Nigeria began administering COVID-19 vaccines on 5 March 2021 and is working towards the WHO’s African regional goal to fully vaccinate 70% of their eligible population by December 2022. Nigeria’s COVID-19 vaccination information system includes a surveillance system for COVID-19 adverse events following immunisation (AEFI), but as of April 2021, AEFI data were being collected and managed by multiple groups and lacked routine analysis and use for action. To fill this gap in COVID-19 vaccine safety monitoring, between April 2021 and June 2022, the US Centers for Disease Control and Prevention, in collaboration with other implementing partners led by the Institute of Human Virology Nigeria, supported the Government of Nigeria to triangulate existing COVID-19 AEFI data. This paper describes the process of implementing published draft guidelines for data triangulation for COVID-19 AEFI data in Nigeria. Here, we focus on the process of implementing data triangulation rather than analysing the results and impacts of triangulation. Work began by mapping the flow of COVID-19 AEFI data, engaging stakeholders and building a data management system to intake and store all shared data. These datasets were used to create an online dashboard with key indicators selected based on existing WHO guidelines and national guidance. The dashboard went through an iterative review before dissemination to stakeholders. This case study highlights a successful example of implementing data triangulation for rapid use of AEFI data for decision-making and emphasises the importance of stakeholder engagement and strong data governance structures to make data triangulation successful.
Background Isoniazid preventive therapy (IPT) significantly reduces the incidence of active tuberculosis in people living with HIV. However, despite high tuberculosis morbidity and mortality in people living with HIV, uptake of IPT remains grossly suboptimal, with implementation impeded by several barriers related to health workers and patients. We evaluated the use of a quality improvement approach to improve IPT in a tertiary hospital in north central Nigeria with a high HIV burden. Methods In July, 2018, a 4-week quality improvement pilot project was undertaken at the Federal Medical Centre in Keffi, Nigeria. The facility-based continuous quality-improvement committee, comprised of different cadres of staff working in the hospital's antiretroviral therapy clinic, reviewed their HIV quality-of-care indicators and noted that only 3% of eligible HIV clients received IPT between September, 2017, and March, 2018. The committee did a root cause analysis and identified poor knowledge of clinicians on the importance of IPT, fear of drug resistance, frequent stock-outs of isoniazid, and poor medication adherence as the key reasons for low rates of IPT. In response to these findings, the following key change ideas were implemented: IPT orientation for clinicians, incorporation of IPT education into routine health education for people living with HIV, display of IPT information education and communication materials in consulting and patient waiting rooms, and auditing of clients' folders prior to consultation to identify and tag eligible folders with IPT sticky notes.
Background: Lassa Fever (LF) is a disease of public health concern globally, with Nigeria as the epicenter of the disease. From 2020 till date, Nigeria has battled with dual epidemics of COVID-19 and Lassa Fever, with more attention on the former. This study seeks to investigate the spread pattern and case fatality rate of Lassa Fever before and during the COVID-19 pandemic in Nigeria.Methodology: A secondary analysis of epidemiological data on Lassa fever from the weekly situation reports of the Nigeria Centre for Disease Control. Data from 2017 to 2019 were grouped as pre-COVID, while data from January 2020 to June 13, 2022 were grouped as intra-COVID. Descriptive statistics was used to report frequencies, while Shapiro-Wilk, t-test and ANOVA (Bonferonni posthoc test) was applied to assess difference across the periods. Analysis was carried out using Stata version 17.Results: There was a 95% increase in the number of LF cases, from 1622 cases prior to the COVID-19 pandemic, to 3167 cases during the COVID-19 pandemic in Nigeria. LF spread across 30 states prior to the COVID pandemic, but was reported in 29 states during the pandemic. There was a 90% increase in the number of deaths pre and during COVID-19 pandemic from 360 deaths to 610 deaths. The case fatality rate changed from 22% prior to the COVID pandemic and 19% during the COVID-19 pandemic. The number of cases and mortality were significantly different (p<0.001) across different years (2017 -2022), with posthoc analysis highlighting significant difference in the intra-COVID period (2020 -Mid 2022).Conclusion: There has been a change in the infection pattern and mortality of LF pre and during the COVID-19 pandemic. While efforts have been geared towards curbing the COVID pandemic, Lassa Fever continues to spread with increase in fatality. Targeted public health strategies that can tackle the spread
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