We conducted a multicenter clinical validity study of the Panbio COVID-19 Antigen Rapid Test of nasopharyngeal samples in pediatric patients with COVID-19 compatible symptoms of =5 days of evolution. Our study showed limited accuracy in nasopharyngeal antigen testing:

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Five opportunities for children we must seize now

An open letter on why I believe we can reimagine a better post-COVID world for every child….

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This article was put together by LHCHF Research Team.

An appraisal of the News media output, WHO pronouncements and people’s perception of the Pandemic  December 2019 to March 2020.

According to the WHO the corona group of viruses can cause illness in man and animals especially respiratory which ranges from the common cold to more severe illness like south asia respiratory syndrome SARs, middle east respiratory syndrome MERs and now COVID 19. At the time of this writeup, more than 1,250,000 people are known to have been infected with about over 67,000 deaths recorded. The spectrum of symptom displayed is varied with up to 80% with mild infection and the other 20% classed severe. The death rate ranges between 0.7 and 3.4 %.

The source of outbreak was traced to a wet market in the town of Wuhan in China. The animal source is not yet defined but the original host is suspected to be Bats.

There is a tracker on the WHO website with updated statistics on the status across the globe.

The virus is spread via aerosol or droplets. This means that strict hand hygiene, cough hygiene and etiquette, avoidance of handshakes, and social distancing is needed to curtail the progression of the disease. The early symptoms of Fever, cough and breathlessness are red flags indicating need for medical attention.

Those with severe illness will need close treatment in Hospital. There has been high profile personalities affected lately. The list includes the British Prime Minister, Prince Charles Heir to the British throne, British Health Minister and in Nigeria a number of State governors and the Chief of staff to the federal government.

The role call of who is who in the society that are affected, clearly indicate the non discriminatory  and the deadly nature of this infection.

Countries around the world have drawn up individulised protocol of care in their bid to align with the WHO template advice.

10 Reasons why COVID 19 Pandemic took the world by storm

China was slow to confirm the severity of the infection and also slow to act in containing the virus. This led to the loss of a golden opportunity to keep the lid on it before its spread in an exponential fashion.

• The rest of the world were complacent because they initially regarded the disease as a local chinese issue and did not put adequate measures in place to prevent spread.
• The developed world (USA, Europe, some wealthy Asian countries) were stampeded initially by negative media coverage and forced to organise the evacuation of their nationals from infection prone areas to their respective countries thereby aiding the spread of the virus exponentially.
• Countries in the developed world, apparently failed to heed in a timely manner to the advice of the WHO and did not put in place measures to mitigate spread within their own countries. Their initial responses left much to be desired and put mildly was complacent and reckless.
• There was no visible coordinated martial plan among countries to stem the flow. Instead responses were bespoke, individualised and selfish. This was no blue print to stop a looming pandemic. Pandemics being worldwide needed a joined up approach to address it and bound to fail if individualised and selfish approach was used instead..
• Most countries were slow to effect local strategies to stem the spread. Emergency contingency plans were patchy and confused. A mix of politics and grand standing in some cases. Early leadership was lost and this was not a good start.
• The delay in controlling flights from affecting areas missed the golden opportunity to stop the spread to areas not earlier affected. Chinese tourists who are widely traveled were still free to move around the world with little attention paid to local health need for protection. This does explain the pockets of infections at key tourist cities ( New York, Paris, London, Italy’s Milan & Lombardy region)
• The lack of intergovernmental engagement with joined up policy on cohesive health prevention measures meant that intervention were not productive and therefore failed to reduce spread.
• The types of at risk people seem to include highly placed politicians who tend to mingle a lot, affluent and high end travelers in close contact in airports and aircraft, and hence the spread is very visible with foreign travels. There is also the issue of old age individuals and those with long standing health conditions that are susceptible to the infection as a result of their compromised immune status.
• There was paucity of material to combart the effect of the infection on the social fabric of the society. The problem of inadequate testing equipment, faulty testing kits in some cases and inadequate number of PPE and ventilators made effective control and management difficult.
• The initial media hysteria which focused on reporting the death statistics, caused panic and confusion which meant that initial key messages were subsumed in confused rhethorics. Tourists were scared and behaved in disorganised ways that facilitated the further spread of the virus.

INITIAL LESSONS FROM THE ACTIONS, INACTIONS AND DEFICIENCY OF RESPONSE TO COVID 19 PANDEMIC.

