Background: The first ever outbreak of Ebola virus disease (EVD) in Nigeria was declared in July, 2014. Level of public knowledge, perception and adequacy of information on EVD were unknown. We assessed the public preparedness level to adopt disease preventive behavior which is premised on appropriate knowledge, perception and adequate information. Methods: We enrolled 5,322 respondents in a community-based cross-sectional study. We used interviewer-administered questionnaire to collect data on socio-demographic characteristics, EVD–related knowledge, perception and source of information. We performed univariate and bivariate data analysis using Epi-Info software setting p-value of 0.05 as cut-off for statistical significance. Results: Mean age of respondents was 34 years (± 11.4 years), 52.3% were males. Forty one percent possessed satisfactory general knowledge; 44% and 43.1% possessed satisfactory knowledge on mode of spread and preventive measures, respectively. Residing in EVD cases districts, male respondents and possessing at least secondary education were positively associated with satisfactory general knowledge (p-value: 0.01, 0.001 and 0.000004, respectively). Seventy one percent perceived EVD as a public health problem while 61% believed they cannot contract the disease. Sixty two percent and 64% of respondents will not shake hands and hug a successfully treated EVD patient respectively. Only 2.2% of respondents practice good hand-washing practice. Television (68.8%) and radio (55.0%) are the most common sources of information on EVD. Conclusions: Gaps in EVD-related knowledge and perception exist. Targeted public health messages to raise knowledge level, correct misconception and discourage stigmatization should be widely disseminated, with television and radio as media of choice.
IntroductionBetween February and October 2009 an increase in morbidity and mortality in dogs in a national kennel in Abuja, Nigeria, was observed with signs indicative of leptospirosis. Concurrent illness was observed in some kennel workers which had high titres of leptospira antibodies.MethodsAn unmatched case-control study was conducted to identify associated factors. Fifteen cases and fifteen controls were recruited. A probable case was defined as any person working at the kennel with history of fever, chills, headache, myalgia with either conjunctivitis or sore throat between February and December 2009. Controls were healthy kennel workers within the same period. Inclusion criteria were any person meeting the definition (for both cases and controls). Kennel workers who were sick but did not fit into the case definition were excluded.ResultsBivariate analysis showed that wounds or cuts on either hands or legs of kennel workers during the period of the outbreak and contact with sewage at the kennel together (p = 0.001) was associated with leptospirosis among kennel workers.ConclusionThe findings revealed the importance of environmental hygiene in the prevention and control of leptospirosis. Sanitation and hygiene improvements were recommended.
Background: Nocardiosis is a clinical and diagnostic challenge, compounded by lacunae in existing literature. Our objectives were to establish the clinical spectrum of this disease in our setting, describe the most common causative agent of the disease and to ascertain differences in our patient population from available data.Methods & Materials: This was a 10 year (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) retrospective study carried out at a tertiary care centre in South India, of 131 cases of nocardiosis. The electronic medical records were studied and data analysed.Results: Sixty three percent were male, 23% of all in the sixth decade of life. The most common sites of infection were the skin and the eye -36 (27%) patients each and the lower respiratory tract -35 patients(26%). 48 (37%) patients were on immunosuppressant therapy, either a triple drug therapy following renal transplant, autoimmune disorders/ haematological malignancies on combination immunosuppressants or patients on prolonged corticosteroids. Of 36 patients with nocardiosis of the eye, 30 (83%) were corneal ulcers with history of trauma with vegetative matter or soil, and 5(14%) were endophthalmitis following intraocular lens implantation. 16(46%) patients with respiratory tract nocardiosis had a previous lung pathology. 11(8%) were HIV associated nocardiosis. Disseminated disease was seen in 7(5.3%) patients following renal transplant and in 3(2.3%) patients with SLE, all on triple drug immunosuppression. The most common organism isolated was Nocardia asteroides in 73(56%), followed by Nocardia spp in 32(24%), aerobic actinomycetes in 24(18%) and Nocardia brasiliensis in 2(1.5%). All patients responded to treatment with cotrimoxazole alone or in addition to surgical debridement for cutaneous and subcutaneous lesions. There was only one Nocardiosis related death in this cohort of patients. Antimicrobial susceptibility testing performed on 72 isolates showed 6.9% , 9.7%, 31%, 38%, 75%, 42%, 31%, 74% susceptibility to penicillin, ampicillin, erythromycin, tetracycline, cotrimoxazole, chloramphenicol, cefazolin and triple sulfa respectively.Conclusion: We report a predominance of nocardiosis from the eye and nocardiosis following immunosuppression. The most common species isolated was N.asteroides. A paucity in HIV associated nocardiosis is striking. Antimicrobial susceptibility showed 75% susceptibility to cotrimoxazole, the drug of choice, which was reflected by a good response to therapy in this cohort. http://dx.
An outbreak of Ebola virus disease occurred in Nigeria between July and September 2014. Contact tracing commenced in Lagos, and extended to Port Harcourt and Enugu as the outbreak continued to spread. A total of 899 contacts were traced. Contact tracing enhanced immediate identification of symptomatic contacts, some of whom eventually became cases. Contact tracing could be challenging in urban cities. However, use of electronic technology, adequate logistics, and highly skilled personnel enhanced the tracing of contacts to facilitate the successful containment of the outbreak. Nigeria was certified to be Ebola free on 21st October 2014. Ebola virus surveillance needs to be maintained to ensure the disease has been contained and to prevent future outbreaks. This case study aims to help trainees to review concepts, apply skills, and address challenges for contact tracing based on the experience of the Nigerian Field Epidemiology Training Network during the 2014 Ebola virus disease outbreak.
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