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Background Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics. Methods The study was conducted at the federal level and in two states in Nigeria. The states were Lagos in the southwest and Enugu in the southeast. In-depth interviews were undertaken with 34 key informants. NVivo version 12 software was used for coding and thematic analysis. Results There were inadequate, inequitable and suboptimal resources (human, financial, equipment and materials) for the response. In some of the countermeasures, only people that were employed in the formal sector benefitted from the distribution of welfare materials and financial packages; the informal sector, which constitutes the majority of the poor population in Nigeria, was excluded. Conclusions Inequity and suboptimal availability of resources to control COVID-19 led to reduced effectiveness of the health system response to the disease in Nigeria. Such negative factors must be mitigated in future responses to pandemics in the country. [ABSTRACT FROM AUTHOR]

Background For effective Public Health measures, factors that influence Knowledge, Attitudes and Practices (KAP) need to be understood. In this paper, we document the relationship between levels of education on the KAP towards COVID-19 among the population of Edo State, Nigeria. Methods A cross-sectional KAP questionnaire was delivered across 13 communities. The study population was dichotomized into those who had or had not completed secondary education. Chi-square tests were conducted to determine statistical significance. Results Of the 538 participants, 30% had completed secondary education. Those with secondary education were significantly more likely to recognize symptoms of COVID-19 (P  < 0.001). For attitudes, only one option showed a statistically significant association with 78.4% of those who did not complete secondary education having a high confidence in the church compared with 66% of those who had (P  = 0.022). For practices, those who have completed secondary education practiced all of the supplied measures more than those who had not, except for taking herbal supplements. Discussion Higher levels of education impacts on knowledge and practices but has less impact on attitudes regarding how well certain individuals/organizations can handle the pandemic. Findings highlighted the importance of tailoring public health communication and strategies to local populations to improve the efficacy. [ABSTRACT FROM AUTHOR]

Background The COVID-19 outbreak is increasing and spreading rapidly globally, with over 20 million cases and 800, 000 thousand deaths reported in 216 countries as of 28th August 2020. Since the report of the index case in Nigeria in February 2020 by the Nigeria Center for Disease Control (NCDC), daily records of confirmed cases have been reported in all states in the country. On 3rd April 2020, an outbreak of Coronavirus disease-2019 (COVID-19) was confirmed in Ondo State, Southwest Nigeria. Field investigations were conducted by the State Ministry of Health (MoH) to identify and confirm additional cases. This paper provides the outcome of the epidemiological investigation of the outbreak to further guide outbreak response activities. Methods Outbreak settings Ondo State is in the South-West Zone of Nigeria with her capital at Akure. The State is situated between longitudes 40 151E and 60 001E of the Greenwich median and latitudes 50 451N and 70 451 N, which are to the North of the equator in the Southwestern geopolitical zones of the country. Field Investigation The investigation was conducted as part of outbreak control and response measures hence permission to conduct the study was obtained from the Ondo State Ministry of Health (OSMoH). Following an alert from clinicians at a government-owned Hospital, Akure, Ondo State on 30 March 2020, the index case of COVID-19, a 34-year-old male with recent travel history to India was investigated. He arrived at Ondo State on 21st March 2020 and presented at the hospital with cough, sore throat and running nose with the onset of symptoms on 23rd March 2020. The State public health emergency Rapid Response Team (RRT) comprising of Commissioner for Health, State Epidemiologist, State and LGA surveillance officers, and health development partners in the state visited the hospital to investigate and implement public health response. Nasopharygeal and oropharyngeal samples were collected and tested for COVID-19, and returned positive from the national reference laboratory on the 3rd of April 2020. Operational definitions During the onset of the outbreak, three categories of case definitions for COVID-19 were used to guide the outbreak investigations according to the Nigeria Center for Diseases Control (NCDC) guidelines. Suspect case: (1) This is a patient with acute respiratory illness (fever and at least one sign/ symptom of respiratory disease (e.g. cough, shortness of breath) and a history of travel to or residence in a country/area or territory reporting local transmission of COVID-19 disease during the 14 days prior to symptom onset; (2) or a patient/health care worker with any acute respiratory illness and has been in contact with a confirmed COVID-19 case in the last 14 days prior to the onset of symptoms; (3) or a patient with a severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g. cough, shortness of breath) and requiring hospitalization and with no other aetiology that fully explains the clinical presentation; (4) or a case for whom testing for COVID-19 is inconclusive. Confirmed case: A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms. Probable case: Any suspected case for whom testing for COVID-19 is indeterminate test result or for whom testing was positive on a pan-coronavirus assay Data analysis The State COVID-19 line-list and case investigation forms of all COVID-19 cases from 19th March to 9th August 2020 were retrieved from the state disease surveillance unit, information on key variables were extracted and exported into SPSS version 20 and analyzed. Descriptive statistics such as frequency table, mean (standard deviation) and charts were used to describe key variables including LGA, age, sex, occupation and education and clinical conditions of cases. The week of report of cases and outcomes were used to generate the epidemic curve. The Chi-square test was used to compare categorical variables including the socio-demographic characteristics, clinical condition and outcome of cases. Two-sided P-values <0.05 were considered statistically significant. Results Socio-demographic characteristics of cases A total of 4353 suspected cases were reported and tested for COVID-19, of which 1316 COVID-19 cases were confirmed, with a case fatality rate of 2.2% recorded in 7 of the 17 Local Government Areas that reported at least a confirmed case (Figure 1). Most of the confirmed cases (1169; 88.8%), resides in urban areas (LGAs) (Table 1). Majority [1110 (84.3%)] were within the age group 20 to 59 years, with a mean age of 37.8 ±14.8 years. Males (713; 54.2%) were more affected compare to females (603; 45.8). More than three quarters (1009; 76.7%) of the cases had a tertiary level of education. Health care workers (404; 30.7%) were most affected compared to other professionals as shown in Table 1. 1170 Figure 1: Open in new tab Download slide Distribution of suspected and confirmed COVID-19 cases in Ondo state, March to August 2020 1170 Figure 1: Open in new tab Download slide Distribution of suspected and confirmed COVID-19 cases in Ondo state, March to August 2020 1170 Table 1: Socio-demographic characteristics of respondents N = 1316 Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Open in new tab 1170 Table 1: Socio-demographic characteristics of respondents N = 1316 Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Variable.  Frequency.  Percentage.  Age in years       <5  18  1.4  5-19  84  6.4  20-39  666  50.6  40-59  444  33.7  60-79  96  7.3  ≥80  8  0.6  Gender       Male  713  54.2  Female  603  45.8  Location of cases       Rural  147  11.2  Urban  1169  88.8  Type of Education       None  15  1.1  Nursery  8  0.6  Primary  80  6.1  Secondary  204  15.5  Tertiary  1009  76.7  Occupation       Health workers  404  30.7  Businessman and woman  225  17.1  Civil servant  168  12.8  Others  182  13.8  Pupil/Student  129  9.8  Political office Holders  77  5.9  Engineer  48  3.6  Religious/traditional leader  24  1.8  Banker  24  1.8  Security officer  35  2.7  Open in new tab Admission and clinical conditions of confirmed cases From Table 2 , 88 (6.7%) of the confirmed cases were admitted as inpatient during investigation, while 325 (24.7%) were symptomatic. The first symptom reported by cases were as follows; cough (98; 30.2%), fever (74; 22.8%), headache (30; 9.2%), runny nose (39; 12.0%), sore throat (24; 7.4%) and difficulty in breathing (15; 4.6%). 