There is an obvious lack of coordinated response to the COVID 19 Pandemic and this meant that most countries including those in the developed economies, lacked preparedness to tackle the Pandemic.

It is therefore the case for the UN and the WHO to take the mantle of leadership and ensure that a blue print for action is available to deal with future occurences.

This should be in the form of a statute that should be made mandatory for all member nations to follow and should take into account the followings.:-

1. Standards for health surveillance, promotion, intervention, and treatment modalities.
2. There should be templated economic intervention by the world Bank with clear and specific economic recovery programs that will ensure that economic activities resume as early as possible and also ensure that poorer economies are not obliterated. Aim is to cushion unfavourable effects on the weakest of the society.
3. There should be joint collaborative work by scientists, medical practitioners, policy makers, and manufacturers. This should have a command structure that will boost a workable governance arrangement for implementing workable solutions.
4. There should be an identified push for local industrialists to switch to produce needed materials and be engaged early to facilitate prompt and adequate response. The lesson from this pandemic shows that the near total dependence on supply from a certain region of the world made it difficult to provide prompt and adequate supplies in timely fashion. The case of inadequacy of PPE, Testing kits for Covid 19, and Ventilators for respiratory care were examples of items in short supply as a result of lock down of factories in China  where these items are produced for world comsumption. This resulted in world wide scarcity and compromised care which no doubt contributed to the escalating mortality and morbidity figures heartily and gleefully reportd by journalist whose trademark is to shock and create sensation.
5. There should be the blue print models for production of Corona virus vaccine when possible scultured from archive scientific models. This should be the mantra for scientists who I believe in our present world have enough know how to achieve this feat. If the desire is strong with emphasis and hunger by all concerned are harnessed, then this goal can be achieved. This is a clarion call  for national governments to focus on adequate research funding ringfenced to achieve this goal.

CONCLUSION  & SUMMARY

The WHO has done the good job of tracking the epidemiology of the infection and proactively engaged stakeholders at every path of the way. The organisation correctly classified the outbreak as a Pandemic and also provided useful information to all countries detailing the spread and advice on how to minimise and control it. There were regular briefings by the DG of WHO and his team who have good knowledge base and support teams that were able to liaise with member nations and supported them with technical advice. All countries should regard the support and advice as the building block for building resilience within their domains in Pandemic situations.

The future world order after the Covid 19 pandemic will make all to note that:-

• We all live in an interdependent world
• No one country is immune to the effect of Pandemics
• Pandemics has no respect for Nuclear or Non-Nuclear Countries, they all need masks, testing kits and ventilators. The most sophisticated healthcare system can be reduced to standards of developing countries if adequate equipments are not provided as needed.
• The casualty figures did not distinguish between the rich and the poor nor was there a racial disparity.
• The current pandemic exposed the inadequacy of health provisions and policy across countries. The developed world failed to see and plan while the developing countries constantly failed to pay attention or fund their health institutions adequately, which exposed their vulnerability with near catastrophic anticipation. There is therefore a clarion call to them to build robust health intitutions that can stand the test of future Epidemics and Pandemics. The current way of doing things in relation to health is not sustainable and will need thorough appraisal for the better. If countries like Nigeria fail to learn from this and respond appropriately then posterity will not look kindly to the future generation who will be recipient of such inaction or failure of doing the good for the many,
• Health is a precious commodity that is more valuable than wealth. A healthy person has the time to acquire wealth while a sick wealthy person will spend their time and money to be healthy. In some cases their money may not guarantee the attainment of the good health they may desire.

To come clean and survive the current Pandemic, Please WASH OR SANITIZE YOUR HANDS, MAINTAIN SOCIAL DISTANCE , STAY AT HOME & FOLLOW MEDICAL ADVICE.

Visit the WHO website on Covid 19 for useful tips and updates on the Pandemic.

Do visit this platform for informed writeups  on Covid 19.

Reference:-

1. Newey S, Gulland A; What is coronavirus, how did it start and how big could it get? :The Telegraph; 5^th April 2020
2. WHO ; who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Dr Benjamin Odeka is the CEO of the Lady Helen Child Health Foundation and the Director for Research of the organization. He has conducted research projects in Universities and pharmaceutical industries as Chief Investigator in a Pan European study on a new drug treatment for childhood constipation. He has also headed many research studies in Paediatric medicine as Principal Investigator. He was an Honorary Senior Lecturer at the University of Manchester for many years and an approved trainer for post graduate and undergraduate studies by the General Medical Council UK.

He is a peer reviewer for notable journals and evidence based practice forums in the medical field and has also published original research articles that has advanced medical knowledge.

He is a Fellow of the Royal College of Physicians of London & Fellow of Royal College of Paediatrics & Child health (UK)

He is an examiner for the medical school of Manchester University and the Royal College of Paediatrics and Child Health UK.  In addition to his medical degrees at undergraduate and post graduate levels, He also holds a Masters degree in Law (health care law).

His clinical and managerial skills was recognized for clinical excellence and earned him the Bronze award for excellence in the NHS UK. He continues to provide clinical service as a Consultant in Paediatrics and Gastroenterology. As part of his contribution to health care governance, he is a Performance assessor to the General Medical Council of the UK and a Professional and Clinical Advisor to the UK Care Quality Commission.

He is now devoting his skills in Research under the auspices of the Lady Helen organization to add value to the Nigeria Research base.

By

Aliyu Yusuf  BSc Anatomy. Research Fellow Lady Helen Child Health Foundation

Dr Benjamin Odeka MB BS DCH MA FRCP FRCPCH – Director of Research LHCHF

Awareness ,Actions , and Support Related to COVID-19 Among Orphanages in the Federal Territory of Abuja at onset of Restricted Movement in March- April 2020.

Background:

Nigeria is among the top three countries in the world with the most orphans. Many of these children have no other option than to live in orphanages. However, are orphanage homes in Nigeria able to provide proper care for the kids? What issues do Nigerian orphanages face? The purpose of this desk review is to assess the challenges affecting orphans and vulnerable children (OVCS) and their caregivers in Nigeria.

Methods:

LHCF research team conducted a desk review of available published reports and other project and program documents — including peer-reviewed and gray literature — related to nutrition, OVC, and caregivers, with emphasis on OVC interventions globally and in Nigeria. Materials included formative research and other studies, previous assessments, project reports, and surveys.

Introduction:

Nigeria’s Federal Ministry of Women Affairs and Social Development estimate that there are 17.5 million orphans and vulnerable children (OVC) nationwide. These children face enormous challenges to their health and development and it is estimated that 95 percent of OVC do not receive any type of medical, emotional, social, material, or school-related assistance (National Population Commission, Federal Republic of Nigeria, and ICF International 2013). Childhood malnutrition is one of the major causes of childhood morbidity and mortality in Nigeria and a cross-sectional study of 2015 revealed that more than a quarter of OVC studied showed symptoms of mild to moderate malnutrition. In addition, close to 70 percent experienced household food insecurity, putting them at risk for malnutrition (Tagurum et al. 2015). Nigeria is currently expanding its support to OVC as well as their caregivers, households, and communities through the rollout of the 2014 National Standards for Improving the Quality of Life of Vulnerable Children. A significant programming challenge is ensuring that OVC have access to a diverse and nutritious diet. As caregivers become ill or die, household labor supply is diminished, which dramatically affects income and/or the ability to cultivate land. Access to nutritious foods dwindles and families often resort to harmful coping strategies to survive. Complicating this scenario, those individuals living with HIV have higher energy requirements.

Definitions:

Defining the term OVC is the first step in understanding the magnitude of the OVC problem and the responses offered by various United Nations and donor agencies, including USAID, nongovernmental organizations (NGOs) and governmental ministries. It is also a critical step in determining the types of nutrition SBCC programming that may have the greatest impact for OVC populations in Nigeria.

In 2004, the World Bank established an OVC Thematic Group to respond to the worldwide OVC crisis due to HIV and AIDS, and developed an OVC toolkit for sub-Saharan Africa (SSA) (World Bank Africa Region and World Bank Institute 2005).

The World Bank defines OVC as children who are-

• orphaned
• separated from their parents
• living with caretakers with serious problems like illness, disabilities, trauma, substance addictions, abusive habits, or
• Having normal families, but special needs that even well-functioning parents will need help to address (trauma, disability, behavioral problems).

The World Bank further defines OVC as children who, in a given local setting, are most likely to fall through the cracks of regular programs, policies, and traditional safety nets and therefore need to be given special attention when programs and policies are designed and implemented. UNAIDS defines OVC much more narrowly, focusing only on orphans and defining them as children under 18 years of age whose mother, father, or both parents have died as a result of AIDS (United Nations, 2004).

