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.

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Background: Complying with guidelines established to control COVID-19 pandemic is critical to the successful outcome of the response. We assessed the willingness of non-symptomatic incoming international air travelers into Nigeria to comply with COVID-19 public health measures upon arrival and identified the factors influencing them- March 2020. Method: We conducted a cross-sectional study among 500 incoming international air travelers involving 17 nationals across four major international airports in Nigeria using a pre-tested self-administered electronic questionnaire. We estimated the proportions and determined predictors of participants’ willingness to comply with the COVID-19 preventive measures. Predictors were examined using multiple logistic regression at 5% level of significance.Results: Majority (83%) were extremely/very willing to comply with public health guidelines. Perception of severity was a significant predictor of their willingness to stay at home for 14 days upon arrival (AOR: 6.82, 95 CI%: 1.19-24.45). Self -efficacy towards observing self for COVID-19 symptoms was a significant predictor of willingness to observe self for symptoms (AOR: 6.82, 95%CI: 1.19-24.45), and willingness to call of national COVID-19 numbers if symptoms develop (AOR: 6.82, 95% CI: 1.19-24.45). Conclusion: There is a need to improve risk communication interventions against COVID-19 for international air travelers particularly enhancing self-efficacy to improve their compliance to public health measures