SARS-CoV-2 population-based seroprevalence surveys are useful for estimating the extent of SARS-CoV-2 infections, which may be underestimated by COVID-19 case counts. Surveys conducted in October 2020 in four Nigerian states showed that SARS-CoV-2 seroprevalence ranged from 9.3% in Gombe (northeast) to 25.2% in Enugu (southeast) after the first COVID-19 wave, more than 100 and 700 times higher than the official number of COVID-19 cases in these two states, respectively. We conducted a serosurvey after the second COVID-19 wave to evaluate the extent of SARS-CoV-2 infections, attitudes to COVID-19 vaccines, and COVID-19 vaccination coverage in two regions of Nigeria. Using the World Health Organization (WHO) Unity protocol, 34 enumeration areas (EAs) each in the Federal Capital Territory (FCT) (Northcentral Zone) and Kano State (Northwest Zone) were sampled in June 2021, using probability proportional to estimated size; 20 households in one EA were randomly selected. All consenting and assenting members of a household were asked about risk behaviors; adults who were 18 years and above (the eligible population for COVID-19 vaccination in Nigeria) responded to questions on COVID-19 vaccine attitudes and receipt. Blood and nasal/oropharyngeal samples were taken from all consenting and assenting household members. Blood samples collected were tested with the Luminex xMAP® SARS-CoV-2 Multi-Antigen IgG Assay and swabs by reverse-transcriptase-PCR (RT-PCR). Overall response rates were 76.8% in the FCT (n = 1,505 blood draws) and 80.4% in Kano State (n = 2,178 blood draws). Following the second COVID-19 wave in Nigeria, more than 40% of residents in the FCT (40.3%, 95% CI: 34.7–45.9) and Kano State (42.6%, 95% CI: 39.4–45.8) had evidence of prior SARS-CoV-2 infection. There were no active SARS-CoV-2 infections detected by RT-PCR in either the FCT or Kano State. In the FCT and Kano State, 3.4% and 1.6% of people surveyed reported receipt of any COVID-19 vaccine, three months after vaccines were available in country. In the FCT, 77.5% of adults were aware of COVID-19 vaccines, of whom 46.9% reported willingness to receive them. In Kano State, 48.7% of adults were aware of COVID-19 vaccines, of whom 61.1% were willing to receive them. In both regions, about 84% of those reporting unwillingness to accept COVID-19 vaccines cited concerns over vaccine safety. “Serosurvey findings revealed that SARS-CoV-2 infection was far more widespread in both the Federal Capital Territory and Kano State than indicated by reported case numbers. Despite high awareness, COVID-19 vaccine uptake remained low, primarily due to concerns about vaccine safety. These results highlight the urgent need for targeted risk communication to address vaccine hesitancy and improve coverage. Serosurveys provide valuable insights that can guide public health interventions and future pandemic preparedness in Nigeria.”

COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98-57∙73)] than in the second wave [19∙19 (17∙60-20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35-2∙02) and second wave 1∙52 (1∙11-2∙06)], being symptomatic [aIRR 3∙17 (2∙59-3∙89) and 3∙04 (2∙20-4∙21)], and being hospitalised [aIRR 4∙19 (3∙26-5∙39) and 7∙84 (4∙90-12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country's surveillance system during the study.

Background Infection prevention and control (IPC) activities play a large role in preventing the transmission of SARS-CoV-2 in healthcare settings. This study describes the state of IPC preparedness within health facilities in Nigeria during the early phase of coronavirus disease (COVID-19) pandemic. Methods We carried out a cross sectional study of health facilities across Nigeria using a COVID-19 IPC checklist adapted from the U.S Centers for Disease Control and Prevention. The IPC aspects assessed were the existence of IPC committee and teams with terms of reference and workplans, IPC training, availability of personal protective equipment and having systems in place for screening, isolation and notification of COVID-19 patients. Existence of the assessed aspects was regarded as preparedness in that aspect. Results In total, 461 health facilities comprising, 350 (75.9%) private and 111 (24.1%) public health facilities participated. Only 19 (4.1%) health facilities were COVID-19 treatment centres with 68% of these being public health facilities. Public health facilities were better prepared in the areas of IPC programme with 69.7% of them having an IPC focal point versus 32.3% of private facilities. More public facilities (59.6%) had an IPC workplan versus 26.8% of private facilities. Neither the public nor the private facilities were adequately prepared for triaging, screening, and notifying suspected cases, as well as having trained staff and equipment to implement triaging. Conclusions The results highlight the need for government, organisations and policymakers to establish conducive IPC structures to reduce the risk of COVID-19 transmission in healthcare settings.