A global perspective on the magnitude of the OVC problem:

The estimated number of orphans, by all causes including AIDS, is reported yearly by agencies such as UNICEF. The varied way in which vulnerability is defined and measured across countries, however, makes the precise count of the world’s total number of vulnerable children challenging. Approximations related to specific types of vulnerability attest to the magnitude of the global problem: 428 million children age 0–17 years live in extreme poverty, 150 million girls have experienced sexual abuse, 2 million children live in institutional care, and 218 million children engage in various forms of exploitative labor (Zosa-Feranil et al. 2010).

The most recent UNICEF estimates for the number of orphans (age 0–17 years) globally (referring to loss of one or both parents to all causes) is 140 million, with an estimated 17.7 million orphans attributed to AIDS. In SSA alone there are close to 60 million orphans, a number that represents more than 20 percent of all children in this region. An estimated 15.2 million children in SSA are orphaned due to AIDS (UNICEF 2013); this represents 86 percent of the global burden of orphans due to AIDS.

While HIV prevalence in Nigeria, at 3.2 percent, is lower than that in many other large countries in SSA, (UNAIDS 2014) its large population means the number of adults and children living with HIV is one of the highest in the world, at approximately 3,200,000 (National Agency for the Control of AIDS 2014). Furthermore, the orphan population in Nigeria is estimated to be 20 percent of the total SSA orphan population (AVERT n.d.).

Although official counts vary, the Nigerian Federal Ministry of Women Affairs and Social Development (FMWASD) reported that there were 17.5 million OVC in 2008 (Tagurum et al. 2015). UNICEF reported 10 million Nigerian orphans due to all causes in 2013, with 2.3 million orphans due to AIDS, as well as 450,000 children and 180,000 adolescents actually living with HIV (UNICEF 2013). One study ranks Nigeria’s OVC burden higher than several countries facing war, such as Sudan, Somalia, Democratic Republic of the Congo, Libya, and Syria (Tagurum et al. 2015). One in every 10 households in the country is also estimated to be providing care for an orphan (Marsden and Miller 2011). The 2013 Nigeria Demographic and Health Survey (NDHS) found that the percentage of orphaned children increases rapidly with age, from 4.2 percent among children under age five to 16.1 percent among children age 15-17. Data also indicate that urban children are slightly more likely to be orphaned than rural children (7 and 5 percent respectively). Among UGM project states, Benue had the highest number of OVC (16.4 percent), followed by Plateau (14.1 percent) and Nasarawa (13.8 percent). which adapts the original NDHS data to show the states where UGM project partners STEER and SMILE are implementing programs, provides further explanation of these data.

A cross-sectional survey carried out in the Plateau State in 2014 revealed that paternal orphans made up 59.8 percent of respondents, followed by vulnerable children (21.7 percent) (Tagurum et al. 2015). This is similar to the situation in South Africa, where the majority of orphans have lost fathers (Bennell, Hyde, and Swainson 2002). Paternal orphanhood is significant because of the documented economic difficulties children face when they lose their fathers (Chirwa 2002, Abebe 2005).

Situation with orphans in Nigeria: 

It is difficult to say exactly how many orphans and orphanages there are in Nigeria. Despite the fact that this topic is very important, it has been severely neglected by researches. The latest statistics that we were able to find dated back to 2012. According to them, there were over 11.5 million orphans in Nigeria. It is safe to say that the situation has probably worsened since then.  Situation with orphanages statistics is even direr, as the government itself does not know for sure how many orphanages operate within the country. It has been said that there are lots of unapproved or illegal orphanages in Lagos and other states. Just from the lack of relevant information and research, it seems pretty obvious that things are not going well for Nigerian orphanages. Nevertheless, let’s talk about the issues with orphanage homes in Nigeria in detail.

Common issues and challenges of orphanages in Nigeria:

Every orphanage home is different. This means that they all have different issues, and some might not have the listed issues at all. However, we have tried our best to compile the most common problems for many Nigerian orphanages.

