Risk factors and knowledge of ebola virus disease among hunters in Kwara State, Nigeria

Ebola virus disease (EVD) is a hemorrhagic, severe, often fatal, zoonotic disease transmitted by exposure to body fluids of infected bats and non-human primates. This study assessed the risk factors and knowledge of EVD among hunters in Kwara state. We conducted a cross-sectional survey of 427 hunters using a structured questionnaire that was administered between January and April 2016.       Most of the hunters (99.3 %, n=424/427)) were male and the mean age was 39 years. The mean knowledge score was 4.3±0.9. Most of the hunters (96.2%, n=411/427) were aware of EVD but only 42.6% (n=182/427) of them had good knowledge (GK) of the disease. About one-quarter (22.5%, n=96/427) of the hunters hunted bats and monkeys and 17.1% (n=73/427) of them have consumed raw or undercooked game animals (bush meat). The knowledge of EVD was significantly influenced by the marital status, form of education, occupation, and religion. Hunters who went through conventional western education (OR:4.6; 95% CI: 2.6, 8.1; p<0.001) and those who were married (OR:4.4; 95%CI: 1.4, 11.0; p = 0.051) were more likely to have a GK of EVD respectively than those with no formal education and single hunters.  Similarly, hunters who were also professional farmers were more likely (OR = 23.1, 95% C.I.: 7.3, 55.2; p <0.01) to have a GK of EVD. Similarly, the education of hunters (OR = 4.6, 95% CI =2.6-8.1; p = <0.001), their ethnicity (OR = 2.4; 95% CI = 1.4-4.1; p = 0.002), and their religion (OR = 8.7, 95% CI = 2.0-38.9; p = 0.004) had significant impact on their knowledge of EVD.      This study reported high awareness of EVD among hunters in Kwara state. However, mass advocacy on the EVD should be re-instituted with emphasis on the mode of transmission, preventive, and control measures to prevent the re-introduction of EVD into the human population.&nbsp

A Hybrid Fuzzy Time Series Technique for Forecasting Univariate Data

In this paper a hybrid forecasting technique that integrates Cat Swarm optimization Clustering (CSO-C) and Particle Swarm Optimization (PSO) with Fuzzy Time Series (FTS) forecasting is presented. In the three stages of FTS, CSO-C found application at the fuzzification module where its efficient capability in terms of data classification was utilized to neutrally divide the universe of discourse into unequal parts. Then, disambiguated fuzzy relationships were obtained using Fuzzy Set Group (FSG). In the final stage, PSO was adopted for optimization; by tuning weights assigned to fuzzy sets in a rule. This rule is a fuzzy logical relationship induced from FSG. The forecasting results showed that the proposed method outperformed other existing methods; using RMSE and MAPE as performance metrics.            

Baseline epidemiology and associated dog ecology study towards stepwise elimination of rabies in Kwara state, Nigeria

Understanding domestic dog population dynamics and ecology is crucial to any effective rabies control program. This study was conducted as part of the baseline epidemiological studies necessary for the establishment of the Kwara Rabies Rapid Alert System "KRRAS". This study aimed to determine the dog population structure of Kwara State by assessing the dog ownership, vaccination status, and prevalence of dog bites. A total of 1460 questionnaires were administered to respondents in the three senatorial zones of the state using Open Data Kit (ODK) between June 2019 to January 2020. Of the 1460 households surveyed, 293 (20.1 %) owned at least one dog with an average of 2.25 dogs per household. The male to female ratio was 1.9:1 and 79.3 % (n = 523/659) of the owned dogs were local breeds. A total of 785 dogs was enumerated (659 dogs from 293 households and 126 free-roaming dogs) and 7811 persons which resulted in a dog-human ratio of 1:9.95. The estimated dog population is 376,789 (95 % CI: 343,700 - 379,878). Only 31 % (n = 204/659) of households vaccinated their dogs against rabies. The prevalence of dog-bite was 13 % (n = 193/1460) of which only 27 % of the victims (n = 61/225) received post-exposure prophylaxis (PEP). Dog ownership was significantly impacted by the ethnicity of respondents. Hausa (OR: 3.76; 95 % CI: 1.15-12.4; p &lt; 0.001) and Nupe (OR: 4.48; 95 % CI: 1.77-11.33; p &lt; 0.001) respondents owned dogs than Yoruba respondents. The rabies vaccination status of owned dogs was significantly impacted by the level of education (OR: 5.03; 95 % CI: 1.50-16.83; p &lt; 0.001); history of previous dog bite incidents (OR: 1.74; 95 % CI: 0.95-3.17; p &lt; 0.001); the breed of the dog with exotic dogs being more vaccinated (OR: 2.79: 95 % 0.64-12.05; p &lt; 0.001). Similarly, Male dogs (OR: 1.49, 95 % 1.03-2.86; p &lt; 0.001) and partially confined dogs (OR: 1.09, 95 % 0.45-2.11, p &lt; 0.001) were found to be vaccinated against rabies. The results of the study showed low dog vaccination coverage, and high number of free roaming dogs. Hence, a threat to public health. The low dog vaccination coverage is below the 70-80 % target recommended for herd immunity by the World Health Organization.</p

Perception of canine rabies among pupils under 15 years in Kwara State, North Central Nigeria

Publisher Copyright: © 2022 Al-Mustapha et al.Rabies is an endemic, highly fatal, and vaccine-preventable disease with severe socio-eco-nomic implications. Most (99%) human rabies cases are transmitted through dog bites. Children under 15 years account for 40% of all dog bite victims and 35–50% of all rabies deaths. Rabies awareness among this vulnerable group is critical to rabies prevention. However, there is a paucity of data on rabies awareness among pupils under 15. Hence, this study assessed the awareness and attitude of pupils under 15 years towards canine rabies in Kwara state in Nigeria. The study was conducted as a cross-sectional survey of 1,388 pupils across the state using a structured questionnaire that was administered as a one-on-one interview using the Open Data Kit on Android phones in December 2019. Of the 1388 pupils included in this study, only 21.7% (n = 301) of them were aware of rabies. The mean rabies score was 1.7±0.8 and only 29.2% (n = 88/301) of the pupils had adequate knowledge of canine rabies. The dog ownership rate was 18.7% (n = 259) with an average of 1.93 dogs per household. Approximately 5% (n = 66) of the pupils have been previously bitten by a dog. One-third of the dog bite victims (35%, n = 23/66) were managed and treated at home and only 12% (n = 8/66) were treated in a health facility. The result of the multivariable logis-tic regression showed that students aged between 13–15 years were more likely (OR: 1.93; 95% CI: 0.72–3.01; p < 0.001) to have adequate knowledge of rabies than the younger pupils. Similarly, pupils that have dogs in their households (OR: 2.09; 95%CI: 1.49–2.75; p < 0.001) and those that reside in Kwara South (OR:1.78 95% CI:1.29, 2.44; p < 0.001) were more likely to be aware and have adequate knowledge of canine rabies respectively. Finally, Pupils from non-dog-owning households were more likely (OR:2.2; 95% CI: 1.45, 4.42; p < 0.001) to have been bitten by dogs than those from dog-owning households. The awareness and attitude of pupils under 15 to canine rabies was poor. We advocate the introduction of rabies lessons into the school curriculum in Kwara State to reduce the incidence of dog bites and prevent dog-mediated human rabies.Peer reviewe

Characteristics of COVID-19 cases and factors associated with their mortality in Katsina State, Nigeria, April-July 2020

Introduction: COVID-19 was first detected in Daura, Katsina State, Nigeria on 4 April 2020. We characterized the cases and outlined factors associated with mortality. Methods: We analysed the COVID-19 data downloaded from Surveillance Outbreak Response, Management and Analysis System between 4 April and 31 July 2020. We defined a case as any person with a positive SARS-CoV-2 test within that period. We described the cases in time, person, and place; calculated the crude and adjusted odds ratios and 95% confidence intervals for factors associated with mortality. Results: We analysed 744 confirmed cases (median age 35, range 1-90), 73% males and 24 deaths (Case fatality rate 3.2%, Attack rate 8.5/100,000). The outbreak affected 31 districts, started in week 14, peaked in week 26, and is ongoing. Highest proportion of cases in the age groups were 26.7% (184) in 30-39, 21.7% (153) in 20-29 years, and 18.3% (129) in 40-49 years. While the highest case fatality rates in the age groups were 35.7% in 70-79, 33.3% in 80-89 years, and 19.4% in 60-69 years. Factors associated with death were cough (AOR: 9.88, 95% CI: 1.29-75.79), age ≥60 years (AOR: 18.42, 95% CI: 7.48-45.38), and male sex (AOR: 4.4, 95% CI: 0.98-20.12). Conclusion: Male contacts below 40 years carried the burden of COVID-19. Also, persons 60 years and above, with cough have an increased risk of dying from COVID-19. Risk communication should advocate for use of preventive measures, protection of persons 60 years and above, and consideration of cough as a red-flag sign

Nigeria's race to zero COVID-19 cases : True disease burden or testing failure?