ObjectivesThis study aimed to develop and validate a symptom prediction tool for COVID-19 test positivity in Nigeria.DesignPredictive modelling study.SettingAll Nigeria States and the Federal Capital Territory.ParticipantsA cohort of 43 221 individuals within the national COVID-19 surveillance dataset from 27 February to 27 August 2020. Complete dataset was randomly split into two equal halves: derivation and validation datasets. Using the derivation dataset (n=21 477), backward multivariable logistic regression approach was used to identify symptoms positively associated with COVID-19 positivity (by real-time PCR) in children (≤17 years), adults (18–64 years) and elderly (≥65 years) patients separately.Outcome measuresWeighted statistical and clinical scores based on beta regression coefficients and clinicians’ judgements, respectively. Using the validation dataset (n=21 744), area under the receiver operating characteristic curve (AUROC) values were used to assess the predictive capacity of individual symptoms, unweighted score and the two weighted scores.ResultsOverall, 27.6% of children (4415/15 988), 34.6% of adults (9154/26 441) and 40.0% of elderly (317/792) that had been tested were positive for COVID-19. Best individual symptom predictor of COVID-19 positivity was loss of smell in children (AUROC 0.56, 95% CI 0.55 to 0.56), either fever or cough in adults (AUROC 0.57, 95% CI 0.56 to 0.58) and difficulty in breathing in the elderly (AUROC 0.53, 95% CI 0.48 to 0.58) patients. In children, adults and the elderly patients, all scoring approaches showed similar predictive performance.ConclusionsThe predictive capacity of various symptom scores for COVID-19 positivity was poor overall. However, the findings could serve as an advocacy tool for more investments in resources for capacity strengthening of molecular testing for COVID-19 in Nigeria.

www.jogh.org • doi: 10.7189/jogh.10.020399 1 December 2020 • Vol. 10 No. 2 • 020399 1 Nigeria Centre for Disease Control, Abuja, Nigeria 2 African Field Epidemiology Network, Abuja, Nigeria 3 Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Nigeria 4 Center for Global Health, Centers for Disease Control and Prevention, FCT Abuja, Nigeria 5 School of Public Health, University of the Western Cape, Cape Town, South Africa 6 World Health Organisation, Abuja, Nigeria 7 Resolve to Save Lives Resolve to Save Lives (Vital Strategies), Abuja, Nigeria 8 World Bank, Nigeria Country Office, Abuja, Nigeria 9 Tony Blair Institute, Tony Blair Institute for Global Change, London, UK 10 George Town University Center for Global Health Practice and Impact, Abuja, Nigeria 11 Public Health England International Health Regulations (IHR) Strengthening Project, British High Commission, Abuja, Nigeria 12 Nigeria Port Health Services, Federal Ministry of Health Abuja, Nigeria 13 ECOWAS Regional Center for Disease Surveillance and Control, Abuja-Nigeria 14 Africa Centers for Disease Control and Prevention, African Union Commission, Addis Ababa Ethiopia 15 Department of Hospital Services, Federal Ministry of Health Abuja, Federal Secretariat Abuja, Nigeria 16 Lagos State Ministry of Health Ikeja, Lagos, Nigeria 17 College of Medicine, University of Lagos Teaching Hospital Lagos, Nigeria 18 Health and Human Services Secretariat Federal, Capital Territory Administration, Abuja, Nigeria 19 Kano State Ministry of Health, Kano, Nigeria 20 Ogun State Ministry of Health Abeokuta, Nigeria 21 Federal Ministry of Agriculture and Rural Development, Federal Secretariat Abuja, Nigeria 22 National Veterinary Research Institute Vom, Plateau State, Nigeria 23 Nigerian Institute of Medical Research, Lagos, Nigeria 24 Institute of Global Health, University College London, London, UK 25 Department of Infectious Diseases, Cambridge University Hospitals, Cambridge, UK © 2020 The Author(s) JoGH © 2020 ISGH

Event Abstract Back to Event The Lead Poisoning Control in Zamfara and Niger States, Nigeria: A 2010-2018 Review Nasir Tsafe Umar-Tsafe1, 2*, Adebola T Olayinka3, 4, Saad Ahmed4, Muhammad S Shehu4, Gaby Poggensi2, Abdulrazaq Habib5, Kabir Sabitu2, 4, Patrick M Nguku2, Abubakar Jafiya2, Mairo Kachalla2, Aishatu Binu Gubio2, Hawwa Inna Muhammad2, Sagir Aliyu6, Bashir Idris1, Bara’atu Shehu1, Abdulrahman Isah1, Halilu Ahmad1, Yusuf Madaro1, Rabi Usman1, Ibrahim Halilu1, Habibu Yalwa1, Hauwa Kolo7, Endie Waziri2, Saheed Gidado2, Mahmud Dalhat2, Benjamin J Mwangombe8, Ruth Olabiyo8, Gbemisola Oloruntuyi8, Abdullahi Zakariyya Yauri8, Balkisu A Shinkafi9, Nasir Sani-Gwarzo7, Zubairu Iliyasu5, Aisha Indo Mamman4, Hassan S Isah4, Shehu Akuyam4, John I. Anetor10 and Mary Jean Brown11 1 Ministry of Health, Zamfara State, Nigeria 2 Nigeria Field Epidemiology and Laboratory Training Program (NFELTP), Nigeria 3 Nigerian Centre for Disease Control (NCDC), Nigeria 4 Faculty of Medicine, College of Health Sciences, Ahmadu Bello University, Nigeria 5 Bayero University Kano, Nigeria 6 Zamfara Environmental Sanitation Agency, Nigeria 7 Federal Ministry of Health (Nigeria), Nigeria 8 Medicines Sans Frontiers (Nigeria), Nigeria 9 School of Science, Federal University of Technology, Nigeria 10 College of Medicine, University of Ibadan, Nigeria 11 National Center for Environmental Health (CDC), United States Background The lead poisoning (LP) disasters in Zamfara (2010) and Niger States (2015), Nigeria, were described as largest in modern times by scope and magnitude. LP due to artisanal gold-ore processing activities, affected children less than five years old (U5) with acute-severe outbreaks. This review provides an update on magnitude, scope, environmental, clinical, safety and other interventions applied to control and prevent further menace. Methods Secondary data reviewed on reports, publications from LP outbreaks and related studies (2010-2018): house-to-house cross-sectional, scoping-chain-referral and cluster sampling surveys. These covered 14 and 1 local government areas of Zamfara and Niger States, respectively. Standard interventions were applied by stakeholders based on Lead contamination (LC) values: >400 ppm defined elevated soil lead levels (ESLL), ≥5 and ≥10 µg/dL defined elevated blood lead levels (EBLL), confirming LP in U5 and animals, respectively. LCs were analysed in blood samples from U5s/animals, soil, water, food-items/crops, air, gold-ore materials and other environmental samples, using lead care II, X-ray fluorescence, atomic absorption and inductively-coupled-mass spectrometers. Data were analysed using SPSS, OpenEpi 2.3 and Epi-Info 7. Results The highest ESLL, EBLL were >150,000ppm, >700µg/dL (2010) and >550,000ppm, 300µg/dL (2015), in Zamfara and Niger States, respectively. These reduced to 10,000ppm, 30µg/dL and 1,000ppm, 29.7µg/dL (2018). Highest animal-EBLL were >300µg/dL (Zamfara,2010) and >270µg/dL (Niger,2015). LC Levels in other samples were significantly above their respective US-EPA standards. The strongest risk-factor associations between U5s requiring chelation therapy and environmental LCs were significant (OR: 5.8, 95% CI: 1.7, 19.1, P<0.01, Zamfara) and (OR: 32.8, 95% CI: 7.6, 141.9, P<0.001, Niger). Over 10,200 and 281 U5s were screened, with >7,200 and 180 successfully treated of LP, in Zamfara and Niger States, respectively (2010-2018). Conclusion LP-based U5 mortality (734-Zamfara and 28-Niger) has ceased. Zamfara LP morbidity-prevalence effectively reduced from >97%(2010) to <3%(2018), Niger’s reduced from 98%(2015) to <1%(2018). LP control program in Niger was so successful, handing-over by December 2018, whereas in Zamfara, >3,000 LP U5s are continuously exposed to LCs. Zamfara disaster remains an emergency, due to ineffective re-contamination control, access to low-cost intervention mechanisms, inadequate Government responses. Recommendations: environmental remediation, chelation therapy, safer mining practices/health education, continuous surveillance, other control and prevention measures. Keywords: Lead Poisoning, Chelation Therapy, Soil remediation, Zamfara, Niger, Nigeria, EBLL, Safer mining Conference: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”, Putrajaya, Malaysia, 3 Dec - 5 Feb, 2019. Presentation Type: Poster Presentation Topic: Miscellaneous Citation: Umar-Tsafe N, T Olayinka A, Ahmed S, S Shehu M, Poggensi G, Habib A, Sabitu K, M Nguku P, Jafiya A, Kachalla M, Binu Gubio A, Inna Muhammad H, Aliyu S, Idris B, Shehu B, Isah A, Ahmad H, Madaro Y, Usman R, Halilu I, Yalwa H, Kolo H, Waziri E, Gidado S, Dalhat M, J Mwangombe B, Olabiyo R, Oloruntuyi G, Zakariyya Yauri A, A Shinkafi B, Sani-Gwarzo N, Iliyasu Z, Indo Mamman A, S Isah H, Akuyam S, Anetor JI and Jean Brown M (2019). The Lead Poisoning Control in Zamfara and Niger States, Nigeria: A 2010-2018 Review. Front. Pharmacol. Conference Abstract: International Conference on Drug Discovery and Translational Medicine 2018 (ICDDTM '18) “Seizing Opportunities and Addressing Challenges of Precision Medicine”. doi: 10.3389/conf.fphar.2019.63.00028 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 05 Nov 2018; Published Online: 17 Jan 2019. * Correspondence: Dr. Nasir Tsafe Umar-Tsafe, Ministry of Health, Zamfara State, Zamfara, Nigeria, untsafe@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Nasir Tsafe Umar-Tsafe Adebola T Olayinka Saad Ahmed Muhammad S Shehu Gaby Poggensi Abdulrazaq Habib Kabir Sabitu Patrick M Nguku Abubakar Jafiya Mairo Kachalla Aishatu Binu Gubio Hawwa Inna Muhammad Sagir Aliyu Bashir Idris Bara’atu Shehu Abdulrahman Isah Halilu Ahmad Yusuf Madaro Rabi Usman Ibrahim Halilu Habibu Yalwa Hauwa Kolo Endie Waziri Saheed Gidado Mahmud Dalhat Benjamin J Mwangombe Ruth Olabiyo Gbemisola Oloruntuyi Abdullahi Zakariyya Yauri Balkisu A Shinkafi Nasir Sani-Gwarzo Zubairu Iliyasu Aisha Indo Mamman Hassan S Isah Shehu Akuyam John I Anetor Mary Jean Brown Google Nasir Tsafe Umar-Tsafe Adebola T Olayinka Saad Ahmed Muhammad S Shehu Gaby Poggensi Abdulrazaq Habib Kabir Sabitu Patrick M Nguku Abubakar Jafiya Mairo Kachalla Aishatu Binu Gubio Hawwa Inna Muhammad Sagir Aliyu Bashir Idris Bara’atu Shehu Abdulrahman Isah Halilu Ahmad Yusuf Madaro Rabi Usman Ibrahim Halilu Habibu Yalwa Hauwa Kolo Endie Waziri Saheed Gidado Mahmud Dalhat Benjamin J Mwangombe Ruth Olabiyo Gbemisola Oloruntuyi Abdullahi Zakariyya Yauri Balkisu A Shinkafi Nasir Sani-Gwarzo Zubairu Iliyasu Aisha Indo Mamman Hassan S Isah Shehu Akuyam John I Anetor Mary Jean Brown Google Scholar Nasir Tsafe Umar-Tsafe Adebola T Olayinka Saad Ahmed Muhammad S Shehu Gaby Poggensi Abdulrazaq Habib Kabir Sabitu Patrick M Nguku Abubakar Jafiya Mairo Kachalla Aishatu Binu Gubio Hawwa Inna Muhammad Sagir Aliyu Bashir Idris Bara’atu Shehu Abdulrahman Isah Halilu Ahmad Yusuf Madaro Rabi Usman Ibrahim Halilu Habibu Yalwa Hauwa Kolo Endie Waziri Saheed Gidado Mahmud Dalhat Benjamin J Mwangombe Ruth Olabiyo Gbemisola Oloruntuyi Abdullahi Zakariyya Yauri Balkisu A Shinkafi Nasir Sani-Gwarzo Zubairu Iliyasu Aisha Indo Mamman Hassan S Isah Shehu Akuyam John I Anetor Mary Jean Brown PubMed Nasir Tsafe Umar-Tsafe Adebola T Olayinka Saad Ahmed Muhammad S Shehu Gaby Poggensi Abdulrazaq Habib Kabir Sabitu Patrick M Nguku Abubakar Jafiya Mairo Kachalla Aishatu Binu Gubio Hawwa Inna Muhammad Sagir Aliyu Bashir Idris Bara’atu Shehu Abdulrahman Isah Halilu Ahmad Yusuf Madaro Rabi Usman Ibrahim Halilu Habibu Yalwa Hauwa Kolo Endie Waziri Saheed Gidado Mahmud Dalhat Benjamin J Mwangombe Ruth Olabiyo Gbemisola Oloruntuyi Abdullahi Zakariyya Yauri Balkisu A Shinkafi Nasir Sani-Gwarzo Zubairu Iliyasu Aisha Indo Mamman Hassan S Isah Shehu Akuyam John I Anetor Mary Jean Brown Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. 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