• First issue we need to talk about is overpopulation. While it is not known how many orphanages Nigeria has, no amount can handle almost a dozen million children that do not have parents and/or homes. This issue is also important to be mentioned first, as many other problems stem from it. For example, many existing orphanage homes are seriously understaffed. People that work with orphaned children are spread thin as they are trying to pay enough attention to all the children. They are overworked, underpaid and exhausted, because working with children is no small feat.
• Lack of staff and unqualified caregivers those employees that do work at orphanages often do not have required qualifications to be working with children. To be fair, some of them should not even be allowed to be close to children, let alone be responsible for their lives and development. Nigeria, as well as many developing countries, suffers from a thing called volunteerism (yes, we are aware that it is a made up word, but it has an important meaning nonetheless). This term describes the practice of people that enjoy ‘giving back’ while they are abroad in less fortunate countries. For instance, they volunteer in orphanages, where they hang out with kids or donate money and clothes. How could volunteering be bad?’ You would be surprised, but it actually brings more harm than good. Many people involved in research of the orphanage systems, as well as those who are directly involved in said systems, reported that volunteerism is harmful for children. People that engage in this type of activity rarely know how to deal with kids. They might be pursuing a noble goal to help the orphans in need, but they might inadvertently cause them harm. In addition to this, volunteers often do not stay long, but children still manage to grow attached to them. When these voluntourists leave the orphanages to go home, this negatively affects the kids’ existing abandonment issues. As for the donations, they, along with the government funds, often disappear in the pockets of those who run the orphanages. Corruption is a prevalent problem that does not help to improve the current situation with orphanages.
• Funding, many orphanage homes in Nigeria do not receive enough money to satisfy even the basic needs of children. Some orphanages in the country, especially those in the rural areas, do not have electricity, plumbing and other necessary facilities. The buildings are often in terrible condition unfit for living. The lack of funds also negatively affects the children’s nutrition and development. This also includes educational programmes. Children do not receive proper education and are often not prepared for the future that lies ahead of them. Kids with special needs suffer from insufficient funding the most, as they might not have the required equipment or educated staff that would meet their needs.
• Unregistered and fake children Home: One of the most horrifying things that exist in Nigeria is fake orphanages. While some exist for the mere purpose of laundering money, some have the nefarious purpose of selling Nigerian children. Nigerian government is struggling to battle this onslaught of illegal orphanages. A few weeks ago, 201 fake orphanages were discovered and closed in Delta State alone. One thought of how many are still left out there.
• The last thing we are going to touch upon is the utter negligence of the people who assign children to orphanages. It has been said that many kids that currently live in orphanages actually have living relatives. They are sentenced to years of living in unacceptable conditions only because nobody bothered to double-check whether they have anyone to care for them or not. Thus, they are deprived of their childhood and the ability to communicate with their families. Overall, staying in an orphanage negatively affects children. Research shows that kids who lived in orphanages have development issues, problems with nutrition, difficulties in adapting to the outside world, as well as many other problems. If the conditions in the orphanages are subpar, the situation only worsens.

Conclusion:

As you can see, there are many issues with orphanage homes in Nigeria. Of course, there are some exemplary institutions that do not fit our profile. Nevertheless, many other orphanages suffer from the same problems. We sincerely hope that the situation will improve in the nearest future, so that children without parents can have a proper chance at life

References

1. Abebe, T. 2005. “Geographical dimensions of AIDS orphanhood in sub-Saharan Africa.” Norwegian Journal of Geography,
2. AIDSTAR-One. 2011. “Early childhood development for orphans and vulnerable children: Key considerations. Technical Brief.” AIDSTAR-One (now AIDSFree) website.
3. AIDSTAR-One. 2012 “The Debilitating Cycle of HIV, Food Insecurity, and Malnutrition Including a Menu of Common Food Security and Nutrition Interventions for orphans and vulnerable children.” AIDSTAR-One (now AIDSFree) website.
4. The Federal Republic of Nigeria, and National Bureau of Statistics. “LSMS – Integrated Surveys on Agriculture General Household Survey Panel 2012/2013. A Report by the National Bureau of Statistics in Collaboration with the Federal Ministry of Agriculture and Rural Development and the World Bank.
5. National Agency for the Control of AIDS. 2014. “Federal Republic of Nigeria Global AIDS Response Country Progress Report 2014.” UNAIDS website.
6. “Nigeria OVC National Plan of Action.” The African Child Policy Forum website(link is external).
7. World Health Organization. “Integrated Management of Childhood Illness.) World Health Organization website.

Research Articles on Vaccine Hesitancy, Public Perceptions and Intention to Vaccinate Against Covid-19. This article was put together by LHCHF research team.

