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BackgroundThe current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.MethodsIn this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 62,020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred.Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders.P-value ≤0.05 was considered statistically significant.ResultsA total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P P = 0.001, 95%CI = 1.4–4.0, death: HR = 2.30,P = 0.001, 95%CI = 1.2–4.6, for those with hypertension only} {severe/critical illness: HR = 3.76,P = 0.001, 95%CI = 2.1–6.4, death: crude HR = 6.63,P = 0.001, 95%CI = 3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities.ConclusionThe potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

Background: In April 2020, a community-based active case search surveillance system of coronavirus disease 2019 (COVID-19) was developed by the emergency outbreak committee in Lagos State. This followed the evidence of community transmission of coronavirus disease in the twenty Local Government Areas in Lagos State. This study assessed the value of respiratory and other symptoms in predicting positive SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR). It is hoped that if symptoms are predictive, they can be used in screening before testing. Methods: Communities were included based on the alerts from community members through the rumour alert system set up by the state. All members of the households of the communities from where the alert came were eligible. Household members who declined to participate were excluded from the study. A standardised interviewer-administered electronic investigation form was used to collect sociodemographic information, clinical details and history for each possible case. Data was analysed to see the extent of agreement or correlation between reported symptoms and the results of PCR testing for SARS-COV-2. Results: A total of 12,739 persons were interviewed. The most common symptoms were fever, general weakness, cough and difficulty in breathing. Different symptoms recorded different levels of sensitivity as follows: fever, 28.9%; cough, 21.7%; general body weakness, 10.9%; and sore throat, 10.9%. Sensitivity and specificity for fever, the most common symptom, were 28.3% and 50.2%, respectively, while similar parameters for general body weakness, the next most common symptom, were 10.9% and 73.2%, respectively. Conclusion: From these findings, the predictive ability of symptoms for COVID-19 diagnosis was extremely weak. It is unlikely that symptoms alone will suffice to predict COVID-19 in a patient. An additional measure, such as confirmatory test by RT-PCR testing, is necessary to confirm the disease.

BackgroundMalaria transmission affects malaria infection rates. There are several potential drivers of malaria transmission. A suitable meteorological factor such as rainfall, temperature, and relative humidity encourages the breeding of the vector. This improves the survival of the parasite in the host. The female Plasmodium falciparum plays a crucial role in the variability of malaria prevalence. Lagos State is a coastal malaria-endemic area in Nigeria. This study presents a correlation analysis of malaria cases and meteorological factors between the periods of January 2015 to April 2018 in Lagos state.MethodsThe study was a secondary data analysis of meteorological variables and records of malaria cases reported by health facilities in Lagos state. We accessed weather variables through free access “weather underground.com” a meteorological data sharing service system (MDSSS). The MDSSS provides real-time online weather information from four meteorological monitoring stations in Lagos state. We accessed the malaria cases through the district health information system 2 databases. It is used to report cases of malaria by all the private and public health facilities in the state. We performed the correlation analyses to show the relationship between temperature, humidity, rainfall, and malaria cases at a 5% level of significance. We analysed data using the statistical package for social sciences version 25.ResultsMalaria cases peaked between the period of July to November 2016 and the period of April to May 2017 and declined between March to May 2017. The temperature, relative humidity, and rainfall showed a positive correlation with malaria cases. The temperature is most correlated with the occurrence of malaria cases (r = 0.65, p< 0.02).ConclusionThis correlation analysis provides an approach for studying the impact of meteorological variability on the prevalence of malaria cases. This can help to forecast the malaria epidemic while preparing for the elimination of malaria in Lagos state.

Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients with COVID-19. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying or being discharged by July 6, 2020. Variables were compared between hypertensive and non-hypertensives using univariable and multivariable logistic regression, cox regression and Kaplan Meier survival analysis methods to assess hypertension as a risk factor associated with worsened disease severity and death.Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension was 17.8% and it was the most common comorbidity followed by diabetes (7.2%) and asthma (2.0%). Overall mortality from COVID-19 was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (PConclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.

Introduction : cholera is a highly infectious disease caused by Vibrio cholerae. On 19th of August suspected outbreak of cholera was reported in Oshodi Isolo Local Government Area (LGA), Ogun State. We investigated to establish the occurrence of an outbreak and determine the risk factors for spread of the disease. Methods : a case control study was carried out. We reviewed medical records to identify cases. We used a semi-structured questionnaire to obtain information on demography, clinical history, symptoms and exposure factors. We collected stool specimens, food sample (Abacha) and water specimens for analysis. We analyzed for presence of Vibrio cholera. We performed bivariate and multivariable analysis to assess the association of risk factors. Results : a total of 37 cases were identified with 5 deaths (attack rate of 7.32/100,000 and case fatality rate of 11.4%). Age group mostly affected were individuals Conclusion : health education with emphasis on the importance of hand washing with soap and water and environmental hygiene were conducted. Sanitary inspection was recommended to the local authorities.