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Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births.

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. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria., Materials and Methods: This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics., Results: The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns., Conclusions: The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Introduction: to support polio eradication activities in Nigeria, in 2012 the National Polio Emergency Operation Center (NEOC) created the Management Support Teams (MST) to address gaps in the quality of supervision of polio vaccination teams. The National Stop Transmission of Polio (NSTOP) Program supported the polio eradication activities by deploying trained supervisors as part of the MST for polio and non-polio immunization campaigns., Methods: trained MST members were deployed approximately 4 days before the start of the campaign to participate in pre-implementation activities and supervise vaccination teams during campaigns. Terms of reference (TOR) developed by NEOC was provided to MST members to guide their activities. Qualified MSTs that met pre-determined criteria were selected and deployed to the field to support pre, intra and post campaigns activities., Results: a pool of over 400 MST personnel have been identified, trained, and repeatedly deployed from 2012 till 2016. The number of deployed MST personnel rose from 40 per campaign in October 2012 to 342 in May 2016. Of these, 270 (79%) MST personnel were deployed to 11 polio high-risk states of northern Nigeria, where campaigns are conducted between eight and ten times yearly as planned by NEOC. For measles campaigns, about 300 (75%) MST personnel were deployed for the one-off northern and southern campaigns in 2016. The results of clustered Lot Quality Assurance Sampling (LQAS) post-campaign vaccination coverage surveys, a measure of campaign quality, of which introduction into the polio program coincided with deployment of MSTs, showed improvement over time, from 10% (very poor quality) in February 2012 to about 90% (good quality) in December 2016., Conclusion: the deployment of MST personnel increased the number of trained supervisors in the field, frequency of supervisory visits and had a positive impact on the quality of polio campaigns., Competing Interests: The authors declare no competing interests., (©Aboyowa Arayuwa Edukugho et al.)

Introduction: Acute flaccid paralysis (AFP) pictorial surveillance reminder cards (AFP cards) could aid AFP case identification during supplementary immunization activities (SIAs). We assessed the availability and utilization of AFP cards among vaccination teams during the December 2014 polio SIAs in Jigawa State, Nigeria., Methods: We conducted a cross-sectional survey of a convenience sample of 95 vaccination team supervisors. We used a semi-structured interviewer-administered questionnaire to collect information on socio-demographics, knowledge of AFP cases, availability and utilization of the AFP cards for case identification and investigation and non-compliance resolution by vaccination teams. Univariate and bivariate analyses were performed using Epi Info version 3.5.1., Results: Of the 95 supervisors interviewed, 86 (91%) reported that vaccinators properly displayed the AFP cards, 90 (95%) reported use of cards for AFP case identification, 88 (93%) reported use of cards to resolve non-compliance with polio vaccination and 77 (81%) reported use of cards to ask caregivers six key questions to prevent missed children. Fifty-eight (61%) supervisors knew the AFP case definition. A total of 21 possible AFP cases were identified by vaccination team members with the aid of the cards, of which 17 (81%) were referred to the nearest health facility., Conclusion: The survey demonstrated usefulness of reminder cards for identification and follow-up of AFP cases. Based on these findings, use of AFP cards was implemented in all Nigerian States and similar cards were developed and implemented for measles surveillance during SIAs., (©Lilian Akudo Okeke et al.)