353 results on '"Nguku, P."'
Search Results
2. Designing Trauma-Informed Online Support and Mentorship for African Applied Science PhD Scholars
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Grossman, Hannah M., Wanjiku, Wangari, and Nguku, Everlyn
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- 2024
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3. Knowledge, risk perception and uptake of COVID-19 vaccination among internally displaced persons in complex humanitarian emergency setting, Northeast Nigeria
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Gidado, Saheed, Musa, Melton, Ba’aba, Ahmed Ibrahim, Francis, Mark Rohit, Okeke, Lilian Akudo, Bukar, Fatima Lawan, Nguku, Patrick M., Hadejia, Idris Suleman, Hassan, Isa Ali, Bande, Ibrahim Muhammad, Onuoha, Martins, Usman, Rabi, Ugbenyo, Gideon, Godwin, Ntadom, Ilori, Elsie, Abulfathi, Aisha Aliyu, Mshelia, Lawi Auta, Mohammed, Abede Momoh, Abdullahi, Muhammad Maijawa, Bammami, Mohammed Isa, Nuorti, Pekka, and Atkins, Salla
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- 2024
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4. Exploring the landscape of routine immunization in Nigeria: A scoping review of barriers and facilitators
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Yahaya Mohammed, Heidi W. Reynolds, Hyelshilni Waziri, Adam Attahiru, Ahmed Olowo-okere, Moreen Kamateeka, Ndadilnasiya Endie Waziri, Aminu Magashi Garba, Gustavo C. Corrêa, Rufai Garba, Nancy Vollmer, and Patrick Nguku
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Immunization ,Barriers ,Facilitators ,Scoping review ,Nigeria ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Despite global efforts to improve vaccination coverage, the number of zero-dose and under-immunized children has increased in Africa, particularly in Nigeria, which has over 2.1 million unvaccinated (zero dose) children, the highest in the continent. This scoping review systematically maps and summarizes existing literature on the barriers and facilitators of immunization in Nigeria, focusing on regional inequalities. Methods: A comprehensive search of electronic databases was conducted, encompassing all data from their inception to October 2023, to identify articles on the determinants of routine immunization uptake in Nigeria. Eligible studies were evaluated using predefined criteria, and the data were analyzed and visualized. Results: The results revealed distinct regional variations in factors influencing immunization practices across Nigeria’s six geopolitical zones. Identified barriers include logistical issues, socio-economic factors, cultural influences, and systemic healthcare deficiencies. Key facilitators across multiple zones are health literacy, maternal education, and community leader influence. However, unique regional differences were also identified. In the North-East, significant factors included peer influence, robust reminder systems, provision of additional security, and financial incentives for health facilities. In the North-West, perceived vaccine benefits, fear of non-immunization consequences, urban residence, health literacy, and antenatal care visits were reported as crucial. Perceived benefits of vaccines and trust in healthcare providers were identified as predominant factors in the North-Central zone In the South-East, maternal autonomy, health literacy, and fear of non-immunization consequences were important. In the South-South, peer influence and reminder systems like WhatsApp and SMS were notable, alongside higher maternal education levels. The South-West highlighted maternal autonomy, peer influence, health card usage, high maternal education, and supportive government policies as critical factors. Conclusion: Our findings underscore the need for region-specific interventions that address these unique barriers to improve immunization coverage across Nigeria. Tailored approaches that consider the socio-economic, cultural, and logistical challenges specific to each region are essential to bridge the immunization gap.
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- 2024
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5. Knowledge, risk perception and uptake of COVID-19 vaccination among internally displaced persons in complex humanitarian emergency setting, Northeast Nigeria
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Saheed Gidado, Melton Musa, Ahmed Ibrahim Ba’aba, Mark Rohit Francis, Lilian Akudo Okeke, Fatima Lawan Bukar, Patrick M. Nguku, Idris Suleman Hadejia, Isa Ali Hassan, Ibrahim Muhammad Bande, Martins Onuoha, Rabi Usman, Gideon Ugbenyo, Ntadom Godwin, Elsie Ilori, Aisha Aliyu Abulfathi, Lawi Auta Mshelia, Abede Momoh Mohammed, Muhammad Maijawa Abdullahi, Mohammed Isa Bammami, Pekka Nuorti, and Salla Atkins
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Internally displaced persons ,COVID-19 ,COVID-19 vaccines ,Perception ,Cross-sectional study ,Nigeria ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Owing to crowded and unsanitary conditions, internally displaced persons (IDPs) have an increased risk of COVID-19 infection. Adoption of COVID-19 preventive measures among this population is premised on accurate information, adequate knowledge, and risk perception. We assessed COVID-19 knowledge and risk perception and investigated the association between risk perception and COVID-19 preventive measures, including vaccination among IDPs in Northeast Nigeria. Methods We conducted a cross-sectional study during July–December 2022 and sampled 2,175 IDPs using stratified sampling. We utilized a 12-point assessment tool to evaluate COVID-19 knowledge. Participants who scored ≥ 6 points were considered to have adequate knowledge. We used a 30-item Risk Behavior Diagnosis Scale to assess COVID-19 risk perception and evaluated each item on a 5-point Likert scale. Participants were divided into risk perception categories by the median of Likert scale scores. We performed weighted logistic regression analysis to identify factors associated with risk perception. Pearson’s chi-squared with Rao-Scott adjustment was used to determine the relationship between risk perception and COVID-19 preventive measures. Results Of 2,175 participants, 55.7% were 18–39 years old, 70.9% were females, and 81.7% had no formal education. Among the IDPs, 32.0% (95% CI: 28.8 – 35.0) were considered to have adequate COVID-19 knowledge, and 51.3% (95% CI: 47.8 – 54.8) perceived COVID-19 risk as high. Moreover, 46.3% (95% CI: 42.8 – 50.0) had received one dose of COVID-19 vaccine, and 33.1% (95% CI: 29.8 – 36.0) received two doses. Adequate knowledge (Adjusted Odds Ratio (AOR) = 2.10, [95% CI: 1.46 – 3.03]) and post-primary education (AOR = 3.20, [95% CI: 1.59 – 6.46]) were associated with risk perception. Furthermore, high risk perception was significantly associated with wearing face masks (χ2 = 106.32, p-value
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- 2024
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6. Influence of participatory monitoring and evaluation on decision-making in maternal and newborn health programs in Mombasa County, Kenya
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Oginga, Pauline Adhiambo, Odongo, Alfred Owino, and Nguku, Julius Njathi
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- 2023
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7. Factors associated with health-seeking patterns among internally displaced persons in complex humanitarian emergency, Northeast Nigeria: a cross-sectional study
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Saheed Gidado, Melton Musa, Ahmed Ibrahim Ba’aba, Lilian Akudo Okeke, Patrick M Nguku, Idris Suleman Hadejia, Isa Ali Hassan, Ibrahim Muhammad Bande, Martins Onuoha, Gideon Ugbenyo, Ntadom Godwin, Rabi Usman, Jibrin Idris Manu, Abede Momoh Mohammed, Muhammad Maijawa Abdullahi, Mohammed Isa Bammami, Pekka Nuorti, and Salla Atkins
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Health-seeking ,Internally displaced persons ,Complex humanitarian emergency ,Nigeria ,Cross-sectional study ,Special situations and conditions ,RC952-1245 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Currently, over two million persons are internally displaced because of the complex humanitarian emergency in Nigeria’s northeast region. Due to crowded and unsanitary living conditions, the risk of communicable disease transmission, morbidity, and mortality among this population is high. This study explored patterns and factors associated with health-seeking among internally displaced persons (IDPs) in northeast Nigeria to inform and strengthen disease surveillance and response activities. Methods In a cross-sectional study conducted during June–October 2022, we employed stratified sampling technique to select 2,373 IDPs from 12 IDPs camps. A semi-structured tool was used to collect data on health-seeking patterns, socio-demographics, households, and IDPs camps characteristics. We classified health-seeking patterns into three outcome categories: ‘facility care’ (reference category), ‘non-facility care’ (patent medicine vendors, chemists, traditional healers, religious centers), and ‘home care/no care’. We performed complex survey data analysis and obtained weighted statistical estimates. Univariate analysis was conducted to describe respondents’ characteristics and health-seeking patterns. We fitted weighted multivariable multinomial logistic regression models to identify factors associated with health-seeking patterns. Results Of 2,373 respondents, 71.8% were 18 to 39 years old, 78.1% were females, and 81.0% had no formal education. Among the respondents, 75.7% (95% CI: 72.9–78.6) sought ‘facility care’, 11.1% (95% CI: 9.1–13.1) sought ‘non-facility care’, while 13.2% (95% CI: 10.9–15.4) practiced ‘home care/no care’. Respondents who perceived illness was severe (Adjusted Odds Ratio (AOR) = 0.15, [95% CI: 0.08–0.30]) and resided in officially-recognized camps (AOR = 0.26, [95% CI: 0.17–0.39]) were less likely to seek ‘non-facility care’ compared to ‘facility care’. Similarly, respondents who resided in officially-recognized camps (AOR = 0.58, [95% CI: 0.36–0.92]), and received disease surveillance information (AOR = 0.42, [95% CI: 0.26–0.67) were less likely to practice ‘home care/no care’ rather than seek ‘facility care’. Conclusions This population exhibited heterogeneous patterns of health-seeking at facility and non-facility centers. Perception of illness severity and camps’ status were major factors associated with health-seeking. To enhance surveillance, non-facility care providers should be systematically integrated into the surveillance network while ramping up risk communication to shape perception of illness severity, prioritizing unofficial camps.
