Derangements of Liver Enzymes in a Study of 201 COVID‑19 Patients in Abuja, Nigeria’s Federal Capital Territory

Background: Several studies reveal abnormalities in liver function tests of COVID-19 patients. However, there are little data on African patients. Aim: This study aimed to evaluate liver function tests (LFT) in severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infected patients admitted in Asokoro COVID‑19 Isolation and Treatment Centre in Abuja, Nigeria. Patients, Materials and Methods: This was a retrospective study of 201 laboratory‑confirmed SARS‑CoV‑2‑infected patients hospitalized in Asokoro District Hospital COVID‑19 Isolation and Treatment Centre between April 10 and July 31, 2020. Demographic, clinical, and laboratory data were obtained, and the outcome measure was LFT abnormalities at presentation. Statistical analysis was done using IBM SPSS Version 24, with P < 0.05 considered statistically significant. Results: Patient median age was 39.3 years(IQR: 26–52); 65.7% were males and 33.8% were health workers. Approximately 49.2% of patients were overweight or obese. Hypertension (22.9%) and diabetes mellitus(7.5%) were the most common comorbidities and only 1% had a known history of liver disease. Abnormal LFTs were observed in 53% of patients(n = 106), most frequently elevated direct bilirubin (78.3%) and alanine aminotransferase (38.7%). Comorbidities were not found significantly associated with LFT abnormalities. Females (odds ratio [OR] = 0.367 P = 0.004 confidence interval [CI] 0.186–0.724) and patients aged 20–29 years (OR = 0.067 P = 0.043 [CI] 0.005–0.916) were found less likely to have abnormal LFTs. Conclusion: Regardless of clinical status at presentation, about half of SARS‑CoV‑2 patients admitted at the Asokoro Isolation and Treatment Centre in Abuja had abnormal LFT results. It is therefore recommended that LFT is included as a part of baseline investigations during the management of COVID‑19 for improved outcomes

Management of blood transfusion services in low‐resource countries

Background and Objectives Enabling universal access to safe blood components should be a key component of every country's national healthcare strategy. This study aimed to assess the current status of infrastructure and resources of blood transfusion services (BTS) in low- and middle-income countries. Materials and Methods A cross-sectional survey was designed to gather information on blood donations, components, redistribution, testing resources and quality management systems (QMSs). The survey was distributed to the International Society of Blood Transfusion members between October 2021 and November 2021. Results A total of 54 respondents from 20 countries responded to the survey. This included hospital-based BTS/blood centres (46%), national blood centres (11%)and national and regional blood services (11%). Voluntary non-remunerated, replacement and paid donors accounted for 94.2%, 84.6% and 21.1% of donations, respectively. Apheresis donation was available in 59.6% of institutions. National/regional criteria for redistribution of blood components were reported by 75.9% of respondents. Blood components incurred payment charges in 81.5% of respondents' institutions, and payments were borne by patients in 50% of them. Testing methods, such as manual (83%), semi-automated (68%) or fully automated (36.2%), were used either alone or in combination. QMSs were reported in 17 institutions, while accreditation and haemovigilance were reported in 12 and 8 countries, respectively. Conclusion QMS was implemented in most of the countries despite the common use of paid donations and the lack of advanced testing. Efforts to overcome persistent challenges and wider implementation of patient blood management programmes are required

Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria

Introduction: recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. Methods: in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. Results: a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. Conclusion: overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system

Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria.

INTRODUCTION: recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. METHODS: in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. RESULTS: a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. CONCLUSION: overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system

Thirty-five years (1986–2021) of HIV/AIDS in Nigeria: bibliometric and scoping analysis

Background Acquired immunodeficiency syndrome (AIDS) is an acquired defect of the cellular immunity associated with the infection by the human immunodeficiency virus (HIV). The disease has reached pandemic proportion and has been considered a public health concern. This study is aimed at analyzing the trend of HIV/AIDS research in Nigeria. Method We used the PUBMED database to a conduct bibliometric analysis of HIV/AIDS-related research in Nigeria from 1986 to 2021 employing “HIV”, “AIDS”, “acquired immunodeficiency syndrome”, “Human immunodeficiency virus”, and “Nigeria” as search description. The most common bibliometric indicators were applied for the selected publications. Result The number of scientific research articles retrieved for HIV/AIDS-related research in Nigeria was 2796. Original research was the predominant article type. Articles authored by 4 authors consisted majority of the papers. The University of Ibadan was found to be the most productive institution. Institutions in the United States dominated external production with the University of Maryland at the top. The most utilized journal was PLoS ONE. While Iliyasu Z. was the most productive principal author, Crowel TA. was the overall most productive author with the highest collaborative strength. The keyword analysis using overlay visualization showed a gradual shift from disease characteristics to diagnosis, treatment and prevention. Trend in HIV/AIDS research in Nigeria is increasing yet evolving. Four articles were retracted while two had an expression of concern. Conclusion The growth of scientific literature in HIV/AIDS-related research in Nigeria was found to be high and increasing. However, the hotspot analysis still shows more unexplored grey areas in future

Moving the Goal Post: Sustainability and the Global Goals -Which Way Nigeria?