1170 Table 2: Admission and clinical conditions of confirmed cases.  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2 .  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2  Others= abdominal pain; chills/sweats; joint pain; inability to walk; Nausea Open in new tab 1170 Table 2: Admission and clinical conditions of confirmed cases.  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2 .  Frequency.  Percentage.  Admitted as inpatient before lab testing   Yes  88  6.7  No  1228  93.3  Symptomatic       Yes  325  24.7  No  991  75.3  First symptom reported by respondents (n = 325)   Cough  98  30.2  Fever  74  22.8  Headache  30  9.2  Runny nose  39  12.0  Sore throat/pharyngitis  24  7.4  Difficulty breathing  15  4.6  New loss of taste  9  2.7  New loss of smell  8  2.5  Chest pain  7  2.2  General Body weakness  6  1.8  Others  15  4.6  Outcome       Alive  1287  97.8  Dead  29  2.2  Others= abdominal pain; chills/sweats; joint pain; inability to walk; Nausea Open in new tab Figure 2 described the epidemic curve of the outbreak from March to August 2020. The index case was confirmed on April 4, 2020. Thereafter, there was a surge in the number of confirmed COVID-19 cases with the outbreak reaching its peak on July 2, 2020. Afterwards, fluctuations in the number of cases were observed before a steady decline was recorded between August 3, 2020 and August 9, 2020. 1170 Figure 2 Open in new tab Download slide Epi-Curve of confirmed cases of COVID-19 in Ondo State, March to August 2020 1170 Figure 2 Open in new tab Download slide Epi-Curve of confirmed cases of COVID-19 in Ondo State, March to August 2020 Association between socio-demographic characteristics, clinical conditions and outcomes of cases In Table 3 , significant proportion of death occurred among cases within the age group 60 years and above (14; 13.5%) compared to other age groups (p < 0.001). Death occurred more among males (26; 3.6%) compared to the females (3; 0.5%) (p < 0.001). Furthermore, symptomatic cases had higher proportion (27; 8.3%) of deaths compared to asymptomatic cases (2; 0.2%) (P < 0.001). Among the symptomatic cases, a high proportion of death was found among those with difficulty in breathing (3; 20%), fever (11; 14.9%), new loss of taste (1; 11.1%), cough (9; 9.2%) and sore throat (2; 8.3%) (P < 0.001) 1170 Table 3: Association between socio-demographic characteristics and outcomes of cases Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Others = chest pain, diarrhea, fatigue, joint pain, malaise, nausea, vomiting Open in new tab 1170 Table 3: Association between socio-demographic characteristics and outcomes of cases Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Variable.  Outcome. .  Total.  P-value.  Dead.  Alive.  Age in years           <5  0 (0.0)  18 (100.0)  18  <0.001  5-19  0 (0.0)  84 (100.0)  84    20-39  2 (0.3)  664 (99.7)  666    40-59  13 (2.9)  431 (97.1)  444    ≥60  14 (13.5)  90 (86.5)  104    Gender           Male  26 (3.6)  687 (96.4)  713  <0.001  Female  3 (0.5)  600 (99.5)  603    Location of cases           Rural  5 (3.4)  142 (96.6)  147  0.294  Urban  24 (2.1)  1145 (97.9)  1169    Type of Education           None  1 (6.7)  14 (93.3)  15  0.630  Nursery  0 (0.0)  8 (100.0)  8    Primary  3 (3.8)  77 (96.2)  80    Secondary  4 (2.0)  200 (98.0)  204    Tertiary  21 (2.1)  988 (97.9)  1009    Occupation           Health workers  2 (0.5)  402 (99.5)  24    Businessman and woman  14 (6.2)  211 (93.8)  225    Civil servant  1 (0.6)  167 (99.4)  168  <0.001  Others  10 (5.5)  172 (94.5)  182    Pupil/Student  0 (0.0)  129 (100.0)  129    Politician  0 (0.0)  77 (100.0)  77    Engineer  0 (0.0)  48 (100.0)  48    Religious/traditional ruler  2 (8.3)  22 (91.7)  24    Banker  0 (0.0)  24 (100.0)  24    Security officer  0 (0.0)  35 (100.0)  35    Symptomatic           Yes  27 (8.3)  298 (91.7)  325  <0.001  No  2 (0.2)  989 (99.8)  991    First symptom       N = 325    Cough  9 (9.2)  89 (90.8)  98    Fever  11 (14.9)  63 (85.1)  74  <0.001  Headache  1 (3.3)  29 (96.7)  30    Running nose  0 (0.0)  39 (100.0)  39    Sore throat  2 (8.3)  22 (91.7)  24    New loss of taste  1 (11.1)  8 (88.9)  9    Difficulty in breathing  3 (20.0)  12 (80.0)  15    New loss of smell  0 (0.0)  5 (100.0)  5    Others  0 (0.0)  31 (100.0)  31    Others = chest pain, diarrhea, fatigue, joint pain, malaise, nausea, vomiting Open in new tab Conclusions The outcome of this investigation indicating high transmission among urban residence and health care workers are key public health concerns in the response to the COVID-19 outbreak in Ondo State, Nigeria. Furthermore, high case mortality among the older age groups requires public health intervention. Thus, we recommend intensified risk communication, enhanced surveillance activities, and use of community structures such as community and religious leaders, market and commercial vehicles associations, Ward Development Committee (WDC) and Village Development Committee (VDC) to ensure compliance with public health COVID-19 preventive measures particularly in the urban areas and among those facing a high risk of death. Furthermore, there is a need to prioritize public health interventions including training and vaccination among the vulnerable groups including health care workers who serve as front liners during case investigation, testing and case management. Key messages Enforcement of public health preventive measures particularly in urban settings, and supporting government to strengthen and monitor Infection Prevention and Control practices in hospital settings. [ABSTRACT FROM AUTHOR]

Background: Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health. Aim: To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria. Methods: This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05. Outcomes: Respondents were aged 20 to 50 years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers. Results: An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores. Clinical Implications: Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction. Strength and Limitations: Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results. Conclusion: A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown. [ABSTRACT FROM AUTHOR]

Background The neglected tropical disease (NTD) sector is adapting to the uncertain circumstances of coronavirus disease 2019 (COVID-19). The development of the Risk Assessment and Mitigation Action (RAMA) tool was driven by partners of the programme Accelerating the Sustainable Control and Elimination of NTDs (hereafter called Ascend) to enable countries to recommence NTD activities following the World Health Organization advisories of April and July 2020. This article explores the advantages of the RAMA process for NTD delivery. Methods The analysis used interview transcripts with NTD practitioners in Cote d'Ivoire, Guinea, Liberia and Nigeria and results from the monitoring of compliance with COVID-19 mitigation measures in Nigeria. Results Three themes emerged from the results: adaptability and innovation, collaboration and government ownership and preparedness. Conclusions The advantages of the RAMA tool suggest its importance in mitigating the transmission of COVID-19 during NTD delivery. There is the potential for the tool to be adapted for use throughout future pandemics. [ABSTRACT FROM AUTHOR]

Literature on the predictors of health behaviour initiation, interruption, consistency and discontinuation is scarce. This study sought to fill this gap by suggesting a model that takes into account these variables. Using the structural equation modelling, we surveyed 470 social media users in Nigeria and found that perceived vulnerability, perceived seriousness; benefits to action, self-efficacy and cues to action significantly predict health behaviour initiation. Also, the predictors of health interruption were found to be perceived vulnerability, perceived seriousness, benefits to action, challenges to action and perceived realness. The predictors of health behaviour consistency were found to be perceived vulnerability, perceived seriousness, benefits to action, perceived realness, self-efficacy and cues to action. Finally, the predictors of health behaviour discontinuation were found to be perceived vulnerability, perceived seriousness, perception on realness, behaviour fatigue and behaviour discomfort. We explored the implication of these results on health promotion and made suggestions for further studies. [ABSTRACT FROM AUTHOR]