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Background: Monkey pox (Mpox) is a zoonotic viral illness that is endemic to Africa. In contrast to earlier years, the current Mpox outbreak has had an unusually rapid worldwide spread in terms of the number of cases, and most of these cases were among Men who have Sex with Men (MSM). The study aims to assess the knowledge, attitude, practice of infection prevention, and stigma of Mpox disease among members of the MSM community. Methods: The study was a cross-sectional design. A self-administered questionnaire was given to 498 respondents. Results: The mean age of the respondents was 30 years; twenty-three (4.6%) of the total respondents identified themselves as female gender. Urban dwellers were 344 (69.1%). Respondents had a good knowledge of both Mpox disease and transmission; an average knowledge of Mpox symptoms; and an average attitude towards prevention and the practice of prevention of Mpox. Age was found to be significantly associated with knowledge of transmission (p-value). Mpox infection was evaluated as a low-risk event by most responses, but the existence of both community stigma and self-stigma if infected were rated as high. Conclusion: The knowledge of Mpox disease and its transmission was good, while the attitude and practice of infection prevention was average. However, the existence of community and self-stigmatization was high; which perhaps may result in the possibility of an iceberg phenomenon of Mpox disease in the MSM community. Community sensitization, advocacy, and key population-friendly services are recommended for the MSM community to improve their general access to healthcare and reduce stigmatisation.

Mpox presents typically with macular papular body rashes with similar-looking sores in genital or oral areas. It may be missed, or wrongly managed as sexually transmitted infections (STI), especially in settings where symptom-based treatment practices are sufficient for care. We describe a 40-year-old cisgender male, heterosexual Nigerian who developed some rash in the genital region associated with penile swelling. It was suspected to be syphilis and managed with presumptive antibiotics. Laboratory investigation (PCR) confirmed that it was a Mpox disease, and VDRLT was negative. Notably, in this case, the early symptoms were a paradigm case of Mpox disease presenting as an STI, which syndromically conformed more to an STI than the case definition for a suspected case of Mpox in our setting. Consequently, the expected early containment activities were delayed. This increased the potential of further disease spread. An Update of the standard case definition as well as a reclassification of the disease as a possible STI is recommended for enhanced surveillance, increased case detection, and reduction in the burden of unrecognized cases.

Cholera is a potentially life-threatening public health menace caused by a gram-negative rod-shaped bacterium known as Vibrio cholerae. This study was an epidemiological investigation of the cholera outbreak in Degema local government area (LGA), Rivers State, Nigeria. An interventional epidemiological study was conducted in a rural community between December 2021 to February 2022. All suspected cases were identified using the World Health Organization (WHO) case definition of acute watery diarrhoea. The standard outbreak investigation procedures (active case search, case management, water sanitation, hygiene) were implemented. The cholera outbreak observed two waves within an at-risk population of 373,071 in the affected LGA. Of the 35 line-listed suspected cases (male-20 versus female-15), the highest frequency was observed among those aged 0-5 years. The index case was reported on the 3rd of December in the 47th week of 2021 and abated by the 49th week, while the 2nd wave began in the 1st week of 2022 and abated by the 6th week. The stool samples result revealed; six positives for RDT, while four samples were positive by microscopy. All patients received home-based treatment except for two cases that were managed at the healthcare facility. The attack and case fatality rates were 0.01, and 8% respectively. The Rivers State public health emergency operation centre deployed standard epidemiological interventions for the containment of acute watery diarrhoea (cholera) aimed at reducing morbidity and mortality; however, vaccines were not part of the response. The deployment of vaccines and provision of potable water will improve response outcomes.

Background: Healthy and well-nourished children are better able to participate completely in school and hence profit from education. Poor hygiene habits contribute to the increasing burden of communicable diseases by causing days lost to illness. The study aims to compare the level of knowledge and practice of personal hygiene of pupils of public and private schools in an urban Local Government Area of Rivers State, Nigeria. Methods: This comparative cross-sectional study was conducted in four public and private primary schools in Port Harcourt LGA, Rivers State. The sample size was calculated and 139 pupils were randomly selected, 75 in the public and 64 in the private schools. Data collection was done with the use of interviewer-administered questionnaire. Data was analysed using SPSS Version 16. Differences in means were compared using Student’s t-test while association between categorical variables were examined with Chi-Square (X2) test. A probability value ≤0.05 was considered statistically significant. Results: Public and private school pupils had very good hygiene knowledge (Χ2=0.101; p=0.97). Assessment of the personal hygiene revealed that the proportion of pupils who were rated as ‘very clean’ was higher in the private schools than the public schools, although not statistically significant (Χ2=2.881; p=0.277). There were significant differences in favour of the private schools in the cleanliness of the nails, body (skin) and mouth/teeth with p-values of 0.027, 0.003 and 0.003 respectively. Conclusions: Pupils in public and private schools have a very high level of hygiene knowledge but low hygiene practice. This could indicate that additional health personnel are needed in Nigeria and other poor nations to care for the health of schoolchildren.

ObjectivesNigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic.DesignA retrospective analysis of national surveillance data.Setting33 of 37 states (including the Federal Capital Territory) in Nigeria.ParticipantsPersons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data.Outcome measuresAttack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs.ResultsOverall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5–14 years and women aged 25–44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96).ConclusionsCholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country.

Background As with any epidemic, coronavirus disease 2019 (COVID-19) has evoked panic, fear and misconceptions. The risk communication pillar of the Public Health Emergency Operations Centre is responding to the pandemic by facilitating correct and consistent information to enable the adoption of behaviours to prevent and control COVID-19. This study explored awareness, perception and practice of COVID-19 prevention among residents in Rivers State, Nigeria, during the early stages of the COVID-19 pandemic response. Methods This was a descriptive cross-sectional survey among 1294 adult residents across all districts of the state. It employed an interviewer-administered questionnaire. Knowledge was graded as excellent for scores of ≥80%, good for scores of 50–79% and poor for scores of Results The respondents were aged 18–80 y with an average age of 39.6 (SD=11.9) y. A total of 710 (54.9%) were male, 476 (36.8%) were unemployed with 685 (52.9%) having secondary education. The most common sources of information about COVID-19 were radio jingles (1102; 86.7%) and television adverts (940; 74.0%). Overall, 608 (47.0%) of the respondents had a poor knowledge of COVID-19. About 443 (34.9%) respondents believed they were unlikely to contract the virus. Only 505 (39.0%) of respondents washed all the critical parts of their hands correctly. Occupation (adjusted OR [AOR]=1.39, 95% CI 1.07 to 1.82, p=0.01), level of education (AOR=4.71, 95% CI 1.90 to 11.68, p Conclusions Broadcast media has a pivotal role to play in risk communication for behavioural change for the control of current and future epidemics in this population.

Background Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awareness, knowledge, attitude, perception, and practice of Covid-19 prevention among healthcare workers in Rivers State, Nigeria. Methods This was a descriptive cross-sectional survey carried out six weeks into Rivers State response that commenced on February 20, 2020, in the 23 Local Government Areas (LGAs). State Disease Surveillance and Notification Officers used multistage sampling to recruit 555 healthcare workers for the survey. A self-designed structured interviewer-administered questionnaire built into the Open Data Kit application for android phones was used for data collection. Descriptive data analysis was done, and outputs presented as frequency and percentages. Results There was a total of 372 (67.0%) female respondents. Majority of study participants had tertiary education 453 (81.6%). The mean age of study participants was 40.6 years (Standard Deviation = 7.8 years). Furthermore, 285 (51.4%) were Community Health Workers, and had over ten years practicing experience 393 (70.8%). Most healthcare workers 554 (99.8%) had heard about Covid-19, through radio 539 (97.1%), and television 445 (80.2%) yet 213 (38.4%) respondents did not know that it is caused by a virus. Most respondents 415 (74.8%) had good knowledge about Covid-19. However, only 148 (26.7%) would refer suspected cases to a facility and only 365 (65.8%) respondents demonstrated the correct hand washing technique. Conclusion There are some gaps in health worker knowledge, attitude, perception, and practice of Covid-19 prevention. Interventions to bridge these gaps are needed for effective containment of this pandemic.

Background COVID-19 has accounted for approximately six million deaths globally. Several risk factors have been identified. However, population profile varies in different population groups. Aim The study aim is to describe the population profile of COVID-19 mortality in Rivers State, Nigeria using captured population-based health records. Study design: Retrospective cohort study Methods Using electronic State Health Records, a secondary data analysis was conducted on recorded COVID-19 mortality. Data were obtained from the Public Health Emergency Operations Centre (PHEOC) at the State Ministry of Health. Data was accessed from the PHEOC database, and it included COVID-19 related mortality. Data were collected on demographics, pre-existing comorbidity, symptoms, facility managed, patient status, treatment outcome, and dates of related events. Cohort characteristics were described using means and proportions. Results There were 191 COVID-19 deaths identified. The mean age was 57.08; of which 144 were male (75.4%). The 51–65-year age group had the highest mortality count (38.9%). Over 50% of the patients were hypertensive and diabetes was the second most common comorbidity (28.8%). Running nose, cough, fever and breathing difficulties were the most reported COVID-19 symptoms. Conclusion Data from this study shows higher mortality in men from COVID-19; and, among cases with hypertension and diabetes. Additionally, age and the presence of comorbidities may be associated with COVID-19 mortality. Future research in this area could further explain these findings.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2) is the causative agent for COVID‑19...