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- 2023
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8. Factors associated with health-seeking patterns among internally displaced persons in complex humanitarian emergency, Northeast Nigeria: a cross-sectional study
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Gidado, Saheed, Musa, Melton, Ba’aba, Ahmed Ibrahim, Okeke, Lilian Akudo, Nguku, Patrick M, Hadejia, Idris Suleman, Hassan, Isa Ali, Bande, Ibrahim Muhammad, Onuoha, Martins, Ugbenyo, Gideon, Godwin, Ntadom, Usman, Rabi, Manu, Jibrin Idris, Mohammed, Abede Momoh, Abdullahi, Muhammad Maijawa, Bammami, Mohammed Isa, Nuorti, Pekka, and Atkins, Salla
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- 2023
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9. Cholera outbreak in some communities in North-East Nigeria, 2019: an unmatched case–control study
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Fagbamila, Idowu O., Abdulkarim, Muhammad A., Aworh, Mabel K., Uba, Belinda, Balogun, Muhammad S., Nguku, Patrick, Gandi, Ajibji Y., Abdullahi, Ibrahim, Okolocha, Emmanuel C., Kwaga, Jacob K. P., and Waziri, Ndadilnasiya E.
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- 2023
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10. Malaria Frontline Project: strategic approaches to improve malaria control program leveraging experiences from Kano and Zamfara States, Nigeria, 2016–2019
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Adewole, Adefisoye, Ajumobi, Olufemi, Waziri, Ndadilnasiya, Umar, Amina Abdullahi, Bala, Usaini, Gidado, Saheed, Ugbenyo, Gideon, Simple, Edwin, Igbaver, Isaac, Attahiru, Adam, Michael, Charles A., Uba, Belinda, Nguku, Patrick, Uhomoibhi, Perpetua, Muhammad, Basheer, Ismael, Munira, Cash, Shelby, Williamson, John, McElroy, Peter, Kachur, Stephen Patrick, and Asamoa, Kwame
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- 2023
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11. COVID-19 vaccination intention among internally displaced persons in complex humanitarian emergency context, Northeast Nigeria.
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Saheed Gidado, Melton Musa, Ahmed Ibrahim Ba'aba, Lilian Akudo Okeke, Patrick M Nguku, Isa Ali Hassan, Ibrahim Muhammad Bande, Rabi Usman, Gideon Ugbenyo, Idris Suleman Hadejia, J Pekka Nuorti, and Salla Atkins
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Medicine ,Science - Abstract
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.
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- 2024
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12. Cholera outbreak in some communities in North-East Nigeria, 2019: an unmatched case–control study
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Idowu O. Fagbamila, Muhammad A. Abdulkarim, Mabel K. Aworh, Belinda Uba, Muhammad S. Balogun, Patrick Nguku, Ajibji Y. Gandi, Ibrahim Abdullahi, Emmanuel C. Okolocha, Jacob K. P. Kwaga, and Ndadilnasiya E. Waziri
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Cholera ,Case–control ,Risk factors ,Outbreak ,Nigeria ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Cholera, a diarrheal disease caused by the bacterium Vibrio cholerae, transmitted through fecal contamination of water or food remains an ever-present risk in many countries, especially where water supply, sanitation, food safety, and hygiene are inadequate. A cholera outbreak was reported in Bauchi State, North-eastern Nigeria. We investigated the outbreak to determine the extent and assess risk factors associated with the outbreak. Methods We conducted a descriptive analysis of suspected cholera cases to determine the fatality rate (CFR), attack rate (AR), and trends/patterns of the outbreak. We also conducted a 1:2 unmatched case–control study to assess risk factors amongst 110 confirmed cases and 220 uninfected individuals (controls). We defined a suspected case as any person > 5 years with acute watery diarrhea with/without vomiting; a confirmed case as any suspected case in which there was laboratory isolation of Vibrio cholerae O1 or O139 from the stool while control was any uninfected individual with close contact (same household) with a confirmed case. Children under 5 were not included in the case definition however, samples from this age group were collected where such symptoms had occurred and line-listed separately. Data were collected with an interviewer-administered questionnaire and analyzed using Epi-info and Microsoft excel for frequencies, proportions, bivariate and multivariate analysis at a 95% confidence interval. Results A total of 9725 cases were line-listed with a CFR of 0.3% in the state. Dass LGA had the highest CFR (14.3%) while Bauchi LGA recorded the highest AR of 1,830 cases per 100,000 persons. Factors significantly associated with cholera infection were attending social gatherings (aOR = 2.04, 95% CI = 1.16–3.59) and drinking unsafe water (aOR = 1.74, 95% CI = 1.07–2.83). Conclusion Attending social gatherings and drinking unsafe water were risk factors for cholera infection. Public health actions included chlorination of wells and distribution of water guard (1% chlorine solution) bottles to households and public education on cholera prevention. We recommend the provision of safe drinking water by the government as well as improved sanitary and hygienic conditions for citizens of the state.
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- 2023
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13. Malaria Frontline Project: strategic approaches to improve malaria control program leveraging experiences from Kano and Zamfara States, Nigeria, 2016–2019
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Adefisoye Adewole, Olufemi Ajumobi, Ndadilnasiya Waziri, Amina Abdullahi Umar, Usaini Bala, Saheed Gidado, Gideon Ugbenyo, Edwin Simple, Isaac Igbaver, Adam Attahiru, Charles A. Michael, Belinda Uba, Patrick Nguku, Perpetua Uhomoibhi, Basheer Muhammad, Munira Ismael, Shelby Cash, John Williamson, Peter McElroy, Stephen Patrick Kachur, and Kwame Asamoa
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Malaria Frontline Project ,Healthcare workers ,Capacity building ,Malaria case management ,Kano ,Zamfara ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The Malaria Frontline Project (MFP) supported the National Malaria Elimination Program for effective program implementation in the high malaria-burden states of Kano and Zamfara adapting the National Stop Transmission of Polio (NSTOP) program elimination strategies. Project implementation The MFP was implemented in 34 LGAs in the two states (20 out of 44 in Kano and all 14 in Zamfara). MFP developed training materials and job aids tailored to expected service delivery for primary and district health facilities and strengthened supportive supervision. Pre- and post-implementation assessments of intervention impacts were conducted in both states. Results A total of 158 (Kano:83; Zamfara:75) and 180 (Kano:100; Zamfara:80) healthcare workers (HCWs), were interviewed for pre-and post-implementation assessments, respectively. The proportions of HCWs with correct knowledge on diagnostic criteria were Kano: 97.5% to 92.0% and Zamfara: 94.7% to 98.8%; and knowledge of recommended first line treatment of uncomplicated malaria were Kano: 68.7% to 76.0% and Zamfara: 69.3% to 65.0%. The proportion of HCWs who adhered to national guidelines for malaria diagnosis and treatment increased in both states (Kano: 36.1% to 73.0%; Zamfara: 39.2% to 67.5%) and HCW knowledge to confirm malaria diagnosis slightly decreased in Kano State but increased in Zamfara State (Kano: 97.5% to 92.0%; Zamfara: 94.8% to 98.8%). HCWs knowledge of correct IPTp drug increased in both states (Kano: 81.9% to 94.0%; Zamfara: 85.3% to 97.5%). Conclusion MFP was successfully implemented using tailored training materials, job aids, supportive supervision, and data use. The project strategy can likely be adapted to improve the effectiveness of malaria program implementation in other Nigerian states, and other malaria endemic countries.
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- 2023
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14. Measuring Zero-Dose Children: Reflections on Age Cohort Flexibilities for Targeted Immunization Surveys at the Local Level
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Gustavo C. Corrêa, Md. Jasim Uddin, Tasnuva Wahed, Elizabeth Oliveras, Christopher Morgan, Moses R. Kamya, Patience Kabatangare, Faith Namugaya, Dorothy Leab, Didier Adjakidje, Patrick Nguku, Adam Attahiru, Jenny Sequeira, Nancy Vollmer, and Heidi W. Reynolds
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zero-dose ,equity ,immunization ,targeted surveys ,measurement ,Medicine - Abstract
Zero-dose (ZD) children is a critical objective in global health, and it is at the heart of the Immunization Agenda 2030 (IA2030) strategy. Coverage for the first dose of diphtheria–tetanus–pertussis (DTP1)-containing vaccine is the global operational indicator used to estimate ZD children. When surveys are used, DTP1 coverage estimates usually rely on information reported from caregivers of children aged 12–23 months. It is important to have a global definition of ZD children, but learning and operational needs at a country level may require different ZD measurement approaches. This article summarizes a recent workshop discussion on ZD measurement for targeted surveys at local levels related to flexibilities in age cohorts of inclusion from the ZD learning Hub (ZDLH) initiative—a learning initiative involving 5 consortia of 14 different organizations across 4 countries—Bangladesh, Mali, Nigeria, and Uganda—and a global learning partner. Those considerations may include the need to generate insights on immunization timeliness and on catch-up activities, made particularly relevant in the post-pandemic context; the need to compare results across different age cohort years to better identify systematically missed communities and validate programmatic priorities, and also generate insights on changes under dynamic contexts such as the introduction of a new ZD intervention or for recovering from the impact of health system shocks. Some practical considerations such as the potential need for a larger sample size when including comparisons across multiple cohort years but a potential reduction in the need for household visits to find eligible children, an increase in recall bias when older age groups are included and a reduction in recall bias for the first year of life, and a potential reduction in sample size needs and time needed to detect impact when the first year of life is included. Finally, the inclusion of the first year of life cohort in the survey may be particularly relevant and improve the utility of evidence for decision-making and enable its use in rapid learning cycles, as insights will be generated for the population being currently targeted by the program. For some of those reasons, the ZDLH initiative decided to align on a recommendation to include the age cohort from 18 weeks to 23 months, with enough power to enable disaggregation of key results across the two different cohort years. We argue that flexibilities with the age cohort for inclusion in targeted surveys at the local level may be an important principle to be considered. More research is needed to better understand in which contexts improvements in timeliness of DTP1 in the first year of life will translate to improvements in ZD results in the age cohort of 12–23 months as defined by the global DTP1 indicator.
