Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January–March 2012)

SummaryObjectivesDespite the epidemic nature of Lassa fever (LF), details of outbreaks and response strategies have not been well documented in resource-poor settings. We describe the course of a LF outbreak in Ebonyi State, Nigeria, during January to March 2012.MethodsWe analyzed clinical, epidemiological, and laboratory data from surveillance records and hospital statistics during the outbreak. Fisher's exact tests were used to compare proportions and t-tests to compare differences in means.ResultsThe outbreak response consisted of effective coordination, laboratory testing, active surveillance, community mobilization, contact and suspected case evaluation, and case management. Twenty LF cases (10 confirmed and 10 suspected) were recorded during the outbreak. Nosocomial transmission to six health workers occurred through the index case. Only 1/110 contacts had an asymptomatic infection. Overall, there was high case fatality rate among all cases (6/20; 30%). Patients who received ribavirin were less likely to die than those who did not (p=0.003). The mean delay to presentation for patients who died was 11±3.5 days, while for those who survived was 6±2.6 days (p<0.001).ConclusionsThe response strategies contained the epidemic. Challenges to control efforts included poor local laboratory capacity, inadequate/poor quality of protective materials, fear among health workers, and inadequate emergency preparedness

Specialty Choice of Residents in the University of Nigeria teaching Hospital, Enugu 1989 - 1999.

Objective: To analyze the specialty choice of residents in the University of Nigeria Teaching Hospital Enugu from 1989 - 1999, and to assess the ratio of community physicians to the clinical specialties of residents. Method: The record of admissions into the residency training programme in the University of Nigeria Teaching Hospital Enugu was analyzed. Simple percentages and proportions of residents in the different specialties were computed and compared with one another and with community medicine. Result: The ratio of community medicine to the other clinical departments of Surgery, Internal medicine, Obstetrics & Gynaecology and Paediatrics is 1:7. When compared individually, each of these four were at a ratio of about 2:1 to community medicine. Conclusion: This study and other studies from other parts of the nation show that Nigeria is producing more core clinicians than community health physicians. As the nation's health policy is anchored on Primary Health Care, Community Health Physicians may be better suited to implement the nation's health policy. It would therefore be beneficial to increase the number of community Health Physicians produced by training institutions in Nigeria. Key Words: Residency training; Health manpower, Primary Health Care; Community physicians Orient Journal of Medicine Vol.16(3&4) 2004: 7-1

Use of Face Mask as a COVID-19 Preventive Measure Among Household Heads in Enugu Nigeria

Background: Corona virus disease 2019 (COVID-19) is a highly infectious disease that can be transmitted from person to person through the respiratory droplets from an infected person and contacts. It is scientifically proven that covering mouth and nose with face mask prevents the spread of respiratory droplets produced by coughing and sneezing from an infected individual.Objective: To evaluate the ownership and use of face mask as preventive practices against COVID-19 as well as factors affecting its use among adults in Enugu.Methodology: We conducted a community-based cross-sectional study among 320 heads of households selected by multi-stage sampling technique in Enugu metropolis, Enugu state, Nigeria. We collected information on ownership and use of face mask from 4th to 15th May 2020. Data entry and analysis were done using IBM Statistical Package for Social Sciences statistical software version 25. The proportion of household heads who own and used face mask was estimated and the factors associated with its use was explored using Chi square test at 5% level of significance.Results: One hundred and six (33.1%) heads of households have and use face mask; 272 (85.0%) were planning to own a face mask and 309 (96.6%) were aware of government directive to use face mask. Overall, 314 (98.1%) of the heads of households were willing to wear face mask if it is available. Ownership and use of face mask was more among females (38.8%) compared to males (28.0%, p =0.04).Conclusion: Majority of respondents did not own or use a face mask but were willing to use one if made available. We therefore recommend that more efforts should be geared towards educating and sensitizing the public, particularly household heads, since they can play a role in ensuring that other family members adhere to the COVID-19 preventive measures