Prevalence of smear positive pulmonary tuberculosis among inmates and staff of Abakaliki Prisons, Nigeria

Introduction: Pulmonary Tuberculosis (PTB) is one of the major diseases of public health importance especially in prisons where case finding rate has been low. The WHO established five facts of prisons PTB spread which include: Prisons receive TB, Prisons concentrate TB, Prisons disseminate TB, Prisons make TB worse, and Prisons export TB. Poor TB case finding result in annual TB transmission risks of 90%. This study determined the prevalence of pulmonary tuberculosis among inmates and staff of Nigerian Prisons, AbakalikiMethods: A prison-based cross-sectional descriptive study was undertaken among 307 inmates and staff selected using a systematic sampling technique. Informed consent was obtained from the staff and inmates. The respondents were interviewed using a pre-tested interviewer administered structured questionnaire. GeneXpert test was done for respondents with cough of two weeks or more. Data analysis was done using SPSS statistical software version 22. Chi squared test was used for bivariate analysis and level of significance was set at a p-value of less than 0.05. Results were treated with strict confidentiality.Results: The mean age of inmates was 34.96±5.7 years while staff was 38.43±3.5 years. Majority had secondary education. GeneXpert test result revealed 2.0% prevalence of PTB among suspected inmates, 1.1% among all inmates and 2.8% among staff. Prevalence of TB was associated with age group of both inmates and staff and duration of stay of inmates only.Conclusion: This study found moderate prevalence of tuberculosis among inmates and prison staff in Abakaliki prison. Although this prevalenceis moderate, it is imperative that periodic screening of old inmates and newly introduced ones be practiced so as to minimize the burden of tuberculosis among prisoners. Implementation of current national or international cell occupancy recommendations would reduce TB transmission by 50% and 94% respectively especially now that there is increase in the incidence of MDR-TB.Keywords: prevalence, PTB, prison, inmates and staf

A prospective, multi-site, cohort study to estimate incidence of infection and disease due to Lassa fever virus in West African countries (the Enable Lassa research programme)–Study protocol

Background Lassa fever (LF), a haemorrhagic illness caused by the Lassa fever virus (LASV), is endemic in West Africa and causes 5000 fatalities every year. The true prevalence and incidence rates of LF are unknown as infections are often asymptomatic, clinical presentations are varied, and surveillance systems are not robust. The aim of the Enable Lassa research programme is to estimate the incidences of LASV infection and LF disease in five West African countries. The core protocol described here harmonises key study components, such as eligibility criteria, case definitions, outcome measures, and laboratory tests, which will maximise the comparability of data for between-country analyses. Method We are conducting a prospective cohort study in Benin, Guinea, Liberia, Nigeria (three sites), and Sierra Leone from 2020 to 2023, with 24 months of follow-up. Each site will assess the incidence of LASV infection, LF disease, or both. When both incidences are assessed the LASV cohort (nmin = 1000 per site) will be drawn from the LF cohort (nmin = 5000 per site). During recruitment participants will complete questionnaires on household composition, socioeconomic status, demographic characteristics, and LF history, and blood samples will be collected to determine IgG LASV serostatus. LF disease cohort participants will be contacted biweekly to identify acute febrile cases, from whom blood samples will be drawn to test for active LASV infection using RT-PCR. Symptom and treatment data will be abstracted from medical records of LF cases. LF survivors will be followed up after four months to assess sequelae, specifically sensorineural hearing loss. LASV infection cohort participants will be asked for a blood sample every six months to assess LASV serostatus (IgG and IgM). Discussion Data on LASV infection and LF disease incidence in West Africa from this research programme will determine the feasibility of future Phase IIb or III clinical trials for LF vaccine candidates

Knowledge, attitude and practice of infection prevention and control among healthcare workers: one year after an outbreak of nosocomial Lassa fever in a tertiary hospital in southeast NigeriaKnowledge, attitude and practice of infection prevention and con