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- 2024
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15. Contributing to a Healthier Nigeria through Public Health Workforce Capacity Development: Afenet Experience in Nigeria
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Patrick M. Nguku, Mohammed S. Balogun, Simeon Antara, and Waziri E. N
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public health workforce ,capacity development ,nigeria ,afenet ,Science - Abstract
The recent upsurge in the number and magnitude of outbreaks of infectious diseases in Nigeria has been managed effectively and efficiently by the Nigeria Centre for Disease Control (NCDC) in an increasingly epidemiology guided approach led by a skilled workforce within the one health collaborative agenda.1–4 The increasing number of the outbreaks of re-emerging infectious diseases could not have been unconnected to the effect of global warming with its resultant effect in the changing population activities and interaction with nature.5–7 Nigeria could not have effectively contained these emerging public health challenges had she not taken steps in developing her public health infrastructure, the laboratory capabilities and manpower development. Since 2008, the Nigeria Field Epidemiology Laboratory Training Program (NFELTP), a collaborative effort by NCDC, Federal Ministry of Health, Federal Ministry of Agriculture and Rural Development, African Field Epidemiology Network (AFENET) with financial and technical support from the US Centers for Disease Control and Prevention (CDC) has been building epidemiology capacity for disease prevention and control. Field epidemiology, the art and practice of epidemiology in the field, has been adopted as an effective tool and practice in preventing, detecting and controlling emerging public health threats and crisis. Field epidemiology provides the scientific evidence for public health actions.
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- 2022
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16. Pattern and predictors of medication use among adults in southwestern Nigeria: A community‐based cross‐sectional study
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Waheed Adeola Adedeji, Magbagbeola David Dairo, Patrick Mboya Nguku, Akin Oyemakinde, and Fatai Adewale Fehintola
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adults ,community ,determinants ,drug use ,drugs utilization ,medication use ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Abstract Population‐based drug utilization studies are scanty in Nigeria. The aim was to determine the pattern and predictors of medication use among adults in the communities of Southwestern Nigeria. A cross‐sectional study was conducted among adults selected by multi‐stage sampling from Oyo State communities. The questionnaires, adapted from the WHO Students' Drug Use Questionnaire and previous studies, were pretested and interviewer administered. The respondents' socio‐demographic characteristics, the pattern of medication use, prescribers, and sources of drug acquisition were obtained. Binary logistic regression was used to determine the predictor of medications used. Of the 999 respondents, 501 resided in rural communities while 498 dwelled in urban areas. The mean (±SD) age of the respondents was 38 ± 15 years. The median (range)% prevalence of medication use were as follows: lifetime use, 58.2 (17.7–81.0); current use, 31.2 (8.9–65.9); and past use, 20.3 (9.2–28.9). Medications were mainly obtained from patent medicine stores, median (range%), 71 (65–80). The commonly used drugs were paracetamol, 626 (67.6); nonsteroidal anti‐inflammatory drugs, 174 (18.8); artemether/lumefantrine, 422 (68.2); ampicillin/cloxacillin, 220 (48.6); and chlorpheniramine, 59 (39.9). Factors predictive of current medication use, adjusted odd ratio (95% confidence interval) were as follows: antimalarial [male, 0.7 (0.5, 0.9)]; antibacterial [male, 0.6 (0.4–0.9)]; analgesics [married, 1.5 (1.1–2.2); presence of health facilities, 0.5 (0.3–0.7); and shorter distance to health facility, 1.5 (1.1–2.1)]. Antimalarials, antibacterial, and analgesics were commonly used and inappropriately obtained by adults in Southwestern Nigeria. Factors predictive of current medication use were gender, marital status, the presence of health facilities, and distance to health facilities. There is a need for more extensive countrywide medication use studies and enlightenment programs to ensure the appropriate use of medications.
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- 2023
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17. Utility of Multiparametric Magnetic Resonance Imaging as a Predictor of Clinically Significant Prostate Cancer in a Sub-Saharan African Population
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Mariah Kerubo Obino, Edward Ng’ang’a Chege, Sudhir Vinayak, and Samuel Gitau Nguku
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mri prostate ,prostate cancer ,clinically significant prostate cancer ,prostate imaging reporting and data system (pi-rads) ,gleason score ,Surgery ,RD1-811 - Published
- 2022
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18. It's not just about pads! Adolescent reproductive health views in Kenya: A qualitative secondary analysis.
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Sylvia Ayieko, Angela Nguku, and Nancy Kidula
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Public aspects of medicine ,RA1-1270 - Abstract
Many adolescents face barriers to accessing reproductive health care even though quality reproductive health care is a fundamental human right. The objective of this study is to understand the requests of quality reproductive health among high school girls in Kenya. We conducted a secondary analysis of qualitative data from a sub-sample of adolescent girls in Kenya who participated in the What Women Want global campaign and analyzed interview data from key informants involved in the survey. We used pre-existing codes and current literature to design the coding framework and thematic analysis to describe emerging themes. Atlas. ti 8 was used to organize and analyze codes. Over 4,500 high school girls, ages 12 and 19 years, were included in the analysis, with 61.6% from all-girls boarding schools and 13.8% from mixed-day schools. Data from nine key informants complemented findings from the survey. Emerging themes included: 1) The need for improved menstrual health and hygiene: Sanitary towels and cleaner toilets; 2) Prevention of adolescent pregnancy: Access to contraception; 3) Respect and dignity: Participants want privacy and confidentiality; and 4) The need to address social determinants of health: Economic stability and a safe physical environment. This study indicated that adolescent high school girls have varied requests for reproductive health care and services. While menstrual health and hygiene are key issues, reproductive needs are beyond just sanitary products. The results suggest a need for targeted reproductive health interventions using a multi-sectoral approach.
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- 2023
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19. Capacity building at points of entry during COVID-19 pandemic: harmonising training curriculum for Economic Community of West African States
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Patrick M Nguku, Bernard Sawadogo, Sarah Ward, Simon Antara, Sombié Issiaka, Muhammad Shakir Balogun, Chukwuma David Umeokonkwo, Aishat Bukola Usman, Virgil Kuassi Lokossou, Kiswendsida Sawadogo, Chelsea Hanlon, Godfrey Kayita, Rebecca Merrill, and Melchior Athanase JC Aïssi
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
This paper describes the process for developing, validating and disseminating through a train-the-trainer (TOT) event a standardised curriculum for public health capacity building for points of entry (POE) staff across the 15-member state Economic Community of West African States (ECOWAS) that reflects both international standards and national guidelines.A five-phase process was used in developing the curriculum: phase (1) assessment of existing materials developed by the US Centers for Disease Control and Prevention (CDC), Africa CDC and the West African Economic and Monetary Union, (2) design of retained and new, harmonised content, (3) validation by the national leadership to produce final content, (4) implementation of the harmonised curriculum during a regional TOT, and (5) evaluation of the curriculum.Of the nine modules assessed in English and French, the technical team agreed to retain six harmonised modules providing materials for 10 days of intensive training. Following the TOT, most participants (n=28/30, 93.3%) indicated that the International Health Regulations and emergency management modules were relevant to their work and 96.7% (n=29/30) reported that the training should be cascaded to POE staff in their countries.The ECOWAS harmonised POE curriculum provides a set of training materials and expectations for national port health and POE staff to use across the region. This initiative contributes to reducing the effort required by countries to identify emergency preparedness and response capacity-building tools for border health systems in the Member States in a highly connected region.
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- 2023
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20. Demand-related factors influencing caregivers’ awareness of malaria tests and health workers’ testing practices, in Makarfi, Nigeria
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Ajumobi, Olufemi, Sabitu, Kabir, Ajayi, IkeOluwapo, Nguku, Patrick, Ufere, Joy, Wasswa, Peter, Isiguzo, Chinwoke, Anyanti, Jennifer, and Liu, Jenny
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Biomedical and Clinical Sciences ,Health Services and Systems ,Clinical Sciences ,Health Sciences ,Medical Microbiology ,Clinical Research ,Vector-Borne Diseases ,Malaria ,Rare Diseases ,Infection ,Good Health and Well Being ,Adult ,Caregivers ,Case Management ,Cross-Sectional Studies ,Diagnostic Tests ,Routine ,Female ,Focus Groups ,Health Knowledge ,Attitudes ,Practice ,Health Personnel ,Humans ,Male ,Nigeria ,Young Adult ,Malaria testing ,Healthcare workers ,Children ,Microbiology ,Public Health and Health Services ,Tropical Medicine ,Medical microbiology ,Public health - Abstract
BackgroundDespite the World Health Organization's recommendation of malaria test-treat strategy, which is the treatment of parasitological confirmed malaria cases with anti-malarials, presumptive diagnosis of malaria remains fairly common in Nigeria. The reasons for this have not been established in Makarfi, Nigeria, despite the high burden of malaria in the area. A study was conducted among caregivers of febrile children less than 5 years presenting for treatment to understand their awareness of malaria diagnostic testing and being offered testing by clinicians, the determinants of these outcomes, and caregivers' perspectives of health workers' testing practices.MethodsUsing mixed-methods, data was combined from sub-analysis of cross-sectional survey data (n = 295) and focus group discussions (n = 4) with caregivers conducted in Makarfi General Hospital (Kaduna State, Nigeria) and surrounding communities in 2011. Bivariate and multivariate analysis of the quantitative survey data was conducted to examine associations of caregivers' sociodemographic characteristics with testing awareness and having ever been offered testing. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers' perspectives on malaria testing.ResultsAmong surveyed caregivers who were predominantly female (81.7%), not formally educated (72.5%), and were housewives (68.8%); only 5.3% were aware of any diagnostic testing for malaria, and only 4.3% had ever been offered a malaria test by a health worker. Having at least a primary level education (adjusted odds ratio [aOR] 20.3, 95% CI 4.5-92.1) and living within 5 km of the hospital (aOR 4.3, 95% CI 1.5-12.5) were determinants of awareness of malaria testing. Also, these were determinants of previously having been offered a test (aOR 9.9, 95% CI 2.1-48.7; and aOR 4.0, 95% CI 1.1-14.7). FGD showed many caregivers believed that malaria testing was for severe illness only, and that proximity to a health facility and cost of treatment influenced the seeking and receiving of care.ConclusionsUptake of malaria testing prior to treatment can be improved by increasing its awareness and addressing misunderstandings among caregivers, promoting testing practices among health workers, and availing caregivers living farther from health centres alternative opportunities for community case management of febrile illnesses.