Non peer reviewe

Perception of canine rabies among pupils under 15 years in Kwara State, North Central Nigeria

Publisher Copyright: © 2022 Al-Mustapha et al.Rabies is an endemic, highly fatal, and vaccine-preventable disease with severe socio-eco-nomic implications. Most (99%) human rabies cases are transmitted through dog bites. Children under 15 years account for 40% of all dog bite victims and 35–50% of all rabies deaths. Rabies awareness among this vulnerable group is critical to rabies prevention. However, there is a paucity of data on rabies awareness among pupils under 15. Hence, this study assessed the awareness and attitude of pupils under 15 years towards canine rabies in Kwara state in Nigeria. The study was conducted as a cross-sectional survey of 1,388 pupils across the state using a structured questionnaire that was administered as a one-on-one interview using the Open Data Kit on Android phones in December 2019. Of the 1388 pupils included in this study, only 21.7% (n = 301) of them were aware of rabies. The mean rabies score was 1.7±0.8 and only 29.2% (n = 88/301) of the pupils had adequate knowledge of canine rabies. The dog ownership rate was 18.7% (n = 259) with an average of 1.93 dogs per household. Approximately 5% (n = 66) of the pupils have been previously bitten by a dog. One-third of the dog bite victims (35%, n = 23/66) were managed and treated at home and only 12% (n = 8/66) were treated in a health facility. The result of the multivariable logis-tic regression showed that students aged between 13–15 years were more likely (OR: 1.93; 95% CI: 0.72–3.01; p < 0.001) to have adequate knowledge of rabies than the younger pupils. Similarly, pupils that have dogs in their households (OR: 2.09; 95%CI: 1.49–2.75; p < 0.001) and those that reside in Kwara South (OR:1.78 95% CI:1.29, 2.44; p < 0.001) were more likely to be aware and have adequate knowledge of canine rabies respectively. Finally, Pupils from non-dog-owning households were more likely (OR:2.2; 95% CI: 1.45, 4.42; p < 0.001) to have been bitten by dogs than those from dog-owning households. The awareness and attitude of pupils under 15 to canine rabies was poor. We advocate the introduction of rabies lessons into the school curriculum in Kwara State to reduce the incidence of dog bites and prevent dog-mediated human rabies.Peer reviewe

Awareness and knowledge of canine rabies: A state-wide cross-sectional study in Nigeria.

Rabies is a highly fatal disease that is endemic in Nigeria. The poor community awareness and knowledge of canine rabies have thwarted the realization of zero deaths from dog mediated human rabies. This study aimed to assess the awareness and knowledge of canine rabies in Kwara state. A total of 1,460 questionnaires were administered to respondents in the three senatorial zones of the state using open data kit (ODK) on mobile phones between September 2019 to January 2020. The rabies awareness rate was 38.1%. The mean knowledge score was 3.78 ± 2.15. Only 10.6% (n = 59/557) of the respondents had satisfactory knowledge of canine rabies. Respondents had poor knowledge of the mode of transmission, symptoms, prevention, and the control measures needed to eliminate canine rabies. Only 20.1% of respondents owned at least a dog. Dog owners were 3.85× (95% CI: 2.89, 5.13; p < 0.01) more likely to be aware of canine rabies and were 1.78× (95% CI: 1.22-2.60; p = 0.003) more likely to have satisfactory knowledge about canine rabies than non-dog owners. Respondents with tertiary education were at least 6.81× (95% CI: 4.24, 10.92; p < 0.01) more likely to be aware of rabies than respondents with no formal education. The findings of this study showed very low awareness and knowledge of canine rabies among residents of Kwara state. Mass sensitization of the populace on the dangers of rabies should be intensified. Such interventions should be targeted at the general public and dog owners

A cross-sectional survey of public knowledge of the monkeypox disease in Nigeria

The Monkeypox Disease (MPXD) gained attention due to its widened geographical distribution outside of Africa, Hence, a it was declared a global health emergency. The index case in Europe was from a Nigerian traveller. This study assessed public awareness and knowledge of the MPXD by conducting an online, cross-sectional survey of educated Nigerians. A total of 822 respondents were recruited using the snowball sampling method between the 16th to 29th of August 2022. More responses were retrieved from the Northeastern geopolitical region (30.1%, n=220) than other regions. Descriptive statistics revealed that 89% (n=731/822) of the study participants were aware of the MPXD but only 58.7% (n=429/731) of them had good knowledge of the disease with a mean knowledge score of 5.31 +/- 2.09. The main knowledge gaps were in the incubation period of the disease, the signs and symptoms, its mode of transmission, and preventive practices needed to curb the spread of the monkeypox virus (MPXV). Specifically, only 24.5% (n=179) of them knew that MPXV can be transmitted via sexual contact. Most of the study participants (79.2%, n=651) opined that we can prevent the occurrence of public health emergencies in the future. The multivariable logistic regression analysis revealed that of the socio-demographic variables, the male gender (OR: 1.69; 95% CI: 1.22,2.33); Ph.D. level education (1.44; 95% CI: 1.048,4.23); and being homosexual (OR:1.65; 95% CI: 1.07,3.78) were significantly associated with good knowledge of MPXD. Despite the varying prevalence across the country, the region of residence within Nigeria did not influence the knowledge of MPXD among the respondents. The knowledge gaps necessitate intensified public health risk communication with a focus on modes of transmission and the preventive measures needed to curb the spread of the MPXV.Peer reviewe

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)