Background

Immunization against childhood diseases such as tuberculosis, poliomyelitis, measles, diphtheria, whooping cough and tetanus reduce childhood morbidity and mortality. Studies have shown that the cost to treat a vaccine preventable disease may be up to 30-times more than the cost of the vaccine, children who contract these preventable diseases usually suffer from impaired physical growth, cognitive development, emotional development, and social skills.

The prevention of child mortality through immunization is one of the most cost-effective and widely applied public health interventions, Immunization is one of the most effective, safest and efficient public health interventions as it is estimated to save at least 3 million lives from vaccine preventable diseases.

Despite the significant decline in the incidence of vaccine-preventable diseases as a result of increased vaccination coverage worldwide, there are many children with delayed and incomplete vaccination.

Globally speaking, 2.5 million children die every year from easily prevented infectious diseases. In fact, in the year 2000, measles resulted in 777,000 deaths and 2 million disabilities.  

Aim and Objectives:

• The objective of this study was to identify determinant factors of incomplete childhood immunization in Oshodi-Isolo district, Lagos southern Nigeria.
• The aim of this study was to review the factors that are associated with incomplete childhood immunization in Oshodi-Isolo, especially related to level of education, socioeconomic conditions and health care system characteristics.

Methods:

study site and Population: Estimate population of the inhabitant of the local government, Number of wards, primary Heath care Facilities and Immunization Centres will be collected.

Study design: Potential study participants will be given an explanation of the purpose of the study and will be ask if they would like to participate. They will be assured of confidentiality of the information they will provide, cross-sectional survey of mothers with children under-5 years of age will be Carried out and simple random sampling technique will be use to collect data via interview administered questionnaires by trained personnel.

References

1. Executive board room; sixth meeting of the technical consultative group on the global eradication of poliomyelitis. WHO Geneva draft meeting, 2001:1-6 (s)
2. Joint press release-UNICEF. www.unicef.org/media/media_46751.html (accessed on October, 2008) (s)
3. International Federation of Red Cross and Red Crescent Societies in Africa. www.ifrc.org (accessed on October, 2008) (s)
4. Centers for Disease Control and Prevention. Global immunizations and Vaccinations. [Electronic] Atlanta: Centers for Disease Control and Prevention; 1600 Clifton Rd, Atlanta, GA 30333, U.S.A: 2008. [updated 2008 December 4, 2008; cited 2009 March 2, 2009]; Web page]. Available from: http://www.cdc.gov/vaccines/programs/global/default.htm. [Google Scholar]
5. Centers for Disease Control and Prevention. National infant immunization week. Information and organization handbook. Atlanata: Centers for Disease Control and Prevention; 1995. [Google Scholar]

5.Belli PC, Bustereo F, Preker A. Investing in children’s health: what are the economic benefits? Bulletin of the World Health Organization [Bulletin] 2005;83(10):777–84. [PMC free article] [PubMed] [Google Scholar]

Impact of home-based records on child health outcomes in Lagos State. Evidence from the Nigerian Demographic Health Survey (NDHS).

Abstract

Home-based records are used to document the progress of health services administered to an individual; It takes account of hospital visits, immunization and child development progress. In Nigeria, despite the high birth-rate and fertility, the use of home-based records is less than 50%. Effective utilization of home-based records has been found to improve health seeking behaviours, breast feeding and communication in high income countries. However, there is still a lack of reliable evidence to prove the value that results from the use of these records specifically in low- and middle-income countries. The 2018 guidelines for home-based records published by the World Health Organization emphasized that more research is required to verify the effectiveness of home-based records in improving MNCH outcomes. Although knowledge and coverage of immunization in Lagos state is higher than in other regions in Nigeria, recent figures from the NDHS show worsening rates of neonatal and under-5 mortality. As such it is important to investigate whether the use of immunization cards and other home-based records has significant effect on child hood outcomes. The NDHS is carried out in the 36 states of Nigeria with a sample size of 41,821 women of reproductive age. So far 10 surveys have been carried out between 1990 and 2018. This study would perform multivariate analysis on responses from the 2018 survey by extracting data collected from women in Lagos state. This would cover responses on the use of immunization cards and other home-based records and the corresponding effect this has on vaccination completion, birth weight, child, nutritional status. For triangulation, the study, might also benefit from a qualitative aspect, that would involve interviews and focus group discussions with women in public hospitals in Lagos state. This study would be in line with WHO recommendation, add to the scarce literature on the subject, and could potentially inform policy.