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- 2017
21. The response to re-emergence of yellow fever in Nigeria, 2017
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Nwachukwu, William E., Yusuff, H., Nwangwu, U., Okon, A., Ogunniyi, A., Imuetinyan-Clement, J., Besong, M., Ayo-Ajayi, P., Nikau, J., Baba, A., Dogunro, F., Akintunde, B., Oguntoye, M., Kamaldeen, K., Fakayode, O., Oyebanji, O., Emelife, O., Oteri, J., Aruna, O., Ilori, E., Ojo, O., Mba, N., Nguku, P., and Ihekweazu, C.
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- 2020
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22. Occupational exposure to HIV among healthcare workers in PMTCT sites in Port Harcourt, Nigeria
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Ndubuisi Akpuh, IkeOluwapo Ajayi, Ayo Adebowale, Hadejia Idris Suleiman, Patrick Nguku, Mahmood Dalhat, and Elizabeth Adedire
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Occupational exposure ,HIV ,HealthCare workers ,Private facility ,Public facility ,PMTCT ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Rivers State is among the states with high HIV prevalence in Nigeria. Occupational exposure to HIV through blood or body fluids of HIV/AIDS patients is a recognised risk factor of HIV infections among healthcare workers. We identified the determinants of occupational exposures to HIV among healthcare workers in Prevention of Maternal to Child Transmission (PMTCT) sites within Port Harcourt metropolis in Rivers State. Methods A descriptive cross-sectional study was conducted and multi-stage sampling technique was used to select 341 healthcare providers from 22 public and 22 private health facilities in PMTCT sites in Port Harcourt metropolis. The data collected were analysed using descriptive statistics, Chi-square and logistic regression models (p-value = 0.05). Results Respondents’ mean age was 35.9 ± SD8.4 years, 270 (80.1%) and 171(50.7%) were females, and from public health facilities respectively. Prevalence of occupational exposure of healthcare workers to HIV in the past 12 months was 153 (45.0%), and 96 (63.3%) experienced such exposure more than once. Contacts with potentially infectious body fluid accounted for the largest proportion 51 (33.3%); followed by needle stick prick 49 (32.6%). About 189 (56.1%) had safety information at their disposal and this serves as a reminder on safety precautions. The likelihood of occupational exposure was significantly higher among doctors (AOR = 2.22, 95% C.I = 1.16–4.25,) but lower among environmental health workers (AOR = 0.10, 95% C.I = 0.02–0.46,) than nurses/midwives when other factors were included in the model. Conclusion Occupational exposure to blood and body fluids remains a frequent occurrence among healthcare workers; highest among doctors in PMTCT sites in the study area. Provision of protective safety materials, training and enforcement of adherence to universal precaution strategies are highly recommended.
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- 2020
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23. Evaluation of malaria surveillance system in Kano State, Nigeria, 2013–2016
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Tyakaray Ibrahim Visa, Olufemi Ajumobi, Eniola Bamgboye, IkeOluwapo Ajayi, and Patrick Nguku
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Malaria ,Performance ,Operation ,Surveillance system attribute ,Health management information system ,Nigeria ,Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Malaria surveillance system strengthening is essential in the progress towards malaria elimination. In Nigeria, more attention is being given to this recently as the country is striving towards achieving elimination. However, the surveillance system performance is fraught with challenges including poor data quality with varying magnitude by state. This study evaluated the operation of the Kano State malaria surveillance system and assessed its key attributes. Methods An observational study design comprising a survey, record review and secondary data analysis, and mixed methods data collection approach were used. Four key stakeholders’ and 35 Roll Back Malaria Focal Persons (RBMs) semi-structured interviews on operation of the system and attributes of the surveillance system, were conducted. We analyzed the abstracted 2013–2016 National Health Management Information System web-based malaria datasets. The surveillance system was evaluated using the “2001 United States Centers for Disease Control’s updated guidelines for Evaluating Public Health Surveillance Systems”. Data were described using means, standard deviation, frequencies and proportions. Chi-squared for linear trends was used. Results Overall, 24 RBMs (68.6%) had ≤ 15-year experience on malaria surveillance, 29 (82.9%) had formal training on malaria surveillance; 32 RBMs (91.4%) reported case definitions were easy-to-use, reporting forms were easy-to-fill and data flow channels were clearly defined. Twenty-seven respondents (69.2%) reported data tools could accommodate changes and all RBMs understood malaria case definitions. All respondents (4 stakeholders and 34 RBMs [97.1%]) expressed willingness to continue using the system and 33 (84.6%) reported analyzed data were used for decision-making. Public health facilities constituted the main data source. Overall, 65.0% of funding were from partner agencies. Trend of malaria cases showed significant decline (χ 2 trend = 7.49; P = 0.0006). Timeliness of reporting was below the target (≥ 80%), except being 82% in 2012. Conclusions Malaria surveillance system in Kano State was simple, flexible, acceptable, useful and donor-driven but the data were not representative of all health facilities. Timeliness of reporting was suboptimal. We recommended reporting from private health facilities, strengthening human resource capacity for supportive supervision and ensuring adequate government funding to enhance the system’s representativeness and improve data quality.
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- 2020
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24. Factors associated with utilization of LLINs among women of child-bearing age in Igabi, Kaduna State, Nigeria
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Obafemi J. Babalola, Mohammed N. Sambo, Suleiman H. Idris, Ike-Oluwapo O. Ajayi, Olufemi Ajumobi, and Patrick Nguku
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Malaria ,Insecticide-treated bed nets ,Ownership ,Awareness ,Knowledge ,Nigeria ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The long-lasting insecticidal nets (LLIN) are effective against prevention of malaria and its utilization has been proven to save lives. Despite the mass distribution of LLIN, Nigeria remains the country with the highest malaria burden in Africa. The awareness of LLIN in Nigeria is high, but the utilization is low. The aim of this work is to describe factors associated with the utilization of LLIN among women of child-bearing age (WCBA) in Igabi, Kaduna, Nigeria. Methods A cross-sectional survey was conducted among 630 WCBA selected using a multi-stage sampling at 63 randomly selected villages in Igabi Local Government Area of Kaduna State. Trained female data collectors administered pre-tested structured questionnaires adapted from the Malaria Indicator Survey. Information collected were demographic profile, knowledge of LLIN as a preventive strategy for malaria, and LLIN ownership and utilization. LLIN utilization was assessed by identifying household members that slept under the hanged LLIN the night before the survey. Questions on the awareness of LLIN, ability to define what it is, use of LLIN, what differentiates LLIN from other bed nets, and duration of use before replacement, were scored and categorized as good, average and poor knowledge of LLIN. Results A total of 629 WCBA was sampled, their mean age (± SD) was 29.3 (± 6.2) years, 22.0% were pregnant, 40.5% had no formal education, 41.1% were employed, and 47.7% lived in rural communities. Awareness and good knowledge about LLINs for the prevention of malaria was 96.0% and 24.0%, respectively. The proportion of women who slept under a LLIN the night before the survey (utilization) was 70.0% and slightly higher (74.0%) among pregnant WCBA. Women who lived in rural communities were more likely to utilize LLINs compared to their urban counterparts (OR 3.4; 95% CI 2.3–4.9). Younger women (aged
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- 2019
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25. Prioritization of zoonotic diseases of public health significance in Nigeria using the one-health approach
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Chikwe Ihekweazu, Charles Akataobi Michael, Patrick M. Nguku, Ndadilnasiya Endie Waziri, Abdulrazaq Garba Habib, Mathew Muturi, Abayomi Olufemi, Asabe A. Dzikwi-Emennaa, Muhammad Shakir Balogun, Tyakaray Ibrahim Visa, Mahmood Muazu Dalhat, Nnomzie Charles Atama, Chukwuma David Umeokonkwo, Gideon Mbrusa Mshelbwala, Columba Teru Vakuru, Junaidu Kabir, Emmanuel C. Okolocha, Jarlath U. Umoh, Babasola Olugasa, Olutayo Babalobi, Lami Lombin, Simeon Cadmus, Kaitlin Sandhaus, Philip M. Ricks, Albert Ogunkoya, Sola Aruna, Aisha Abubakar, Yusuf Bidemi, Kariuki Njenga, Garba Ibrahim, Olukemi Adekanmbi, Ifeoma Nwadiuto, Idris S. Hadejia, Gatai Nganda, Kwaga Jacob, Olajide Owolodun, Okafor Christoper, T.Z. Gandi Benjamin Tule, Habib Abdulrazak, Dooshima Kwange, Sabitu Kabiru, Gidado M. Muhammed, Tony Joannis, Sunday Omilabu, Junaid Kabir, G.A.T. Ogundipe, Olubunmi Ojo, Obasanya Joshua, Aisha Abubakar Sadiq, Olayinka Adebola, Abdullahi A. Magaji, Aisha Nasir, Dan Duvall, S. Tekki, Sati Ngulukun, Dotun Soruuke, Abiodun Egumenu, Ibro Idiona, Oyiri Ferdinand, Olufemi Abayomi, Ilori Elsie, Visa I. Tyakaray, Angela Oyo-Ita, Godson Ana, Olaniran Alabi, Mabel Aworh, John Kvagai, Gana Chinyere, and Okara Gloria
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Zoonotic diseases ,Prioritization ,Public Health ,One Health ,Nigeria ,Medicine (General) ,R5-920 - Abstract
Nigeria, with a population of over 190 million people, is rated among the 10 countries with the highest burden of infectious and zoonotic diseases globally. In Nigeria, there exist a sub-optimal surveillance system to monitor and track priority zoonoses. We therefore conducted a prioritization of zoonotic diseases for the first time in Nigeria to guide prevention and control efforts. Towards this, a two-day in-country consultative meeting involving experts from the human, animal, and environmental health backgrounds prioritized zoonotic diseases using a modified semi-quantitative One Health Zoonotic Disease Prioritization tool in July 2017. Overall, 36 of 52 previously selected zoonoses were identified for prioritization. Five selection criteria were used to arrive at the relative importance of prioritized diseases based on their weighted score. Overall, this zoonotic disease prioritization process marks the first major step of bringing together experts from the human-animal-environment health spectrum in Nigeria. Importantly, the country ranked rabies, avian influenza, Ebola Virus Disease, swine influenza and anthrax as the first five priority zoonoses in Nigeria. Finally, this One Health approach to prioritizing important zoonoses is a step that will help to guide future tracking and monitoring of diseases of grave public health importance in Nigeria.
