No abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS- has resulted in an unprecedented global health security challenge, economic downturns and psychosocial disruptions. First reported in Wuhan, China, the epidemic swiftly spread to over 200 countries and territories. In Nigeria, the first confirmed COVID-19 case was imported via air travel on 24 th of February 2020 and Confirmed on 27 th of February 2020. Minimal public health surveillance activities were initiated before then. In response to the confirmation of COVID-19, incident management activities, epidemiologic surveillance, contact tracing, infection, prevention and control trainings, COVID-19 testing and activation of isolation and treatment centers were immediately implemented in Ogun State. The objective of the outbreak investigation in Ogun State was to determine the magnitude of the outbreak, characterize the outbreak, and implement disease detection and response activities. This report documents and reflects on the steps taken to mitigate the initial spread of COVID-19 and the outbreak response activities in Ogun State, Nigeria. Adequate risk communication, robust surveillance, effective contact tracing and isolation of primary contacts of the first confirmed case in Nigeria as well as implementation of infection, prevention and control measures were pivotal tools that helped to curtail the initial spread of the infection. Operative collaboration between all stakeholders involved in response and surveillance to emerging dangers is necessary to detect cases early and to implement adequate preventive and control measures.

Aim/objectives: It was aimed to assess the prevalence of latent TB among HIV+ patients, evaluate the coverage of isoniazid preventive therapy (IPT), the  continuous risk of latent tuberculosis infection, and factors associated with the presence of latent Tb in HIV+ patients. Methods: This is an analytical cross-sectional study of HIV+ patients attending the HIV clinic or admitted not previously treated for TB and did not have  clinical and laboratory evidence of active TB and matched HIV-negative population attending our GOC. Data collected with a pre-tested investigator  administered questionnaire included the age, sex, height and weight, medical and drug history, and relevant physical examination findings such as body  temperature and respiratory rate. Active TB was excluded by history, sputum AFB Z-N staining, or GeneXpert test and chest radiography. Whole blood  samples were collected from participants for QuantiFERON TB Gold Plus for quantification of Interferon Gamma Release assay (IGRA) in order to  diagnose or exclude latent TB. Data were analyzed using IBM SPSS version 25.0 software at a level of significance of p < 0.05. Association between means  and qualitative variables was analyzed with student-t-test and Chi-square test Results: The mean ages of the HIV+ and control groups were 42.69 ± 9.91 and 41.29 ± 9.20 years respectively with no significant statistical difference.  76(95.0%) of HIV+ patients and 74(92.5%) controls had no symptoms of TB and chronic lung disease. 18(22.5%) HIV+ patients and 2(2.5%) controls were  exposed to persons with chronic cough (p=<0.001). The prevalence of latent TB among HIV+ patients was 22.50% and 10.0% among controls (p-  value=0.001). 8(44.4%) out of 18 with latent TB had prior use of IPT compared with 24 (38.7%) out of 62 without latent TB (p-value =0.67). CD4 count was a  significant factor associated with the presence of latent TB among HIV+ persons (p-0.03). Similarly, there was a significant association between viral load  and positive IGRA (p<0.001). Conclusion: Latent TB infection remains significantly higher among HIV+ than HIV-negative patients which may account for the higher incidence of active  disease amongst them. Isoniazid preventive therapy coverage was poor amongst HIV+ patients in this study.