n = 53) and provision of COVID-19 testing (n = 48) as the major things that were handled poorly by the government and health authorities. Conclusion we advocate coordinated forward planning for public safety until vaccines are widely available; while social distancing should continue. Policymakers need to be adaptable to changing conditions, given fluctuating case numbers and fatality rates.
Journal of Health Care for the Poor and Underserved, 2022
We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were... more We report the COVID-19 experience across Nigeria from March 2020 to March 2021. Demographics were obtained from Nigerian Centre for Disease Control. By 21 March 2021, 161,737 people were confirmed positive for SARS-COV-2. Overall, testing rates were 0.8% of the population, with positivity rates of 9.6%, complete recovery rates without longterm sequelae of 91.4%, and case fatality rates of 1.3%. Most Nigerian regions contributed to figures for cases and deaths in 2021. The picture may change as testing is scaled up to include community testing. Given so-called "pandemic fatigue" among the general population, various conspiracy theories being prevalent, and the recent introduction of COVID-19 vaccines in Nigeria, we assume that Nigeria is at a pivotal stage of the outbreak. Effort must be made by government to learn successful strategies in other countries to adapt to prevent a rise in case numbers and deaths.
Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Afri... more Malaria remains a major cause of mortality across the world, but particularly in sub-Saharan Africa. WHOsponsored World Malaria Day activity has helped to improve education and has contributed to a reduction in mortality globally in the past decade. However, much needs to be done still in Africa. We report on a World Malaria Day scheme in three primary Healthcare Facilities in and around the Abuja Federal Capital Territory in Nigeria in 2017. Activity included educational talks to pregnant women and nursing mothers of young children, with malarial testing, distribution of free mosquito nets and also medical treatment if needed. We found a large clinical over-diagnosis of malaria with simple fevers of any cause being reported as malaria. None of these cases were found to be due to malaria on formal malarial testing. We conclude that efforts should continue into education and prevention of malaria with insecticide-impregnated mosquito nets a key factor. However, over-diagnosis of malaria and the use of unnecessary antimalarial treatment may lead to parasite resistance to antimalarial treatment, morbidity from drug side-effects and potential mortality from not receiving the right treatment for other febrile illnesses. We recommend that malarial testing, particularly with simple blood film microscopy is implemented more widely across Africa, as it is simple to perform and allows effective management plans to be drawn up for individual patients.
Annals of Medical and Health Sciences Research, 2017
Context: The Royal College of Physicians of London and the West African College of Physicians hav... more Context: The Royal College of Physicians of London and the West African College of Physicians have a long history of collaboration with a focus on postgraduate education. The Millennium Development Goal 6 Partnership for African Clinical Training (M-PACT) Clinical Course project was undertaken to improve the theoretical and practical knowledge base in the pertinent diseases of the Millennium Developments Goals (MDG 6): Tuberculosis, HIV/AIDS, Malaria, and medical leadership. Aim: To assess the impact of the training on everyday practice of the participants at least six months’ post training. Material and methods: A cross-sectional descriptive survey was used to execute this study between April to May 2016. A self-administered questionnaire was used for this study. Questionnaires were distributed using SurveyMonkey®. Data were analyzed using SurveyMonkey® Analysis Tool and Microsoft Excel Sheet. Results: A total of 73 trainees from six different courses responded to the survey. Major...
While the Millennium Development Goal 6 has concentrated on malaria elimination strategies with s... more While the Millennium Development Goal 6 has concentrated on malaria elimination strategies with some degree of success, reflected in falling morbidity and mortality over the past 15 years, the situation in Africa is not as promising as the rest of the world. We wondered how effective the message to use insecticide-treated mosquito nets was and with this in mind, in September 2016, we undertook a survey of highly-trained doctors from Nigeria and Ghana, attending Millennium Development Goal 6 postgraduate training courses in Ibadan and Accra to assess whether they practiced antimalarial personal protection policies themselves. Surprisingly, over 40% of the doctors in the Accra survey did not even own a mosquito net with 20% in Ibadan. Only 7% of those in Ghana used their nets daily, rising to 20% in the Nigerian respondents. We conclude that further public health measures are needed to bring home the message that mosquito nets should be used on a daily basis in endemic areas and that ...
Access to quality care is essential for improved health outcomes. Decentralization improves acces... more Access to quality care is essential for improved health outcomes. Decentralization improves access to healthcare services at lower levels of care, but it does not dismantle structural, funding and programming restrictions to access, resulting in inequity and inequality in population health. Unlike decentralization, Commonization Model of care reduces health inequalities and inequity, dismantles structural, funding and other program related obstacles to population health. Excellence and Friends Management Care Center (EFMC) using Commonization Model (CM), fully integrated HIV services into core health services in 121 supported facilities.This initiative improved access to care, treatment, support services, reduced stigmatization/discrimination, and improved uptake of HTC. We call on governments to adequately finance CM for health systems restructuring towards better health outcomes.