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- 2021
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26. The One Health approach to incident management of the 2019 Lassa fever outbreak response in Nigeria
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Chioma Dan Nwafor, Elsie Ilori, Adebola Olayinka, Chinwe Ochu, Rosemary Olorundare, Edwin Edeh, Tochi Okwor, Oyeronke Oyebanji, Esther Namukose, Winifred Ukponu, Michael Olugbile, Usman Adekanye, Nastassya Chandra, Hikaru Bolt, Geofrey Namara, Oladipupo Ipadeola, Yuki Furuse, Solomon Woldetsadik, Adejoke Akano, Akanimo Iniobong, Michael Amedu, Chimezie Anueyiagu, Lawal Bakare, Anthony Ahumibe, Gbenga Joseph, Chibuzo Eneh, Muhammad Saleh, Naidoo Dhamari, Ihekerenma Okoli, Mairo Kachalla, Rita Okea, Collins Okenyi, Favour Makava, Catherine Makwe, Nkem Ugbogulu, Fritz Fonkeng, Everistus Aniaku, Emmanuel Agogo, Nwando Mba, Olusola Aruna, Patrick Nguku, and Chikwe Ihekweazu
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One Health ,Lassa fever ,Incident management system ,Emergency operation centre ,Medicine (General) ,R5-920 - Abstract
Globally, effective emergency response to disease outbreaks is usually affected by weak coordination. However, coordination using an incident management system (IMS) in line with a One Health approach involving human, environment, and animal health with collaborations between government and non-governmental agencies result in improved response outcome for zoonotic diseases such as Lassa fever (LF).We provide an overview of the 2019 LF outbreak response in Nigeria using the IMS and One Health approach. The response was coordinated via ten Emergency Operation Centre (EOC) response pillars. Cardinal response activities included activation of EOC, development of an incident action plan, deployment of One Health rapid response teams to support affected states, mid-outbreak review and after-action review meetings.Between 1st January and 29th December 2019, of the 5057 people tested for LF, 833 were confirmed positive from 23 States, across 86 Local Government Areas. Of the 833 confirmed cases, 650 (78%) were from hotspot States of Edo (36%), Ondo (26%) and Ebonyi (16%). Those in the age-group 21–40 years (47%) were mostly affected, with a male to female ratio of 1:1. Twenty healthcare workers were affected. Two LF naïve states Kebbi and Zamfara, reported confirmed cases for the first time during this period.The outbreak peaked earlier in the year compared to previous years, and the emergency phase of the outbreak was declared over by epidemiological week 17 based on low national threshold composite indicators over a period of six consecutive weeks.Multisectoral and multidisciplinary strategic One Health EOC coordination at all levels facilitated the swift containment of Nigeria's large LF outbreak in 2019. It is therefore imperative to embrace One Health approach embedded within the EOC to holistically address the increasing LF incidence in Nigeria.
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- 2021
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27. Building local capacity for emergency coordination: establishment of subnational Public Health Emergency Operations Centres in Nigeria
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Oyeronke Oyebanji, Chikwe Ihekweazu, Patrick M Nguku, Olaolu Aderinola, John Oladejo, Oluwatosin Wuraola Akande, Anwar Abubakar, Fatima Ibrahim Abba, Everistus Chijioke Aniaku, Emmanuel Benyeogor, Femi Owoeye, and Valerie Nkamgang Bemo
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Public Health Emergency Operations Centres (PHEOCs) provide a platform for multisectoral coordination and collaboration, to enhance the efficiency of outbreak response activities and enable the control of disease outbreaks. Over the last decade, PHEOCs have been introduced to address the gaps in outbreak response coordination. With its tropical climate, high population density and poor socioeconomic indicators, Nigeria experiences large outbreaks of infectious diseases annually. These outbreaks have led to mortality and negative economic impact as a result of large disparities in healthcare and poor coordination systems. Nigeria is a federal republic with a presidential system of government and a separation of powers among the three tiers of government which are the federal, state and local governments. There are 36 states in Nigeria, and as with other countries with a federal system of governance, each state in Nigeria has its budgets, priorities and constitutional authority for health sector interventions including the response to disease outbreaks. Following the establishment of a National PHEOC in 2017 to improve the coordination of public health emergencies, the Nigeria Centre for Disease Control began the establishment of State PHEOCs. Using a defined process, the establishment of State PHEOCs has led to improved coordination, coherence of thoughts among public health officials, government ownership, commitment and collaboration. This paper aims to share the experience and importance of establishing PHEOCs at national and subnational levels in Nigeria and the lessons learnt which can be used by other countries considering the use of PHEOCs in managing complex emergencies.
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- 2021
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28. Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative
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Christopher T Lee, Richard Lako, Faisal Shuaib, Mohammed Lamorde, Andrew Kambugu, Patrick Nguku, Leena N Patel, Samantha Kozikott, Rodrigue Ilboudo, Moreen Kamateeka, Marion Subah, Fatima Tsiouris, Anna Vorndran, Ramatu Abdu-Aguye, Usman Gana Abdulkadir, Usman Saidu Adamu, Olugbemiga Aina, Jackson Amone, Philip Bammeke, Bakunawa Garba Bello, Karen Brudney, Sae-Rom Chae, António Cristóvão, Eunice Damisa, Georges Alain Etoundi Mballa, Ntombi Ginindza, Nkwan Jacob Gobte, Benjamin Grant, Kieran Hartsough, Shambel A. Hussen, Harrison Kamiru, Jones Kaponda Masiye, Felix Kayigamba, Stephen Macheso, Limpho Maile, Olivier Manzi, Joana Maria, Susan Michaels-Strasser, Lucy Moe, Lumbani Munthali, Naomi Mviha, Gerald Mwima, Felix Ndagije, Isilda Neves, Folasade Ogunsula, Solome Okware, Charles Olaro, Ibrahim Suleiman Ozaki, Miriam Rabkin, Mantue Reeves, T. Ruston Yarnko, Ruben Sahabo, Likelay Tehmeh, Lyson Tenthani, Marshall Thomas, Belinda Ubar, Gideon Ugbenyo, Onyekachi Ukaejiofo, Chukwuma David Umeokonkwo, George Upenytho, Debra Vambe, Chea Sanford Wesseh, and Habtamu Ayalneh Worku
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.
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- 2021
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29. A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018
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Chioma C. Dan-Nwafor, Oladipupo Ipadeola, Elizabeth Smout, Elsie Ilori, Ayodele Adeyemo, Chukwuma Umeokonkwo, Damian Nwidi, Williams Nwachukwu, Winifred Ukponu, Emeka Omabe, Uchenna Anaebonam, Nneka Igwenyi, Gordon Igbodo, Womi Eteng, Ikemefule Uzoma, Muhammed Saleh, Joseph Agboeze, Samuel Mutbam, Tanyth de Gooyer, Rosie Short, Everistus Aniaku, Robinson Onoh, Emeka Ogah, Patrick Nguku, John Oladejo, Clement Peter, Olubunmi Ojo, and Chikwe Ihekweazu
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Infectious and parasitic diseases ,RC109-216 - Abstract
Background: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. Methods: We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. Results: The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. Conclusion: Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient’s provisional diagnosis. Keywords: Lassa fever, Healthcare workers, Nosocomial infection
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- 2019
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30. Preference for Artemisinin–based combination therapy among healthcare providers, Lokoja, North-Central Nigeria
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Sylvanus C. Welle, Olufemi Ajumobi, Magbagbeola Dairo, Muhammad Balogun, Peter Adewuyi, Babatunde Adedokun, Patrick Nguku, Saheed Gidado, and IkeOluwapo Ajayi
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Artemisinin-based combination therapy ,Preference for ACT ,Healthcare providers ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background In Nigeria, Artemisinin-based Combination Therapy (ACT) is the recommended first line antimalarial medicine for uncomplicated malaria. However, health care providers still continue the use of less efficacious medicines such as Sulphadoxine-pyrimethamine and chloroquine. We therefore determined preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, North-Central Nigeria as well as assessed healthcare providers’ knowledge of malaria case management. Methods We conducted a cross-sectional study among physicians, nurses, pharmacists, community health officers (CHOs), community health extension workers (CHEWs) and, patent and proprietary medicine vendors (PPMVs). Interviewer-administered questionnaires were administered to collect data on respondents’ characteristics, previously received malaria case management training and knowledge of malaria treatment. Knowledge scores ≥3 were categorised as good, maximum obtainable being 5. Results Of the 404 respondents, 214 (53.0%) were males. Overall, 219 (54.2%) respondents who received malaria case management training included PPMVs: 79 (65.8%), CHEWs: 25 (64.1%), CHOs: 5 (55.6%), nurses: 72 (48.7%), physicians: 35 (47.3%) and pharmacists: 3 (23.1%). Overall, 202 (50.0%) providers including physicians: 69 (93.2%), CHO: 8 (88.9%), CHEWs: 33 (84.6%), pharmacists: 8 (61.5%), nurses: 64 (43.2%) and PPMVs: 20 (16.5%), had good knowledge of malaria treatment guidelines. Overall, preference for ACT among healthcare providers was 39.6%. Physicians: 50 (67.6%), pharmacists: 7 (59.3%) CHOs: 5 (55.6%), CHEWS: 16 (41.0%), nurses: 56 (37.8%) and PPMV: 24 (19.8%) had PFA. Receiving malaria case management training (adjusted odds ratio [aOR]) = 2.3; CI = 1.4 – 3.7) and having good knowledge of malaria treatment (aOR = 4.0; CI = 2.4 – 6.7) were associated with PFA. Conclusions Overall preference for ACT use was low among health care providers in this study. Preference for ACTs and proportion of health workers with good knowledge of malaria case management were even lower among PPMVs who had highest proportion of those who received malaria case management training. We recommend evaluation of current training quality, enhanced targeted training, follow-up supportive supervision of PPMVs and behavior change communication on ACT use.
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- 2019
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31. A cholera outbreak in a rural north central Nigerian community: an unmatched case-control study
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Chioma Cindy Dan-Nwafor, Uzoma Ogbonna, Pamela Onyiah, Saheed Gidado, Bashorun Adebobola, Patrick Nguku, and Peter Nsubuga
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Unmatched case control study ,Cholera outbreak ,Hand hygiene ,Nigeria ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Cholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in suspected cholera cases in Gomani, Kwali Local Government Area. NFELTP residents were deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and instituting appropriate control measures to control the outbreak. Methods We conducted an unmatched case-control study. We defined a cholera case as any person aged ≥5 years with acute watery diarrhea in Gomani community. We identified community controls. A total of 43 cases and 68 controls were recruited. Structured questionnaires were administered to both cases and controls. Four stool samples from case-patients and two water samples from the community water source were collected for laboratory investigation. We performed univariate and bivariate analysis using Epi-Info version 7.1.3.10. Results The mean age of cases and controls was 20.3 years and 25.4 respectively (p value 0.09). Females constituted 58.1% (cases) and 51.5%(controls). The attack rate was 4.3% with a case fatality rate of 13%. Four stool (100%) specimen tested positive for Vibrio cholerae. The water source and environment were polluted by indiscriminate defecation. Compared to controls, cases were more likely to have drank from Zamani river (OR 14.2, 95% CI: 5.5–36.8) and living in households(HH) with more than 5 persons/HH (OR 5.9, 95% CI: 1.3–27.2). Good hand hygiene was found to be protective (OR 0.3, 95% CI: 0.1–0.7). Conclusion Vibrio cholerae was the cause of the outbreak in Gomani. Drinking water from Zamani river, living in overcrowded HH and poor hand hygiene were significantly associated with the outbreak. We initiated hand hygiene and water treatment to control the outbreak.
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- 2019
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32. Predictors of intestinal parasite infection among HIV patients on antiretroviral therapy in Jos, Plateau State, Nigeria, 2016: a cross-sectional survey
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Olawunmi Toyin Ajayi, Olufunmilola Bamidele Makanjuola, Adebola Temitope Olayinka, Abdulhakeem Olorukooba, Josephine Ene Olofu, Patrick Nguku, and Olufunmilayo Ibitola Fawole
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antiretroviral therapy ,hiv/aids ,prevalence ,intestinal parasites ,protozoa ,factors ,toilets ,Medicine - Abstract
INTRODUCTION: Intestinal parasitic infection has been reported as a cause of morbidity and mortality among HIV patients on antiretroviral therapy (ART) due to interruption in treatment of the defaulting HIV patients. This study aimed to determine the prevalence and possible causes of intestinal parasites among HIV patients on ART. METHODS: a survey involving 375 adult HIV/AIDS patients selected using a systematic random sampling technique was conducted in a Jos University Teaching hospital, Plateau State, Nigeria. Socio-demographic and clinical data was collected using semi- structured interviewer administered questionnaire and electronic dataset review. Fresh stool samples were collected from all participants for laboratory identification of intestinal parasites using formol-ether sedimentation and modified Ziehl-Neelsen techniques. Descriptive statistics, odds ratio and logistic regression model were computed at P = 0.05. RESULTS: the mean age of the study participants was 41.6±9.3 years. Majority 294 (78.4%) were females, 141 (37.6%) lived in the rural area, 50 (13.3%) respondents did not have toilets in their homes. Most 275 (73.3%) had ART adherence level of 95% and above. Prevalence of intestinal parasites was 28.5%. Females (aOR = 2.14, 95% CI=1.12 - 3.89) and participants with no toilet facilities (aOR = 2.0, 95% CI=1.03 – 3.94) were significantly more likely to have intestinal parasites. CONCLUSION: the prevalence of intestinal parasites was high among HIV patients. Gender and unavailability of toilet in homes were found to be predictors of having parasites. We recommend that HIV patients should be periodically screened for IPs during the follow-up clinic visits.
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- 2021
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33. Awareness and knowledge of canine rabies: A state-wide cross-sectional study in Nigeria.
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Ahmad I Al-Mustapha, Abubakar A Tijani, Folashade O Bamidele, Oyewo Muftau, Ahmed Ibrahim, Ibrahim Abdulrahim, Muhammad Shuaib Osu, Grace Kia, Nguku Patrick, and Waziri N Endie
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Medicine ,Science - Abstract
Rabies is a highly fatal disease that is endemic in Nigeria. The poor community awareness and knowledge of canine rabies have thwarted the realization of zero deaths from dog mediated human rabies. This study aimed to assess the awareness and knowledge of canine rabies in Kwara state. A total of 1,460 questionnaires were administered to respondents in the three senatorial zones of the state using open data kit (ODK) on mobile phones between September 2019 to January 2020. The rabies awareness rate was 38.1%. The mean knowledge score was 3.78 ± 2.15. Only 10.6% (n = 59/557) of the respondents had satisfactory knowledge of canine rabies. Respondents had poor knowledge of the mode of transmission, symptoms, prevention, and the control measures needed to eliminate canine rabies. Only 20.1% of respondents owned at least a dog. Dog owners were 3.85× (95% CI: 2.89, 5.13; p < 0.01) more likely to be aware of canine rabies and were 1.78× (95% CI: 1.22-2.60; p = 0.003) more likely to have satisfactory knowledge about canine rabies than non-dog owners. Respondents with tertiary education were at least 6.81× (95% CI: 4.24, 10.92; p < 0.01) more likely to be aware of rabies than respondents with no formal education. The findings of this study showed very low awareness and knowledge of canine rabies among residents of Kwara state. Mass sensitization of the populace on the dangers of rabies should be intensified. Such interventions should be targeted at the general public and dog owners.
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- 2021
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34. Serological markers and risk factors associated with Hepatitis B virus infection among Federal Capital Territory prison inmates, Nigeria: Should we be concerned?
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Chioma Cindy Dan-Nwafor, Ikeola Adeoye, Kehinde Aderemi, Martins Onuoha, Elizabeth Adedire, Adebobola Bashorun, Damaris Osunkwo, Saheed Gidado, Muhammad Balogun, Suleiman Idris, Ibrahim Ade-Yusuf, Ekpedeme Udom, and Patrick Nguku
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Medicine ,Science - Abstract
IntroductionHepatitis B virus (HBV) infection is hyper-endemic in Nigeria. Prisons are high-risk environments for the spread of infectious diseases. Worldwide, seroprevalence of HBV infection is substantially higher among individuals in correctional facilities when compared to general population. We determined the seroprevalence and risk factors associated with HBV infection among Kuje prison inmates, Nigeria.Material and methodsWe conducted a prison facility based cross-sectional study. Interviewer administered questionnaires were used to obtain information on participants socio-demographic characteristics, HBV risk factors, previous HBV test and vaccination history. Blood samples collected from participants were analysed for HBsAg, HBsAb, HBcAb, HBeAg and HBeAb markers using rapid lateral chromatographic immunoassay kit. Univariate, bivariate, and multivariate analysis were performed.ResultsA total of 271 inmates (63 convicts and 208 awaiting trial inmates) were recruited into the study as participants. The mean age of the participants was 32.7 SD±9 years. HBV seroprevalence (HBsAg) of 13.7% (95% CI: 9.8-18.3) was found. 55.4% (95% CI: 49.2-61.4) of inmates were susceptible to HBV infection, 20.7% (95%CI; 16.0-26.0) had past HBV infection while 10.3% (95% CI: 7.0-14.6) had acquired natural or artificial HBV immunity. Factors found to be associated with current HBV infection (HBsAg) include age-group ≤25years (aOR = 8.0,95% CI: 2.9-22.3), being ever married (aOR = 4.2, 95% CI: 1.7-10.4) and history of alcohol consumption (aOR = 3.4, 95% CI: 1.3-8.4).ConclusionThis study reveals a high seroprevalence of HBV infection among Kuje Prison inmates, hence the need to introduce prison-focused health intervention initiatives such as HBV screening, vaccination and care to reduce the transmission of HBV infection among inmates and ultimately the general population.
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- 2021
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35. What do malaria program officers want to learn? A survey of perspectives on a proposed malaria short course in Nigeria.
