Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria.Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted.Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research.Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis.Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities.Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults. 

Qualitative Analysis of Coping Strategies Among Older Persons During COVID-19 Lockdown in Nigeria: Considerations for Community Health Promotion

Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria. Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted. Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research. Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis. Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities. Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults.

The COVID-19 pandemic has placed tremendous burdens on healthcare workers (HCWs), accounting for over 1.4 million HCW infections and 10% of global fatalities. HCWs faced elevated infection risk, psychological distress, long working hours, fatigue, stigma, and violence. While vaccines are pivotal in reducing severe illness, HCW vaccine hesitancy, given their role as advocates, jeopardizes vaccination coverage global goals and healthcare systems. Addressing this vaccine uptake is imperative through education, transparent communication, and support to safeguard HCWs’ safety and pandemic containment. This study assessed COVID-19 vaccination uptake among frontline HCWs in Kaduna State, Nigeria, and its impact on morbidity and mortality. Utilizing a descriptive cross-sectional approach, we analyzed secondary data from the Surveillance Outbreak Response Management and Analysis System (SORMAS). The study encompassed HCWs in Kaduna State, excluding pregnant and lactating individuals, following national guidelines. Among 8095 HCWs tested for COVID-19, most were aged 31-40 years (35%), female (60.2%), and urban residents (70.3%). COVID-19 vaccination uptake was low at 17.4%, with 82.6% unvaccinated. COVID-19 infection was significantly associated with vaccination (p = 0.039). Although unvaccinated participants exhibited a higher mortality rate (60%) than vaccinated ones (40%), this difference was not statistically significant (p = 0.209). In conclusion, this study unveiled insufficient vaccination uptake among HCWs, potentially impeding pandemic response. While vaccination seemed to positively impact disease outcomes, it didn’t significantly affect the infection risk. Addressing HCW vaccine hesitancy remains critical for achieving immunization goals and ensuring healthcare system safety. Keywords: Covid-19, Vaccines, Vaccination uptake, Healthcare workers (HCW), Infection. 

pdf/covid-19-vaccination-uptake-and-its-effect-on-morbidity-and-5cdud3051y.pdf

COVID-19 Vaccination Uptake and Its Effect on Morbidity and Mortality among Frontline Healthcare Workers in Kaduna State, Nigeria

Background: The predictors of mortality among patients presenting with severe to critical disease in Nigeria are presently unknown. Aim: The aim of this study was to identify the predictors of mortality among patients with COVID-19 presenting for admission in a tertiary referral hospital in Lagos, Nigeria. Patients and Methods: The study was a retrospective study. Patients' sociodemographics, clinical characteristics, comorbidities, complications, treatment outcomes, and hospital duration were documented. Pearson's Chi-square, Fischer's Exact test, or Student's t-test were used to assess the relationship between the variables and mortality. To compare the survival experience across medical comorbidities, Kaplan Meir plots and life tables were used. Univariable and multivariable Cox-proportional hazard analyses were conducted. Results: A total of 734 patients were recruited. Participants' age ranged from five months to 92 years, with a mean ± SD of 47.4 ± 17.2 years, and a male preponderance (58.5% vs. 41.5%). The mortality rate was 9.07 per thousand person-days. About 73.9% (n = 51/69) of the deceased had one or more co-morbidities, compared to 41.6% (252/606) of those discharged. Patients who were older than 50 years, with diabetes mellitus, hypertension, chronic renal illness, and cancer had a statistically significant relationship with mortality. Conclusion: These findings call for a more comprehensive approach to the control of non-communicable diseases, the allocation of sufficient resources for ICU care during outbreaks, an improvement in the quality of health care available to Nigerians, and further research into the relationship between obesity and COVID-19 in Nigerians.

Clinical predictors of Covid-19 mortality in a tertiary hospital in Lagos, Nigeria: A retrospective cohort study

This paper investigates the spread of COVID-19 pandemic in Katsina state from 23rd June to 27th November, 2021, using graphical tools to visually analyse infection over time and time-dependent reproduction number to quantify the transmissibility of the disease. Study data consist of diagnostic results of reverse transcriptase real-time quantitative polymerase chain reaction assays (RT-PCR) on nine hundred and eighty-nine nasal swab samples from suspected COVID-19 cases, collected from public and private health facilities across Local government areas of the State and analysed by the Molecular Laboratory of the Federal Medical Centre Katsina, recording a total of 137 positive cases. Our investigation revealed that, over the study period, COVID-19 transmission reaches its peak on 17th October 2021 (Epidemic Week 41), with a mean Reproduction number (Rt) of 3.22 and a standard deviation of 0.5976 (95% CI: 2.6193 - 3.8145), culminating in 19 new infections on Wednesday the 27th (Epidemic Week 43). The combined age groups 21-30 and 31-40 constituted the most affected cases with 29 (21.17%) and 19 (13.87%) positive cases, respectively. This was closely followed by age group 51-60 with 19 (13.87%) positive cases. On gender basis, 70 (51%) females tested positive compared to 67 (49%) males. We therefore conclude that for the third wave of COVID-19 pandemic in Katsina State, disease transmission reaches its peak in Epidemic Week 41 in October, then rapidly diminishes to Rt values of less than one, indicating that no new infections were expected by the end of November, with female gender and age groups in the range 21 to 40 years being most infected. We recommend that mitigation strategies that take into consideration features inherent in female gender and more pronounced in young (21 to 40 years) and middle-aged (51-60 years) adults should be adopted in case of future waves. 

An Estimate of Time-Dependent Transmission of COVID-19 Pandemic in Katsina State from June to November 2021

COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98–57∙73)] than in the second wave [19∙19 (17∙60–20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35–2∙02) and second wave 1∙52 (1∙11–2∙06)], being symptomatic [aIRR 3∙17 (2∙59–3∙89) and 3∙04 (2∙20–4∙21)], and being hospitalised [aIRR 4∙19 (3∙26–5∙39) and 7∙84 (4∙90–12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country’s surveillance system during the study.

/pdf/covid-19-mortality-rate-and-its-associated-factors-during-14q1xbrd.pdf

COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria

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COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria