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Background: Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response.Discussion: Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment.Conclusion: Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries. [ABSTRACT FROM AUTHOR]

Background: The presence of COVID-19 has led to the disruption of health systems globally, including essential reproductive, maternal, newborn and child health (RMNCH) services. This study aimed to assess the challenges faced by women who used RMNCH services in Nigeria's epicentre, their satisfaction with care received during the COVID-19 pandemic and the factors associated with their satisfaction. Methods: This cross-sectional survey was conducted in Lagos, southwest Nigeria among 1,241 women of reproductive age who had just received RMNCH services at one of twenty-two health facilities across the primary, secondary and tertiary tiers of health care. The respondents were selected via multi-stage sampling and face to face exit interviews were conducted by trained interviewers. Client satisfaction was assessed across four sub-scales: health care delivery, health facility, interpersonal aspects of care and access to services. Bivariate and multivariate analyses were used to assess the relationship between personal characteristics and client satisfaction. Results: About 43.51% of respondents had at least one challenge in accessing RMNCH services since the COVID-19 outbreak. Close to a third (31.91%) could not access service because they could not leave their houses during the lockdown and 18.13% could not access service because there was no transportation. The mean clients' satisfaction score among the respondents was 43.25 (SD: 6.28) out of a possible score of 57. Satisfaction scores for the interpersonal aspects of care were statistically significantly lower in the PHCs and general hospitals compared to teaching hospitals. Being over 30 years of age was significantly associated with an increased clients' satisfaction score (ß = 1.80, 95%CI: 1.10–2.50). Conclusion: The COVID-19 lockdown posed challenges to accessing RMNCH services for a significant proportion of women surveyed. Although overall satisfaction with care was fairly high, there is a need to provide tailored COVID-19 sensitive inter-personal care to clients at all levels of care. [ABSTRACT FROM AUTHOR]

Background: Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. Methods: This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. Results: Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33–55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22–4.01), diabetes (OR: 3.69, 95% CI: 1.99–6.85), renal disease (OR: 12.53, 95%CI: 1.97–79.56), cancer (OR: 14.12, 95% CI: 2.03–98.19) and HIV (OR: 1.77–84.15]. Conclusion: Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves. [ABSTRACT FROM AUTHOR]