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Olufemi Ajumobi, Rotimi Felix Afolabi, Adefisoye Adewole, Muhammad Shakir Balogun, Patrick Nguku, and IkeOluwapo O Ajayi
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Medicine ,Science - Abstract
BackgroundIn disease control, the program officers are vital to the successful implementation of control strategies. However, poor knowledge of the disease and its control, staff attrition, and lack of intentional training for new staff can lead to under-performance and ineffectiveness of interventions. Thus, the Nigeria Field Epidemiology and Laboratory Training Program, in collaboration with National Malaria Elimination Program, planned a malaria short course (MSC) to strengthen the capacity of current program managers and incoming staff. To guide the development of the curriculum for the MSC, we conducted a needs assessment survey to ascertain the perceived usefulness of the MSC, the priority rating of MSC thematic domains and associated factors.MethodsOverall, 384 purposively selected respondents across ten states and the Federal Capital Territory in Nigeria were interviewed. These comprised malaria and non-malaria control program staff at state, local government area (LGA) and ward levels. We administered a structured questionnaire to elicit information on socio-demographics, training needs, priority malaria thematic domains, perceived course usefulness and willingness of ministries/organizations to release staff to attend the MSC. Data were analyzed using descriptive and inferential statistics at pResultsMean age was 43.9 (standard deviation: 7.6 years), 172 (44.8%) were females. Of the 384 respondents, 181 (47.1%), 144 (37.5%) and 59 (15.4%) were at the ward, LGA and state levels, respectively. Seventy-two (18.8%) had never worked in malaria control program. Majority (98.7%, n = 379) reported the need for further training, 382 (99.5%) opined that the course would be useful, and all affirmed their employers' willingness towards their participation at the training. Respondents rated high the domains of basic malariology, malaria treatment, malaria prevention, surveillance/data management, use of computers, leadership skills, program management and basic statistics. Predictors of malaria topical domains' high rating were gender (odds ratio (OR) = 6.77; 95% CI:3.55-12.93) and educational qualifications (OR = 0.48; 95% CI:0.26-0.89).ConclusionsA malaria short course is a necessity and appropriate for program officers at different levels of health administration in Nigeria to achieve malaria elimination, taking into consideration the challenges of human resource retention. The outcome of this study should inform the curriculum and the delivery of the MSC.
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- 2021
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36. Predictors of adherence to option B+ approach for the prevention of mother to child transmission of human immunodeficiency virus in Abuja, 2017
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Augustine Olajide Dada, Aisha Abubakar, Adebobola Bashorun, Patrick Nguku, and Abisola Oladimeji
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hiv/aids ,adherence ,antiretroviral therapy ,nigeria ,Medicine - Abstract
INTRODUCTION: Option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja. METHODS: we enrolled 284 HIV positive pregnant women and lactating mothers in a hospital-based cross-sectional study. We sampled respondents using two-staged sampling technique. We collected data on socio-demographic characteristics, level of adherence, Patients and healthcare related factors affecting adherence, knowledge of clients on HIV, ART and MTCT. Focused group discussion guide, data abstraction form and key informant interview guide were used for PMTCT focal persons. We conducted bivariate analysis and logistic regression using Epi-Info version 7 at 5% level of significance. RESULTS: The mean age of respondents was 30.12 years (SD±4.86) with mean knowledge score of 16.7 and 75.5%% of them had good knowledge. The level of good adherence was 83.3%. Independent factors associated with non-adherence to ART included: Forgetfulness (OR 20.02; 95% CI 6.42-62.48), having side effects (OR 39.6; 95% C.I: 4.46-352.32), lack of food (OR 34.76; 95% C.I: 2.37-509.33), disclosure of HIV status (OR 2.51; 95% CI 1.22-5.15), being too busy (OR 13.96; 95% CI 3.89-49.98). Encountering challenge in ART initiation (OR 2.05; 95% CI 1.01-4.72) and level of Knowledge (OR 2.12; 95% CI 1.06-5.42). CONCLUSION: the level of adherence would improve study if the Public health department of FMOH, FCDA and NACA sponsors public enlightenment on HIV/AIDS through the media which may help reduce stigma and encourage voluntary HIV status disclosure. Reminders should be used by patients to help them overcome forgetfulness.
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- 2021
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37. Emergence of Neisseria meningitidis serogroup X in the 2017/2018 Cerebrospinal Meningitis outbreak, Nigeria
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R. Amaza, M. Popoola, E. Ekeng, M. Antonio, C.B. Okoi, C. Ameh, M.S. Balogun, P. Nguku, O. Aderinola, A. Adebayo, N. Mba, and C. Ihekweazu
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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38. Risk factors associated with cholera outbreak in Mubi Adamawa state – Nigeria, 2018
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T. Visa, T. Emmanuel, F. Mbodi, and P. Nguku
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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39. Acute flaccid paralysis surveillance system evaluation-Enugu state, Nigeria 2015–2018
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R.N. Nnaji, P. Osai, P. Nguku, C. Ihekweazu, and C.C. Ezeudu
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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40. Temporal trend of measles cases and impact of vaccination on mortality-Jigawa state, Nigeria, 2013–2017
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A. Faruk, O. Adeoye, M. Abdulkarim, L. Amadu, I. Umar, M. Balogun, and P. Nguku
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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41. Factors associated with immune status of dogs against rabies in Kano Metropolis – Nigeria, December 2018
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T. Visa, J. Kabir, G.S. Kia, and P. Nguku
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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42. Reemergence of Yellow Fever in Nigeria 2018: The Anambra state experience
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O. Okoro, S. Owoicho, U. Nwangwu, E. Eloy, I. Yohanna, C. Okedo, N. Uba, C. Dan-Nwafor, M.S. Balogun, M. Balogun, W. Nwachukwu, N. Mba, P. Nguku, and C. Ihekweazu
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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43. Descriptive epidemiology of Monkeypox outbreak in Bayelsa State South-South Nigeria, November 2017
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M. Ibegu, T.-W. Numbere, M. Balogun, and P. Nguku
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Infectious and parasitic diseases ,RC109-216 - Published
- 2020
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44. Building a new platform to support public health emergency response in Africa: the AFENET Corps of Disease Detectives, 2018–2019
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Peter Nsubuga, Patrick M Nguku, Ben Masiira, Simon N Antara, Herbert B Kazoora, Olivia Namusisi, Notion T Gombe, Alain N Magazani, Ditu Kazambu, Sheba N Gitta, Christine Kihembo, Bernard Sawadogo, Tatek A Bogale, Chima Ohuabunwo, and Mufuta Tshimanga
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Public health emergency (PHE) response in sub-Saharan Africa is constrained by inadequate skilled public health workforce and underfunding. Since 2005, the African Field Epidemiology Network (AFENET) has been supporting field epidemiology capacity development and innovative strategies are required to use this workforce. In 2018, AFENET launched a continental rapid response team: the AFENET Corps of Disease Detectives (ACoDD). ACoDD comprises field epidemiology graduates and residents and was established to support PHE response. Since 2018, AFENET has deployed the ACoDD to support response to several PHEs. The main challenges faced during ACoDD deployments were financing of operations, ACoDD safety and security, resistance to interventions and distrust of the responders by some communities. Our experience during these deployments showed that it was feasible to mobilise and deploy ACoDD within 48 hours. However, the sustainability of deployments will depend on establishing strong linkages with the employers of ACoDD members. PHEs are effectively controlled when there is a fast deployment and strong linkages between the stakeholders. There are ongoing efforts to strengthen PHE preparedness and response in sub-Saharan Africa. ACoDD members are a competent workforce that can effectively augment PHE response. ACoDD teams mentored front-line health workers and community health workers who are critical in PHE response. Public health emergence response in sub-Saharan Africa is constrained by inadequacies in a skilled workforce and underfunding. ACoDD can be utilised to overcome the challenges of accessing a skilled public health workforce. To improve health security in sub-Saharan Africa, more financing of PHE response is needed.
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- 2020
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45. Determinants of perinatal mortality in public secondary health facilities, Abuja Municipal Area Council, Federal Capital Territory, Abuja, Nigeria
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Ugochukwu Uzoechina Nwokoro, Tukur Dahiru, Abdulhakeem Olorukooba, Clement Koelengoen Daam, Hyelshini Samuel Waziri, Ayo Adebowale, Ndadilnasiya Endie Waziri, and Patrick Nguku
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perinatal death ,antenatal care ,secondary health facility ,nigeria ,Medicine - Abstract
INTRODUCTION: In Nigeria, perinatal mortality rate remains high among births at the health facility. Births occur majorly at the secondary healthcare level in Abuja Municipal Area Council (AMAC) of the Federal Capital Territory (FCT). Identifying factors influencing perinatal deaths in this setting would inform interventions on perinatal deaths reduction. We assessed perinatal mortality and its determinants in public secondary health facilities in AMAC. METHODS: delivery and neonatal data from two selected public secondary health facilities between 2013 and 2016 were reviewed and we extracted maternal socio-demographics, obstetrics and neonatal data from hospital delivery, newborns´ admissions and discharge registers. Data were analyzed using descriptive statistics and Cox proportional hazard models (α = 5%). RESULTS: perinatal mortality rate was 129.5 per 1000 births. Asphyxia 475 (34.0%), neonatal infection 279 (20.0%) and prematurity 242 (17.3%) accounted for majority of the 1,398 perinatal deaths. Unbooked status [aHR = 1.8 (95% CI 1.4 - 2.2)], antepartum haemorrhage [aHR = 2.8 (95% CI 1.2 - 6.7)], previous perinatal death [aHR= 2.3 (95% CI 1.7 - 3.1)] and maternal age e"35 years [aHR= 1.4 (95% CI 1.0 - 1.8)] were associated with increased risk of perinatal death. CONCLUSION: perinatal mortality in the studied hospitals was high. Determinants of perinatal death were unbooked ANC status, antepartum haemorrhage, previous perinatal death and high maternal age. Reducing perinatal deaths would require improving antenatal care attendance with healthcare staff identifying and targeting women at risk of pregnancy complications.
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- 2020
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46. Descriptive epidemiology of Lassa fever in Nigeria, 2012-2017
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Onyebuchi Augustine Okoro, Eniola Bamgboye, Chioma Dan-Nwafor, Chukwuma Umeokonkwo, Elsie Ilori, Rimamdeyati Yashe, Muhammad Balogun, Patrick Nguku, and Chikwe Ihekweazu
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lassa fever ,nigeria ,outbreak ,Medicine - Abstract
INTRODUCTION: Lassa fever, an acute viral hemorrhagic zoonotic disease is endemic in some parts of Nigeria. The disease alert and outbreak threshold are known; however, there has been a shift from the previous seasonal transmission pattern to an all year-round transmission. We described data on Lassa fever and highlighted the magnitude of the disease over a six-year period. METHODS: we conducted a secondary data analyses of Lassa fever specific surveillance data from the Integrated Disease Surveillance and Response (IDSR) records of all states in Nigeria over a six-year period (2012-2017). RESULTS: a total of 5974 suspected cases were reported within the study period; of these, 759 (12.7%) were confirmed by laboratory diagnosis. Highest number of cases was recorded in 2012. Edo and Ondo states in the southern region of the country were mostly affected within the study period. The seasonal trend of Lassa fever cases showed peaks within January to March, except for year 2015. CONCLUSION: there was a high burden of Lassa fever in Nigeria especially in the southern part. Lassa fever transmission occurs all year-round with peaks in January and March. There is need to develop preparedness plans and define thresholds for Lassa fever epidemic.
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- 2020
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47. Emergency response to a cluster of suspected food-borne botulism in Abuja, Nigeria: challenges with diagnosis and treatment in a resource-poor setting
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Oyeladun Okunromade, Mahmood Muazu Dalhat, Aminatu Makarfi Umar, Augustine Olajide Dada, Jamilu Nikau, Lamin Maneh, Okokon Ita Ita, Muhammad Shakir Balogun, Patrick Nguku, Olubunmi Ojo, and Chikwe Ihekweazu
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case report ,botulism ,anti-toxin ,botulinum ,mouse assay ,Medicine - Abstract
Food-borne botulism is a rare, acute and potentially fatal neurologic disorder that results from ingestion of food contaminated by botulinum toxin released from the anaerobic, spore-forming, gram-positive bacterium Clostridium botulinum. We reported an unusual cluster of botulism outbreak with high case fatality affecting a family following ingestion of home-made fish. A suspected outbreak of botulism affecting three patients in a family of six was reported to the Nigeria Centre for Disease Control. A rapid response team investigated by line-listing all the family members, interviewed extended family members, caregivers, clinicians, and nurses to collect socio-demographic and clinicoepidemiological information using a semi-structured questionnaires. We collected blood from patients and food samples and locally made drink from the family home for laboratory testing. All family members ingested the same home-made food within the 48hrs before onset of symptoms in the index case. The clinical presentation of the three affected cases (AR=50.0%) was consistent with botulinum poisoning. Two of the affected cases died (CFR=66.7%) within 48hrs of admission before antitoxin was made available. The third case had a milder presentation and survived, after administration of appropriate antitoxin. The remaining three children developed no symptoms. None of the samples cultured clostridium botulinum. The blood samples were negative for mouse lethality test. Our report describes the challenges of diagnosis and management of rare emerging infectious disease outbreaks in resource-constrained settings.
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- 2020
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48. Implementing the routine immunisation data module and dashboard of DHIS2 in Nigeria, 2014–2019
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Faisal Shuaib, Abdullahi Bulama Garba, Emmanuel Meribole, Samuel Obasi, Adamu Sule, Chimeremma Nnadi, Ndadilnasiya Endie Waziri, Omotayo Bolu, Patrick M Nguku, Margherita Ghiselli, Oluwasegun Joel Adegoke, Sara Jacenko, Ester Mungure, Saheed Gidado, Idongesit Wilson, Eric Wiesen, Hashim Elmousaad, Peter Bloland, Louie Rosencrans, Frank Mahoney, Adam MacNeil, Richard Franka, and John Vertefeuille
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Medicine (General) ,R5-920 ,Infectious and parasitic diseases ,RC109-216 - Abstract
In 2010, Nigeria adopted the use of web-based software District Health Information System, V.2 (DHIS2) as the platform for the National Health Management Information System. The platform supports real-time data reporting and promotes government ownership and accountability. To strengthen its routine immunisation (RI) component, the US Centers for Disease Control and Prevention (CDC) through its implementing partner, the African Field Epidemiology Network-National Stop Transmission of Polio, in collaboration with the Government of Nigeria, developed the RI module and dashboard and piloted it in Kano state in 2014. The module was scaled up nationally over the next 4 years with funding from the Bill & Melinda Gates Foundation and CDC. One implementation officer was deployed per state for 2 years to support operations. Over 60 000 RI healthcare workers were trained on data collection, entry and interpretation and each local immunisation officer in the 774 local government areas (LGAs) received a laptop and stock of RI paper data tools. Templates for national-level and state-level RI bulletins and LGA quarterly performance tools were developed to promote real-time data use for feedback and decision making, and enhance the performance of RI services. By December 2017, the DHIS2 RI module had been rolled out in all 36 states and the Federal Capital Territory, and all states now report their RI data through the RI Module. All states identified at least one government DHIS2 focal person for oversight of the system’s reporting and management operations. Government officials routinely collect RI data and use them to improve RI vaccination coverage. This article describes the implementation process—including planning and implementation activities, achievements, lessons learnt, challenges and innovative solutions—and reports the achievements in improving timeliness and completeness rates.
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- 2020
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49. Seroprevalence of brucellosis and associated risk factors among abattoir workers in Bauchi State, Nigeria
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Philip Bobu Igawe, Emmanuel Okolocha, Grace Sabo Kia, Istifanus Bugun Irmiya, Muhammad Shakir Balogun, and Patrick Nguku
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brucellosis ,seroprevalence ,abattoir ,occupational hazard ,elisa ,nigeria ,Medicine - Abstract
INTRODUCTION: brucellosis is a reemerging and neglected zoonotic disease. It is an occupational bio-hazard and a public health problem. The objective of the study was to determine the seroprevalence of brucellosis and its risk factors among abattoir workers in Bauchi State. METHODS: a cross-sectional study was conducted in the three senatorial district abattoirs of Bauchi state. Abattoir workers (n=284) were selected by stratified random sampling. Data were collected using an adapted questionnaire. Serum samples collected, were screened for brucellosis with Rose Bengal Plate Test (RBPT), tested with Enzyme Linked Immunosorbent Assay (ELISA). Seropositive participants were positive for both RBPT and ELISA. Data were described in proportions and analyzed using bivariate and multivariate analysis. RESULTS: participants were all male, age range: 18-70 years (mean 35 ±13 years). Ninety-five participants were seropositive (seroprevalence 33.5%) after laboratory testing. Following bivariate analysis, using personal protective equipment (PPE) [OR: 0.5 CI95%=0.3OR: 0.5 CI95%=0.3-0.9] was significantly protective against brucellosis. Slaughtering of animals (OR: 2.19 CI95%= 1.2-3.7), assisting in animal parturition (OR: 2.25 CI95%= 1.3-3.7), working with an open cut/wound (OR:2.1 CI95%= 1.1-3.9) and eating while working in the abattoir [OR:2.4 CI95%= 1.1=OR:2.4 CI95%= 1.1-4.9] were risks of brucellosis. Multivariate analysis showed that slaughtering of animals: Adjusted Odds-Ratio (AOR) = 1.92; CI95% = 1.03 - 3.59) and assisting in animal parturition (AOR = 2.43; CI95% = 1.40 - 4.23) remained significantly associated with brucellosis. CONCLUSION: seroprevalence of brucellosis among abattoir workers in Bauchi State is high. Workers should use PPEs and animal parturitions should be handled by trained personnel alone.
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- 2020
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50. Suitability of resampled multispectral datasets for mapping flowering plants in the Kenyan savannah.
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David Masereti Makori, Elfatih M Abdel-Rahman, Tobias Landmann, Onisimo Mutanga, John Odindi, Evelyn Nguku, Henry E Tonnang, and Suresh Raina
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Medicine ,Science - Abstract
Pollination services and honeybee health in general are important in the African savannahs particularly to farmers who often rely on honeybee products as a supplementary source of income. Therefore, it is imperative to understand the floral cycle, abundance and spatial distribution of melliferous plants in the African savannah landscapes. Furthermore, placement of apiaries in the landscapes could benefit from information on spatiotemporal patterns of flowering plants, by optimising honeybees' foraging behaviours, which could improve apiary productivity. This study sought to assess the suitability of simulated multispectral data for mapping melliferous (flowering) plants in the African savannahs. Bi-temporal AISA Eagle hyperspectral images, resampled to four sensors (i.e. WorldView-2, RapidEye, Spot-6 and Sentinel-2) spatial and spectral resolutions, and a 10-cm ultra-high spatial resolution aerial imagery coinciding with onset and peak flowering periods were used in this study. Ground reference data was collected at the time of imagery capture. The advanced machine learning random forest (RF) classifier was used to map the flowering plants at a landscape scale and a classification accuracy validated using 30% independent test samples. The results showed that 93.33%, 69.43%, 67.52% and 82.18% accuracies could be achieved using WorldView-2, RapidEye, Spot-6 and Sentinel-2 data sets respectively, at the peak flowering period. Our study provides a basis for the development of operational and cost-effective approaches for mapping flowering plants in an African semiarid agroecological landscape. Specifically, such mapping approaches are valuable in providing timely and reliable advisory tools for guiding the implementation of beekeeping systems at a landscape scale.
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- 2020
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