Background: With the rise in cases of Lassa fever in recent times in West Africa, the healthcare setting continues to pose significant risk especially among healthcare workers (HCWs) for diseases like Lassa fever that are transmitted via contact with blood and other body fluids. We therefore assessed the knowledge, attitude and practice (KAP) of infection prevention and control (IPC) one year after an outbreak of nosocomial transmission of Lassa fever in the study hospital. Methodology: A cross-sectional study of HCWs was conducted in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, a tertiary hospital designated for Lassa fever treatment in southeast Nigeria. A total of 631 HCWs selected by systematic random sampling were surveyed using self-administered questionnaire to determine the KAP of IPC. Data analysis was done with EPI INFO version 7.2 and Microsoft Excel 2016, and Chi square statistic was used to examine relationship between variables at 5% level of significance. Results: Only 287 (51.1%) of the 562 respondent HCWs had good knowledge of IPC, 442 (78.6%) had good attitude towards IPC, and 268 (47.7%) had good practice of IPC. Socio-demographic predictors of IPC knowledge included being a medical laboratory scientist (AOR=0.5; 95% CI=0.29-0.83; p=0.009), tertiary education level (AOR=7.0; 95% CI=1.11-44.60; p=0.038), and work experience of ≥ 7 years (AOR=2.3; 95% CI=1.47-3.57; p<0.001). Male gender (AOR=1.9; 95% CI=1.06-3.42; p=0.031), nurse professional (AOR=6.5; 95% CI=2.67-15.81; p<0.001) and work experience of ≥ 7 years (AOR=2.5; 95% CI=1.37-4.54; p=0.003) were predictors of good attitude towards IPC. Also, nurse professional (AOR=3.1; 95% CI=1.79-5.20; p<0.001) and married status (AOR=1.6; 95% CI=1.05-2.55; p=0.028) were predictors of good practice of IPC among the respondents. Conclusions: The study demonstrated that knowledge and practice of IPC was low in the study location despite the interventions that had been instituted to improve the IPC framework. Therefore, there is need to adapt approaches that will influence behavior change towards IPC in the course of the in-service trainings being conducted in the hospital. French title: Connaissances, attitude et pratique de la prévention et du contrôle des infections chez les agents de santé: un an après une épidémie de fièvre de Lassa nosocomiale dans un hôpital tertiaire du sud-est du Nigeria Contexte: Avec l'augmentation récente des cas de fièvre de Lassa en Afrique de l'Ouest, le milieu de la santé continue de présenter un risque important, en particulier chez les travailleurs de la santé (TS) pour des maladies comme la fièvre de Lassa qui se transmettent par contact avec le sang et d'autres fluides corporels. Nous avons donc évalué les connaissances, l'attitude et la pratique (CAP) de la prévention et du contrôle des infections (PCI) un an après une épidémie de transmission nosocomiale de la fièvre de Lassa dans l'hôpital de l'étude. Méthodologie: Une étude transversale des travailleurs de la santé a été menée à l'hôpital universitaire fédéral Alex Ekwueme, à Abakaliki, dans l'État d'Ebonyi, un hôpital tertiaire désigné pour le traitement de la fièvre de Lassa dans le sud-est du Nigéria. Un total de 631 TS sélectionnés par échantillonnage aléatoire systématique ont été interrogés à l'aide d'un questionnaire auto-administré pour déterminer le CAP de la CIP. L'analyse des données a été effectuée avec EPI INFO version 7.2 et Microsoft Excel 2016, et la statistique du Chi carré a été utilisée pour examiner la relation entre les variables à un niveau de signification de 5 %. Résultats: Seuls 287 (51,1%) des 562 TS interrogés avaient une bonne connaissance de la CIP, 442 (78,6%) avaient une bonne attitude envers la CIP et 268 (47,7%) avaient une bonne pratique de la CIP. Les prédicteurs sociodémographiques des connaissances en CIP comprenaient le fait d'être un scientifique de laboratoire médical (AOR=0,5; IC à 95%=0,29-0,83; p=0,009), le niveau d'études supérieures (AOR=7,0; IC à 95% =1,11-44,60; p=0,038) et une expérience de travail ≥ 7 ans (AOR=2,3; IC à 95%=1,47-3,57; p<0,001). Sexe masculin (AOR=1,9; IC à 95%=1,06-3,42; p=0,031), infirmier professionnel (AOR=6,5; IC à 95%=2,67-15,81; p<0,001) et expérience professionnelle de ≥ 7 ans (AOR=2,5; IC à 95%=1,37-4,54; p=0,003) étaient des prédicteurs d'une bonne attitude envers la CIP. De plus, l'infirmière professionnelle (AOR=3,1; à 95% IC=1,79-5,20; p<0,001) et le statut de personne mariée (AOR=1,6; à 95% IC=1,05-2,55; p=0,028) étaient des prédicteurs de bonne pratique de la CIP parmi les répondants. Conclusions: L'étude a démontré que les connaissances et la pratique de la CIP étaient faibles dans le lieu de l'étude malgré les interventions qui avaient été instituées pour améliorer le cadre de la CIP. Par conséquent, il est nécessaire d'adapter les approches qui influenceront le changement de comportement envers la CIP au cours des formations en cours d'emploi menées à l'hôpital