Outbreak of Fatal Childhood Lead Poisoning Related to Artisanal Gold Mining in Northwestern Nigeria, 2010.

Background: In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria. Objectives: To determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children aged <5 years in need of emergency chelation therapy for lead poisoning. Methods: We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children aged 2-59 months, and soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood-lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality. Results: We surveyed 119 family compounds. One hundred eighteen of 463 (25%) children aged <5 years had died in the last year. We tested 59% (204/345) of children, aged <5 years, and all were lead poisoned (≥10 µg/dL); 97% (198/204) of children had blood-lead levels ≥45 µg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling significant risk factors for death in the previous year from suspected lead poisoning included: the child's age, the mother performing ore-processing activities, community well as primary water source, and the soil-lead concentration in the compound. Conclusion: The high levels of environmental contamination, percentage of children aged <5 years with elevated blood-lead levels (97%, >45 µg/dL), and incidence of convulsions among children prior to death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities

Outbreak of measles in Sokoto State North-Western Nigeria, three months after a supplementary immunization campaign

BackgroundWorldwide, measles infects about 20 million people with about 200,000 deaths annually. On February 12, 2016 an outbreak of measles was reported from Sokoto state, Nigeria.AimsA team of Nigeria Field Epidemiology and Laboratory Training Program (NFELTP) Residents was sent to confirm the existence of the outbreak, describe the socio-demographic characteristics and identify risk factors for the outbreak.MethodsWe defined cases according to the World Health Organization (WHO) criteria. We conducted an unmatched case-control study and descriptive study. We actively searched for cases across local government areas (LGAs) of the state, and administered questionnaires to parents of affected children. We analyzed the data using Epi-Info 7 and Microsoft Excel 2013.ResultsA total of 979 cases were recorded. Median age was 36 months with age range of 3–168 months. Ten deaths were recorded with a Case Fatality Rate (CFR) of 1.02 per cent. About 76.51 per cent of cases were under-five years of age. The outbreak spanned over a period of 10 weeks. Twenty-two out of 23 LGAs were affected. Eighty-nine cases (9.1 per cent) had their blood sample taken for laboratory confirmation, where 21 (23.6 per cent) tested positive for measles.A total of 238 respondents were interviewed; 128 cases and 110 controls. Mothers’ education (OR: 2.9, 95 per cent CI: 1.4–5.9), immunization status of children (OR: 2.0, 95 per cent CI: 1.1–3.4), and fathers’ occupation (OR: 0.2, 95 per cent CI: 0.1–0.5), are the factors that affect measles infection among children in the state.ConclusionOur investigation confirmed a measles outbreak in Sokoto state. Though with a low CFR, the majority of deaths occur in children are factors that adversely affect development of measles in Sokoto state

COVID-19 vaccination intention among internally displaced persons in complex humanitarian emergency context, Northeast Nigeria

Internally displaced persons (IDPs) are at high risk for COVID-19 transmission because of congested and unsanitary living conditions. COVID-19 vaccination is essential to build population immunity and prevent severe disease among this population. We determined the prevalence and factors associated with intention to accept COVID-19 vaccine among IDPs in Northeast Nigeria. This cross-sectional study, conducted during July–December 2022, included 1,537 unvaccinated IDPs from 18 IDPs camps. We performed a complex sample survey analysis and described participants’ characteristics and vaccination intention with weighted descriptive statistics. We fitted weighted logistic regression models and computed adjusted odds ratios with 95% confidence intervals to identify factors associated with intention to accept COVID-19 vaccine. Of 1,537 IDPs, 55.4% were 18–39 years old, 82.6% were females, and 88.6% had no formal education. Among them, 63.5% (95% CI: 59.0–68.1) expressed intention to accept COVID-19 vaccine. Among the IDPs who intended to reject vaccine, 42.8% provided no reason, 35.3% had COVID-19 misconceptions, 9.5% reported vaccine safety concerns, and 7.4% felt no need. IDPs who perceived COVID-19 as severe (Adjusted Odds Ratio (AOR) = 2.31, [95% CI: 1.35–3.96]), perceived COVID-19 vaccine as effective (AOR = 4.28, [95% CI: 2.46–7.44]) and resided in official camps (AOR = 3.29, [95% CI: 1.94–5.56]) were more likely to accept COVID-19 vaccine. However, IDPs who resided 2 kilometers or farther from the nearest health facility (AOR = 0.34, [95% CI: 0.20–0.58]) were less likely to accept vaccine. Intention to accept COVID-19 vaccine among the IDPs was suboptimal. To improve vaccination acceptance among this population, health education and risk communication should be intensified to counter misinformation, strengthen vaccine confidence, and shape perception of COVID-19 severity, focusing on IDPs in unofficial camps. Appropriate interventions to deliver vaccines to remote households should be ramped up.Peer reviewe

Carbapenem resistance expressed by Gram-negative bacilli isolated from a cohort of Libyan patients

Background and objectives: Carbapenem-resistant Enterobacteriaceae (CRE) and other Gram-negative bacteria are among the most common pathogens responsible for both community and hospital acquired infection. The global spread of cephalosporinases in Enterobacteriaceae has led to the increased use of carbapenems resulting in the emergence and rapid spread of CRE. This has become an alarming public health concern, yet the condition in Libya remains unclear. The aim of this study was to obtain a better understanding of CRE strains prevalent in Libyan patients by investigating their phenotypic characteristics and antibiograms. Methods: Gram-negative bacterial species were collected from Misrata Central Hospital, Misrata Cancer Centre and Privet Pathology Laboratories. Clinical samples and swabs were obtained from hospitalised and non-hospitalised patients and from mechanical ventilation and suction machines. Patients who had received antibiotic therapy for at least three days prior to the study were excluded. The identification and characterization of the isolated species were achieved using the growth characteristics on MacConkey and blood agar, spot tests and API 20E or API 20NE biochemical testing systems. Screening for carbapenem resistance was performed using the disk diffusion method with carbapenem 10 μg and cephalosporin 30 μg disks and minimum inhibitory concentrations (MIC) determined using the Sensititre Gram-negative Xtra plate format (GNX2F). All strains demonstrating resistance or reduced susceptibility to one of the four carbapenems were subjected to carbapenememase activity detection using the RAPIDEC CARBA NP test, Modified Hodge test and carbapenem inactivation methods. Results: A total of one hundred and forty isolates representing fourteen bacterial species were isolated from 140 non-duplicated specimens. Clinical specimens included urine samples (96/140, 68.57%), sputum (15/140, 10.71%), surgical wound swabs (18/140, 12.85%), foot swabs from diabetes mellitus (DM) patients (6/140, 4.29%), ear swabs (3/140, 2.14%) and wound swabs (2/140, 1.43%). Thirty-four (24.29%) isolates demonstrated resistance to at least one of the four carbapenems with Klebsiella pneumoniae representing 73.53% (25 isolates) of all carbapenem resistant species, followed by 8.82% for Pseudomonas aeruginosa (3 isolates), 5.88% for both Proteus mirabilis (2 isolates) and Escherichia coli (2 isolates) and 2.94% for both Citrobacter koseri (1 isolate) and Rahnella aquatilis (1 isolate). The other isolates were either susceptible or cephalosporinase producers. Conclusion: This study has revealed the high rate of carbapenem resistance amongst Libyan patients and emphasizes the crucial need for accurate screening, identification and susceptibility testing to prevent further spread of nosocomial and community acquired resistance. This may be achieved through the establishment of antibiotic stewardship programmes along with firm infection control practices.National Research Foundation of South Africa; Libyan GovernmentWeb of Scienc

Secondary Data Analysis of HIV/AIDS Control Programme Data, Enugu State, (2010-2013)

As of 2012, 3,400 million people are living with HIV in Nigeria. The estimated new HIV infections is 260,000 and estimated AIDS death is 240,000.The number of adults on ART was 459,465 and the ART coverage according to WHO guideline was 36%.Nigeria has developed the president's Comprehensive Response Plan that assesses needs and gaps, identifies focus area and set targets for PMCT, ART and HCT services.This study therefore aims to determine the number of individual that were counselled and tested for HIV and those currently on ART drugs in Enugu State, Nigeria

Evaluation of the Malaria Surveillance System in Kaduna State, Nigeria 2016

ObjectiveTo describe the process of operation of the system and assessits key attributes, to determine the effectiveness and efficiency ofthe surveillance system and make appropriate recommendations tostakeholders for its improvement.IntroductionMalaria is a parasitic disease caused by Plasmodium falciparum.About 3.2 billion people worldwide are at risk of malaria.1Childrenand pregnant women are particularly vulnerable to the disease. Sub-Saharan Africa carries a high share of the global malaria burden.2Effective malaria surveillance system is essential in the control andelimination of malaria. Worldwide, there were an estimated 198million cases of malaria in 2013 and 584,000 deaths.1,3,4MethodsThis study was conducted using the “CDC’s Updated Guidelinesfor Evaluating Public Health Surveillance System, 2001”. Keystakeholders and Malaria Focal Persons were interviewed. IntegratedDisease Surveillance and Response case summary data from Januaryto December 2014 was reviewed. Data analysis was done usingMicrosoft Excel 2016 and Epi-info 7.ResultsThe system provides information on malaria trends, morbidityand mortality. Case definitions are well understood by participants.All Malaria focal persons (MFPs) were willing to continue usingthe system. Standardized data collection tools are available in 91%of Health Facilities (HF). The system was rated flexible by 91%of MFPs. The system was however not representative because datawere essentially from public health facilities only. The system hasan average timeliness of 37.7% and completeness of 59.4%, bothparameters were below the State’s 80% target. About 91% MFPs hadrefresher training, while 78% MFPs received supportive supervision.Main challenges identified were lack of commodities in all HFs, andinadequate mobile facilities in 70% of HFs.ConclusionsThe Kaduna state Malaria surveillance system is meeting itsobjectives. However, challenges are observed in its timeliness,representativeness, and data quality. Efforts should be made tointegrate tertiary and private health facilities into the system. MFPsneed more training on malaria reporting to improve timeliness anddata quality. There is the need to improve on the supply of malariatreatment commodities to all health facilities within Kaduna state