Abstract It has been about a year since the sustainable development goals came into effect, and countries have had to adopt the sustainability agenda. Leaving the millennium development goals and their emphasis behind to chart a new course focusing on integrating and strengthening health systems would require innovative and strategic thinking at the country and global level, in addition to harnessing the potential for multiple inter-sectoral collaborations for success. Despite the adoption of the sustainability agenda post-2015, the achievements of the millennium development goals must still be leveraged and lessons learnt from both its successes and failures for the sustainable development goals to maximize their potential and result in positive global health outcomes. In the context of sub-Saharan Africa, several strengths, weaknesses and opportunities have been highlighted as either stepping stones or possible obstacles to the attainment of the sustainable development goals on the continent in general and Nigeria in particular. The outlook is optimistic but will call upon the galvanizing of partnerships and collaborations in order to build, strengthen and integrate background health systems for people, the planet and for prosperity. This paper is therefore a general reflection which aims at emphasizing Nigeria and Africa's challenges with achieving the millennium development goals and delineating the prospects which exist for achieving the sustainable development goals

Accidental kerosene oil ingestion in under-five age children in Nigeria – The need for vigilance in primary care settings in low- and middle-income countries (LMICs)

Four children aged between 15 months and two years presented in several different out-patient emergency departments with a history of recent ingestion of kerosene. Majority of the patients lived in crowded domestic settings, and they all presented with varying degrees of respiratory distress, different presentations of respiratory clinical symptoms and signs, after being subjected to various potentially dangerous home remedies to counter the effect of the kerosene. Majority of the children presented late, but all recovered following appropriate management. The presented cases demonstrate the vital importance of prompt emergency management in primary care settings, family counseling on childcare and domestic safety, and community enlightenment on reducing the complications and frequency of childhood poisoning in increasingly overcrowded and less affluent communities

Production and Quality Assurance of Human Polyclonal Hyperimmune Immunoglobulins Against SARS-CoV-2

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the potential therapeutic value of early passive polyclonal immunotherapy using high-titer convalescent plasma (CCP). Human polyclonal hyperimmune immunoglobulin (HIG) has several advantages over CCP. Unlike CCP, HIG can provide standardized and controlled antibody content. It is also subjected to robust pathogen reduction rendering it virally safe and is purified by technologies demonstrated to preserve immunoglobulin neutralization capacity and Fc fragment integrity. This document provides an overview of current practices and guidance for the collection and testing of plasma rich in antibodies against Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) and its industrial fractionation for the manufacture of quality-assured and safe HIG. Considerations are also given to the production of HIG preparations in low- and middle-income countries

Lessons learned in the collection of convalescent plasma during the COVID-19 pandemic

Background: The lack of definitive treatment or preventative options for COVID-19 led many clinicians early on to consider convalescent plasma (CCP) as potentially therapeutic. Regulators, blood centres and hospitals worldwide worked quickly to get CCP to the bedside. Although response was admirable, several areas have been identified to help improve future pandemic management. Materials and methods: A multidisciplinary, multinational subgroup from the ISBT Working Group on COVID-19 was tasked with drafting a manuscript that describes the lessons learned pertaining to procurement and administration of CCP, derived from a comprehensive questionnaire within the subgroup. Results: While each country’s responses and preparedness for the pandemic varied, there were shared challenges, spanning supply chain disruptions, staffing, impact of social distancing on the collection of regular blood and CCP products, and the availability of screening and confirmatory SARS-CoV-2 testing for donors and patients. The lack of a general framework to organize data gathering across clinical trials and the desire to provide a potentially life-saving therapeutic through compassionate use hampered the collection of much-needed safety and outcome data worldwide. Communication across all stakeholders was identified as being central to reducing confusion. Conclusion: The need for flexibility and adaptability remains paramount when dealing with a pandemic. As the world approaches the first anniversary of the COVID-19 pandemic with rising rates worldwide and over 115 million cases and 2·55 million deaths, respectively, it is important to reflect on how to better prepare for future pandemics as we continue to combat the current one

Early and out-of-hospital use of COVID-19 convalescent plasma: An international assessment of utilization and feasibility

Background and Objectives The use of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) in the treatment of patients with severe acute respiratory syndrome-2 infection has been controversial. Early administration of CCP before hospital admission offers a potential advantage. This manuscript summarizes current trials of early use of CCP and explores the feasibility of this approach in different countries. Materials and Methods A questionnaire was distributed to the International Society of Blood Transfusion (ISBT) CCP working group. We recorded respondents' input on existing trials on early/outpatient CCP and out-of-hospital (OOH)/home transfusion (HT) practices in their countries and feedback on challenges in initiating home CCP infusion programmes. In addition, details of existing trials registered on clinicaltrials.gov were summarized. Results A total of 31 country representatives participated. Early/OOH CCP transfusion studies were reported in the United States, the Netherlands, Spain and Brazil. There were a total of six published and five ongoing trials on the prophylactic and therapeutic early use of CCP. HT was practised in Australia, the UK, Belgium, France, Japan, Nigeria, the Netherlands, Spain, Italy, Norway, the United States and some provinces in Canada. Thirty-four representatives indicated a lack of OOH CCP or HT in their institutions and countries. Barriers to implementation of OOH/HT included existing legislation, lack of policies pertaining to outpatient transfusion, and associated logistical challenges, including lack of staffing and resources. Conclusion Early administration of CCP remains a potential option in COVID-19 management in countries with existing OOH/HT programmes. Legislation and regulatory bodies should consider OOH/HT practice for transfusion in future pandemics