Descriptive epidemiology and mortality risk factors of COVID-19 outbreak in Delta State, Nigeria, March - August 2020

Introduction: The highly contagious Coronavirus Disease 2019 (COVID-19) was first confirmed in Nigeria on February 27, 2020. In Delta State, the first COVID-19 case was recorded on April 7, 2020, which spread across the state. We characterized the COVD-19 pandemic in Delta State in terms of person, place, and time, and determined the risk factors for COVID-19 mortality. Methods: We conducted a retrospective analysis of COVID-19 pandemic in Delta State between March 23 to August 17, 2020. We obtained line-lists of 5,917 COVID-19 patients, cleaned and analyzed sociodemographic, clinical characteristics and outcome variables using IBM SPSS Statistics 25. We calculated frequencies, proportions, mean and standard deviation (SD). Bivariate and multivariate logistics regression analysis were conducted to determine the risk factors of COVID-19 mortality, adjusted-odds-ratios were reported at 95% confidence interval and p-value set at 5% significance level. Results: From March-August 2020, 1,605 confirmed COVID-19 cases and 47 deaths (case-fatality-rate 2.9%) were recorded. Majority were aged 20-39 years 675 (42.1%) while 1,064 (66.3%) were males (mean age 39±15years). Persons aged ≥60years were more likely to die from COVID-19 than younger cases (aOR: 11.0; 95% CI: 4.9-24.4) while Symptomatic positive cases at time of test were more likely to die than those who were not (aOR: 3.2; 95% CI: 1.3-7.5). Conclusion: Males in the youthful age-group were mostly affected. Independent predictors of mortality were being elderly or symptomatic at time of testing. Strengthening case management to target symptomatic patients and intensifying sensitization activities targeting youthful males and elderly persons, are important to reduce mortality

Pattern of the meningococcal meningitis outbreak in Northern Nigeria, 2009

Objectives: Despite the availability of vaccines, children are the people most often affected by epidemic meningococcal meningitis. The pattern of the epidemic meningococcal meningitis outbreak in Northern Nigeria in 2009 and the Neisseria meningitidis strains responsible for this epidemic are described here. Methods: A retrospective cross-sectional study was conducted in 16 states, involving 48 local government areas (LGAs), 91 health facilities, and 96 communities. Data collection involved in-depth interviews with key informants from the federal to the community level, a review of records, and a solution-oriented national workshop with participants from all states of the Federation. Cerebrospinal fluid (CSF) samples were collected from some of the suspected cases at the start of the outbreak and were tested using the rapid Pastorex latex agglutination kit. Results: Kastina (11153, 20.4%), Jigawa (8643, 15.8%), Bauchi (8463, 15.5%), Kano (6811, 12.4%), and Gombe (6110, 11.2%) were the states with the highest prevalence of meningitis. The states of Nasarawa (11.0%), Adamawa (8.0%), and Borno (7.6%) recorded the highest percentage of deaths, while the Shongom (Gombe State 12.5%), Illela (Sokoto State 9.8%), and Ikara (Kaduna State 9.1%) LGAs recorded the most deaths amongst cases seen. Conclusions: The testing of CSF samples during meningitis outbreaks is recommended in order to monitor the occurrence of the multiple meningitis serotypes during these outbreaks and to direct serotype-specific vaccination response activities