International Journal of Infectious Diseases, 2010
e432 14th International Congress on Infectious Diseases (ICID) Abstracts vaccination clinics. Vac... more e432 14th International Congress on Infectious Diseases (ICID) Abstracts vaccination clinics. Vaccination clinics were successful both years, increasing the number of vaccines administered from approximately 604,000 to 1,053,388. The WRD website has currently received over 180,000 visitors from more than 200 countries/territories; the majority (81%) of which are new visitors and remain on the site for an average of 2 minutes. Conclusion: The success of WRD is promising, and web traffic demonstrates interest from a broader scope of potential participants. The evaluation metrics serve as a continuous feedback loop into the yearly campaign design and global outreach plan.
International Journal of Infectious Diseases, 2010
e103 members, were followed up with home visits to determine secondary infections in the househol... more e103 members, were followed up with home visits to determine secondary infections in the household. Serum samples taken at baseline and convalescence were tested for HAI specific to pandemic H1N1, seasonal H1N1 and seasonal H3N2. Nasal and throat swabs (NTS) were collected from each individual and tested by RTPCR to confirm active infections. Results: There were 18 pandemic H1N1, 5 seasonal H1N1, and 24 seasonal H3N2 virus positive cases confirmed by RT-PCR. Among those positive for influenza virus, 39 were adults (''16 years) and 8 were children. The proportion of individuals with a homologous antibody titer of ≥1:40 rose from 17%, 20% and 4% to 78%, 100% and 38% after infection with the pandemic H1N1, seasonal H1N1 and seasonal H3N2 viruses respectively. Heterologous responses were strongest between pandemic H1N1 and seasonal H1N1. In individuals with RT-PCR confirmed seasonal H1N1 infection, the proportion with an antibody titer ''1:40 for pandemic H1N1 increased from 20% to 40%. In the opposite direction, the proportion of those confirmed with pandemic H1N1 with an antibody titer ≥1:40 for seasonal H1N1 increased from 33% to 44%. Low levels of cross-strain HAI titer rise to ≥1:40 were detected in other variations. Conclusion: We identified low baseline immunity prior to naturally-acquired infection with seasonal or pandemic strains of influenza in the 2009 summer season in Hong Kong. This suggests that a proportion of those infected with either seasonal H1N1 or H3N2 viruses could gain protection against the novel pandemic H1N1 strain and vice-versa.
International Journal of Infectious Diseases, 2010
e28 14th International Congress on Infectious Diseases (ICID) Abstracts sis and meningitis were d... more e28 14th International Congress on Infectious Diseases (ICID) Abstracts sis and meningitis were detected. Age-specific proportions of those <5 years with suspected disease were 43% (n = 530) 2-11 months, 32% (n = 387) 1 year, and 25% (n = 308) 2-4 years. Of those aged ''5 years, 42% (n = 100) were <15 years and 58% (n = 138) were ≥15.7% (95/1385) of blood cultures grew pathogens; 38% (36/95) pneumococcus and 20% (19/95) Staphylococcus aureus. 80% (76/95) of invasive bacterial disease occurred <5 years of age. 86% (25/29) of IPD <5 years of age was associated with pneumonia and there were seven cases of bacterial meningitis. All cases of IPD ''5 years of age were associated with pneumonia and there were two cases of bacterial meningitis. The estimated incidence of IPD per 100000 person years was 362 (2-11 months), 295 (1 year), 56 (2-4 years), 4 (5-14 years) and 9 (≥15 years).
ObjectivesA study designed to assess the public perception of the response of government and its ... more ObjectivesA study designed to assess the public perception of the response of government and its institutions to the COVID-19 pandemic in Nigeria.SettingSelf-selecting participants throughout Nigeria completed a self-administered questionnaire through an online cross-sectional survey.Participants495.ResultsThe majority of respondents were married (76.6%), were males (61.8%), had tertiary level education (91.0%), were public servants (36.8%), Christians (82.6%), and resident either in the Federal Capital Territory (Abuja) (49.1%) or in the South-East Region of Nigeria (36.6%). Over 95% of the respondents had heard of COVID-19 (98.8%) and knew it is a viral disease (95.4%). The government and its institutions response to the pandemic were rated as poor, with the largest rating as poor for Federal President’s Office (57.5%). Communication (50.0%) and prevention messages (43.7%) received the highest perception good rating. Female respondents and those less than 40 years generally rated ...
International Journal of Research Publications, 2022
Nigeria is a country with over 190 million people spread across 36 states including the federal c... more Nigeria is a country with over 190 million people spread across 36 states including the federal capital territory of the country. Although significant progress has been made towards strengthening the health system, the quality of Water Sanitation and Hygiene (WASH) services that results in Infection Prevention and Control (IPC) advancement efforts are lacking in most Primary Health Care (PHC) facilities in the country. For this reason, there are still gaps in attaining sustainable development goals (SDG-6). This pilot proposal if implemented will bring sustainable and improved WASH services that will improve IPC effort in Primary Health Care facilities. It will address bottleneck issues in leadership and governance and the health workforce which are major health system building blocks. Our target population is about 20 million vulnerable people living in and accessing PHC facilities in South-South, Nigeria. The proposal seeks to bridge the identified system gaps by strengthening leadership, governance, and workforce. This will be achieved by appointing WASH and IPC focal persons from the facilities and communities to improve community participation, accountability, and responsiveness. The pilot program will be scalable to the rest of the country. Liberia and Ethiopia are used as benchmarks references.
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