ObjectiveDespite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria.DesignRetrospective cohort study.SettingCOVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control.ParticipantsIndividuals who were investigated for SARS-CoV-2 using real-time PCR testing during the study period 27 February–8 June 2020.MethodsCOVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs.ResultsA total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trendConclusionThe significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals.

Introduction:the knowledge of epidemiologic and clinical variables in patients with SARS- CoV-2 infection provides evidence and lessons that are useful for the pandemic response, with consideration of National and sub-National variations. The objective of this study was to characterize and describe the clinical and epidemiologic features of all the hospitalised patients with COVID-19 in Rivers State Nigeria, from March to August 2020. Methods:a prospective descriptive multi-center study of patients with positive SARS-CoV-2 RT PCR, who were hospitalised for treatment and self-isolation in four treatment centers in Rivers state, Nigeria. Results:the mean age of all the patients was 39.21 ± 12.31 years, with a range of 2 to 77 years. The majority of patients were in the 31 to 40-year (33.0%), 41 to 50-year (23.1%) and 18-to 30-year (22.0%) age groups. The patient population included 474 (73.4%) males and 172 (26.6%) females, with 93 (14.4%) healthcare workers. A history of contact and travel was established in 38.5% and at least one comorbid disease condition was present in 32.8% of patients. Patients with severe disease were 61 (9.45%), while the overall case fatality rate was 2%. The leading comorbid disease conditions were Hypertension in 23.8% and diabetes in 7.7% of patients. Fever (26.0%), dry Cough (17.6%), dyspnoea (12.7%), anosmia (12.7%) and headache (9.9%) were the most common symptoms. The presence of comorbidity and increasing age predicted death from COVID-19. Conclusion:the clinical and epidemiologic characteristics of this cohort of hospitalised patients show significant similarities with existing trends from previously reported studies, with contextual peculiarities.

BackgroundThis research explored awareness, perception, and practice of COVID 19 prevention among residents of communities in all the local government areas (districts) in Rivers State during the early stages of the pandemic response.DesignThis was a descriptive cross-sectional survey which employed an interviewer-administered four-page questionnaire built into the Open Data Kit application for android phones. Knowledge and practice scores were computed by scoring every correct response/action as 1 and wrong responses as 0. Knowledge was graded as excellent for scores of ≥80%, good for scores of 50-79% and poor for scores of SettingRivers State in the South-South region of Nigeria had recorded over 2000 cases of COVID 19 as of 18th August 2020, ranking 5th among the high burden states in Nigeria. As with any epidemic of an infectious nature, panic, fear, and misconceptions are rife. Risk communication utilizes multi-faceted activities geared towards facilitating correct and consistent knowledge and prevention practice.ParticipantsStudy involved 1,294 adult community residents in the 23 districts of the state.ResultsThe respondents were aged between 18 and 80 years with average age of 39.6 years (SD = 11.9 years). A total of 710 (54.9%) were male, 476 (36.8%) were unemployed with 685 (52.9%) having secondary education. Almost all respondents 1,271 (98.2%) had heard about COVID 19. The three most common sources of information about COVID 19 were radio jingles 1102 (86.7%), television adverts 940 (74.0%) and announcements in Church 612 (48.2%). Overall, 608 (47.0%) of the respondents had poor knowledge of COVID 19. About 1167 (90.2%) of the respondents who were aware of COVID 19 acknowledged that COVID 19 is a problem in the state while 443 (34.9%) respondents believed they were unlikely contract the virus. Only 505 (39.0%) of the respondents washed all critical parts of the hand correctly.ConclusionsRisk communication interventions during pandemics need to be based on an understanding of the gaps in knowledge, attitude, perceptions, and practice. Broadcast media has a pivotal role to play in risk communication for behaviour change for the control of current and future epidemics in this population.

The methanol poisoning outbreak in Rivers State, Nigeria in May 2015, involved 84 persons in five local government areas. An incident management system comprised of an Emergency Preparedness and Response (EPR) committee and the Local Government Area Rapid Response Teams in an Emergency Operations Centre (EOC). The EOC teams conducted case finding activities, line listing, and descriptive analysis, a retrospective cohort study and collection of local gin samples for laboratory investigation. They also coordinated community mobilization and sensitization activities, intervention meetings with local gin sellers, trace back activities and case management. Those affected were male (72; 85.7%) aged between 20 and 79 years. Of the 55 persons whose socio-demographics were obtained, forty-one persons (74.6%) were married, and 23 (41.8%) had primary education. Case fatality rate was 83.3% with an attack rate of 16 per 100,000 persons. Those exposed to ingestion of adulterated gin were six times more likely to develop methanol poisoning than those not exposed RR=6 (1.0-38.5); P=0.0078. It is hoped that this experience has positioned the state for better preparedness towards future outbreaks.