REFERENCES

Brown, D. W., Bosch-Capblanch, X., & Shimp, L. (2019). Where Do We Go From Here? Defining an Agenda for Home-Based Records Research and Action Considering the 2018 WHO Guidelines. Global Health: Science and Practice, 7(1), 6-11.

Brown, D. W., Gacic-Dobo, M., & Young, S. L. (2014). Home-based child vaccination records – A reflection on form. Elseivier, 32(16), 1775-1777.

Magwood, O., Kpadé, V., Thavorn, K., Oliver, S., Mayhew, A. D., & Pottie, K. (2019). Effectiveness of home-based records on maternal, newborn and child health outcomes: A systematic review and meta-analysis. PLOS ONE , 14(2), e0212698. Retrieved from https://doi.org/10.1371/journal.pone.0209278

National Population Commission (NPC). (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

Omomila, J. O., Ogunyemi, A. O., Kanma-Okafor, O. J., & Ogunnowo, B. E. (2020). Vaccine-related knowledge and utilization of childhood immunization among mothers in urban Lagos. Niger J Paediatr, 270-276.

Osaki, K., Hattori, T., & Kosen, S. (2013). The role of home-based records in the establishment of a continuum of care for mothers, newborns, and children in Indonesia. Global Health Action, 6(1). Retrieved from https://doi.org/10.3402/gha.v6i0.20429

WHO. (2018). WHO recommendations on home based records for maternal , newborn and child health. Geneva: World Health Organization.

Research Articles on Freedom of Information (FOI)  in Nigeria Health Sector – Understanding the Issues & Need for Appraisal and Education.. This article was put together by LHCHF research team.

Research Articles on COVID-19 and Child Mental Health, how are children and adolescents in Lagos State adjusting. This article was put together by LHCHF research team.

Abstract

The outbreak of COVID-19 was declared to be a public health emergency by the World Health Organization in January, 2020. The uncontrolled spread and rise in cases eventually transformed it into a global pandemic, with Lagos recording Nigeria’s index case in February 2020.  One year after these incidents, there has been a myriad of life style adjustments to curb the virus and reduce its spread. Concerns were raised about certain groups being more vulnerable as a result of socio-economic status, underlying health issues and age, as such necessary guidelines were mandated. The impact of the lockdowns, and economic challenges as a result of COVID is still an emergent area of research with high rates of psychological distress and increase in mental health disorders being associated with the pandemic. Yet many studies acknowledge that low- and middle-income countries, do not place sufficient emphasis on the impact of COVID on children and adolescents. As the lockdown restrictions are being lifted in Lagos state, social distancing, virtualization of classrooms, and wearing face masks still continue to affect children. This creates a need to assess the short- and long-term effects of COVID-19 on children’s overall mental health. This study attempts to fill an identified gap in literature by examining the impact of covid on children and adolescents in Lagos state. The primary objective of this study is to gain knowledge on the lived experiences of children and adolescents with COVID-19 and what effect this has had on their mental health. The study would be carried out using both quantitative and qualitative techniques. While electronic questionnaires would be administered to derive data for statistical inference. Focus group discussions and interviews would also be carried out in schools, from which emerging themes would be analysed. The lack of current and representative epidemiological data on the mental health of Nigerian children continues to be a barrier to advocacy for CAMH policy initiatives.

References

Atilola, O., Ayinde, O. O., Emedoh, C. T., & Oladimeji, O. (2014). State of the Nigerian child – neglect of child and adolescent mental health: a review. Paediatrics and International Child Health, 35(2), 135-143. doi:10.1179/2046905514y.0000000137

Briggs, D. C., & Numbere, T.-W. (2020). COVID-19 and the Nigerian child: the time to act is now. Pan Afr Med J, Jun 18;35(Suppl 2):82. doi:10.11604/pamj.supp.2020.35.23286

Kubb, C., & Foran, H. M. (2020). Measuring COVID-19 Related Anxiety in Parents: Psychometric Comparison of Four Different Inventories. JMIR Ment Health, Dec 3;7(12):e24507. doi:10.2196/24507

L, K., BA, K., C, H., JA, N., S, S., M, B., . . . Patha. (2021). COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry, S2215-0366(21)00025-0. doi: 10.1016/S2215-0366(21)00025-0

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This article was put together by LHCHF Research Team.

An appraisal of the News media output, WHO pronouncements and people’s perception of the Pandemic  December 2019 to March 2020.

