A comprehensive review of barriers to a functional Zakat system in Nigeria: what needs to be done?

Purpose: Muslims in Nigeria, like in many Muslim-majority countries, are striving to have a functional Zakat system in search of solutions to the perennial problem of poverty and its damning consequences. Nevertheless, there are still unsettled concerns arising from the current and widespread implementation of dissimilar (diverse) approaches to the Zakat system in various parts of the country. The purpose of this paper is to review comprehensively what are the hindrances of a vibrant Zakat system and how far the identified impediments may affect the system in the Nigerian context.Design/methodology/approach:The methodology adopted is the review of extant relevant literature in the field of scholarly publications.Findings: The findings of this study revealed that the fragmented implementation of the Zakat system within the context of the Nigerian democratic system of government lead to the weak governance with respect to law, administration and management; lack of a generally accepted fatwa from the Muslims scholars (Ulamas); absence of Zakat accounting standard; and low compliance behavior are the major barriers that require the attention of government and other stakeholders such as the traditional leaders, the accounting regulatory bodies, the Ulamas, as well as the economic and accounting researchers.Practical implications: It was recommended that the stakeholders should make concerted efforts toward ensuring success of the Zakat system for attaining salvation in the hereafter and for social security, as well as economic prosperity. Originality/value: The paper is the first paper that comprehensively reviews previous literature in the Zakat environment on factors that become barriers to implement a comprehensive Zakat system in Nigeria

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable