On 31 December 2019, the World Health Organization (WHO) was notified of a novel coronavirus disease in China that was later named COVID-19. On 11 March 2020, the outbreak of COVID-19 was declared a pandemic. The first instance of the virus in Nigeria was documented on 27 February 2020. This study provides a preliminary epidemiological analysis of the first 45 days of COVID-19 outbreak in Nigeria. We estimated the early transmissibility via time-varying reproduction number based on the Bayesian method that incorporates uncertainty in the distribution of serial interval (time interval between symptoms onset in an infected individual and the infector), and adjusted for disease importation. By 11 April 2020, 318 confirmed cases and 10 deaths from COVID-19 have occurred in Nigeria. At day 45, the exponential growth rate was 0.07 (95% confidence interval (CI): 0.05-0.10) with a doubling time of 9.84 days (95% CI: 7.28-15.18). Separately for imported cases (travel-related) and local cases, the doubling time was 12.88 days and 2.86 days, respectively. Furthermore, we estimated the reproduction number for each day of the outbreak using a three-weekly window while adjusting for imported cases. The estimated reproduction number was 4.98 (95% CrI: 2.65-8.41) at day 22 (19 March 2020), peaking at 5.61 (95% credible interval (CrI): 3.83-7.88) at day 25 (22 March 2020). The median reproduction number over the study period was 2.71 and the latest value on 11 April 2020, was 1.42 (95% CrI: 1.26-1.58). These 45-day estimates suggested that cases of COVID-19 in Nigeria have been remarkably lower than expected and the preparedness to detect needs to be shifted to stop local transmission.

There is a need for state level implementation of specific programmes that target vulnerable children as this can help in reversing the existing patterns.

Corona virus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected in the city of Wuhan, China in December 2019. Although, the disease appeared in Africa later than other regions, it has now spread to virtually all countries on the continent. We provide early spatio-temporal dynamics of COVID-19 within the first 62 days of the disease's appearance on the African continent. We used a two-parameter hurdle Poisson model to simultaneously analyse the zero counts and the frequency of occurrence. We investigate the effects of important healthcare capacities including hospital beds and number of medical doctors in different countries. The results show that cases of the pandemic vary geographically across Africa with notably high incidence in neighbouring countries particularly in West and North Africa. The burden of the disease (per 100 000) mostly impacted Djibouti, Tunisia, Morocco and Algeria. Temporally, during the first 4 weeks, the burden was highest in Senegal, Egypt and Mauritania, but by mid-April it shifted to Somalia, Chad, Guinea, Tanzania, Gabon, Sudan and Zimbabwe. Currently, Namibia, Angola, South Sudan, Burundi and Uganda have the least burden. These findings could be useful in guiding epidemiological interventions and the allocation of scarce resources based on heterogeneity of the disease patterns.

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As of mid-August 2020, Brazil was the country with the second-highest number of cases and deaths by the COVID-19 pandemic, but with large regional and social differences. In this study, using data from the Brazilian Ministry of Health, we analyze the spatial patterns of infection and mortality from Covid-19 across small areas of Brazil. We apply spatial autoregressive Bayesian models and estimate the risks of infection and mortality, taking into account age, sex composition of the population and other variables that describe the health situation of the spatial units. We also perform a decomposition analysis to study how age composition impacts the differences in mortality and infection rates across regions. Our results indicate that death and infections are spatially distributed, forming clusters and hotspots, especially in the Northern Amazon, Northeast coast and Southeast of the country. The high mortality risk in the Southeast part of the country, where the major cities are located, can be explained by the high proportion of the elderly in the population. In the less developed areas of the North and Northeast, there are high rates of infection among young adults, people of lower socioeconomic status, and people without access to health care, resulting in more deaths.

The outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that originated in the city of Wuhan, China has now spread to every inhabitable continent, but now theattention has shifted from China to other epicenters, especially Italy. This study explored the influence of spatial proximities and travel patterns from Italy on the further spread of SARS-CoV-2 around the globe. We showed that as the epicenter changes, the dynamics of SARS-CoV-2 spread change to reflect spatial proximities.

BackgroundMiddle East respiratory syndrome coronavirus is a contagious respiratory pathogen that is contracted via close contact with an infected subject. Transmission of the pathogen has occurred through animal-to-human contact at first followed by human-to-human contact within families and health care facilities.Data and methodsThis study is based on a retrospective analysis of the Middle East respiratory syndrome coronavirus outbreak in the Kingdom of Saudi Arabia between June 2012 and July 2015. A Geoadditive variable model for binary outcomes was applied to account for both individual level risk factors as well spatial variation via a fully Bayesian approach.ResultsOut of 959 confirmed cases, 642 (67%) were males and 317 (33%) had died. Three hundred and sixty four (38%) cases occurred in Ar Riyad province, while 325 (34%) cases occurred in Makkah. Individuals with some comorbidity had a significantly higher likelihood of dying from MERS-CoV compared with those who did not suffer comorbidity [Odds ratio (OR) = 2.071; 95% confidence interval (CI): 1.307, 3.263]. Health-care workers were significantly less likely to die from the disease compared with non-health workers [OR = 0.372, 95% CI: 0.151, 0.827]. Patients who had fatal clinical experience and those with clinical and subclinical experiences were equally less likely to die from the disease compared with patients who did not have fatal clinical experience and those without clinical and subclinical experiences respectively. The odds of dying from the disease was found to increase as age increased beyond 25 years and was much higher for individuals with any underlying comorbidities.ConclusionInterventions to minimize mortality from the Middle East respiratory syndrome coronavirus should particularly focus individuals with comorbidity, non-health-care workers, patients with no clinical fatal experience, and patients without any clinical and subclinical experiences.

Summary Understanding the level, trend, geographical variations and determinants of use of modern family planning (FP) plays a major role in designing effective interventions leading to increased usage. This study assessed these characteristics of FP use in Nigeria using data from the 2003, 2005 and 2007 National HIV/AIDS and Reproductive Health Survey, a national population-based household survey. A Bayesian geo-additive procedure was used, which provides flexible modelling of non-linear and spatial effects at a highly disaggregated level of states. The findings reveal considerable geographical variation in the use of modern FP in Nigeria, with a distinct north-south divide. Furthermore, a significant trend in the use of modern FP was evident, with an increase between 2003 and 2005 followed by a decline between 2005 and 2007. The effect of respondent's age was non-linear, and use of modern FP was found to differ significantly between never-married and currently/formerly married respondents. Awareness of FP methods and knowledge of where to get/buy FP services/methods were found to be significantly associated with usage. The findings provide policymakers with tools to prioritize the use of scarce resources for implementing FP and reproductive health interventions.