A monkeypox outbreak in Nigeria during 2017–2020 provides an illustrative case study for emerging zoonoses. We built a statistical model to simulate declining immunity from monkeypox at 2 levels: At the individual level, we used a constant rate of decline in immunity of 1.29% per year as smallpox vaccination rates fell. At the population level, the cohort of vaccinated residents decreased over time because of deaths and births. By 2016, only 10.1% of the total population in Nigeria was vaccinated against smallpox; the serologic immunity level was 25.7% among vaccinated persons and 2.6% in the overall population. The substantial resurgence of monkeypox in Nigeria in 2017 appears to have been driven by a combination of population growth, accumulation of unvaccinated cohorts, and decline in smallpox vaccine immunity. The expanding unvaccinated population means that entire households, not just children, are now more susceptible to monkeypox, increasing risk of human-to-human transmission.

, Nigeria has been experiencing the largest monkeypox outbreak in the country's history. As of November 2019, the country had reported 183 confi rmed cases across 18 states (1). This outbreak is also the largest recorded that has been caused by the West Africa clade of the monkeypox virus (MPXV). Beyond its scale, this outbreak is an illustrative case study for emerging zoonosis because of its epidemiologic characteristics. Preliminary genetic analysis suggests multiple zoonotic introductions from animal reservoirs into

In Africa, mortality due to non-communicable diseases (NCDs) is projected to overtake the combined mortality from communicable, maternal, neonatal, and nutritional diseases by 2030. To address this growing NCD burden, primary health care (PHC) systems will require substantial reorientation. In this study, we reviewed the progress of African countries towards integrating essential NCD services into PHC. Methods A review of World Health Organization (WHO) reports was conducted for all 47 countries in the WHO African Region. To report each country's progress, we used an a priori framework developed by the WHO regional office for Africa (AFRO). Twelve indicators were used to measure countries' progress. The proportion of countries meeting each indicator was tabulated using a heat map. Correlation between country income status and attainment of each indicator was also assessed. Findings No country met all the recommended indicators to integrate NCD services into PHC and seven countries met none of the indicators. Few countries (30%) had nationally approved guidelines for NCD management and very few reported availabilities of all essential NCD

The current Coronavirus Disease (COVID-19) outbreak has affected over 200 countries including Nigeria. It is one of the largest respiratory disease outbreaks affecting several countries simultaneously and a novel strain of Coronavirus (SARS-CoV 2) has been identified as the causative agent. Sequel to the advice of the International Health Regulation Emergency Committee, the Director-General of WHO declared the COVID-19 outbreak a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and characterized it as a pandemic on 11 March 2020. The aim of the study was to describe the current situation of the outbreak in Nigeria and argued the need for effective engagement of community health workers for an appropriate response to COVID-19. We reviewed published articles on COVID-19 and daily epidemiological reports from the website of the Nigeria Centre for Disease Control (NCDC) from 27 February 2020 till 3 May 2020 (Epidemiology week 7-17) to describe the outbreak. We also reviewed ongoing responses by the government and other relevant agencies. Our findings revealed possible evidence of ongoing and increasing community transmission of COVID-19 infections, inadequate testing capacity and overwhelming of health resources. Our review also revealed infection of several health workers in the face of existing critical skilled health workforce shortage. With surging of new COVID-19 cases and a huge number of contacts to be traced, we recommended that the government needs to promptly bring community health workers on board, deploy rapid epidemic intelligence and scale up the use of mobile Apps for contact tracing. This will result in an effective and coordinated response to the ongoing outbreak, sustain routine health services especially at the community level, reduce morbidity and mortality, and preserve health indices gains already made in the health system.