According to the WHO the corona group of viruses can cause illness in man and animals especially respiratory which ranges from the common cold to more severe illness like south asia respiratory syndrome SARs, middle east respiratory syndrome MERs and now COVID 19. At the time of this writeup, more than 1,250,000 people are known to have been infected with about over 67,000 deaths recorded. The spectrum of symptom displayed is varied with up to 80% with mild infection and the other 20% classed severe. The death rate ranges between 0.7 and 3.4 %.

The source of outbreak was traced to a wet market in the town of Wuhan in China. The animal source is not yet defined but the original host is suspected to be Bats.

There is a tracker on the WHO website with updated statistics on the status across the globe.

The virus is spread via aerosol or droplets. This means that strict hand hygiene, cough hygiene and etiquette, avoidance of handshakes, and social distancing is needed to curtail the progression of the disease. The early symptoms of Fever, cough and breathlessness are red flags indicating need for medical attention.

Those with severe illness will need close treatment in Hospital. There has been high profile personalities affected lately. The list includes the British Prime Minister, Prince Charles Heir to the British throne, British Health Minister and in Nigeria a number of State governors and the Chief of staff to the federal government.

The role call of who is who in the society that are affected, clearly indicate the non discriminatory  and the deadly nature of this infection.

Countries around the world have drawn up individulised protocol of care in their bid to align with the WHO template advice.

10 Reasons why COVID 19 Pandemic took the world by storm

China was slow to confirm the severity of the infection and also slow to act in containing the virus. This led to the loss of a golden opportunity to keep the lid on it before its spread in an exponential fashion.

• The rest of the world were complacent because they initially regarded the disease as a local chinese issue and did not put adequate measures in place to prevent spread.
• The developed world (USA, Europe, some wealthy Asian countries) were stampeded initially by negative media coverage and forced to organise the evacuation of their nationals from infection prone areas to their respective countries thereby aiding the spread of the virus exponentially.
• Countries in the developed world, apparently failed to heed in a timely manner to the advice of the WHO and did not put in place measures to mitigate spread within their own countries. Their initial responses left much to be desired and put mildly was complacent and reckless.
• There was no visible coordinated martial plan among countries to stem the flow. Instead responses were bespoke, individualised and selfish. This was no blue print to stop a looming pandemic. Pandemics being worldwide needed a joined up approach to address it and bound to fail if individualised and selfish approach was used instead..
• Most countries were slow to effect local strategies to stem the spread. Emergency contingency plans were patchy and confused. A mix of politics and grand standing in some cases. Early leadership was lost and this was not a good start.
• The delay in controlling flights from affecting areas missed the golden opportunity to stop the spread to areas not earlier affected. Chinese tourists who are widely traveled were still free to move around the world with little attention paid to local health need for protection. This does explain the pockets of infections at key tourist cities ( New York, Paris, London, Italy’s Milan & Lombardy region)
• The lack of intergovernmental engagement with joined up policy on cohesive health prevention measures meant that intervention were not productive and therefore failed to reduce spread.
• The types of at risk people seem to include highly placed politicians who tend to mingle a lot, affluent and high end travelers in close contact in airports and aircraft, and hence the spread is very visible with foreign travels. There is also the issue of old age individuals and those with long standing health conditions that are susceptible to the infection as a result of their compromised immune status.
• There was paucity of material to combart the effect of the infection on the social fabric of the society. The problem of inadequate testing equipment, faulty testing kits in some cases and inadequate number of PPE and ventilators made effective control and management difficult.
• The initial media hysteria which focused on reporting the death statistics, caused panic and confusion which meant that initial key messages were subsumed in confused rhethorics. Tourists were scared and behaved in disorganised ways that facilitated the further spread of the virus.

INITIAL LESSONS FROM THE ACTIONS, INACTIONS AND DEFICIENCY OF RESPONSE TO COVID 19 PANDEMIC.

There is an obvious lack of coordinated response to the COVID 19 Pandemic and this meant that most countries including those in the developed economies, lacked preparedness to tackle the Pandemic.

It is therefore the case for the UN and the WHO to take the mantle of leadership and ensure that a blue print for action is available to deal with future occurences.

This should be in the form of a statute that should be made mandatory for all member nations to follow and should take into account the followings.:-

1. Standards for health surveillance, promotion, intervention, and treatment modalities.
2. There should be templated economic intervention by the world Bank with clear and specific economic recovery programs that will ensure that economic activities resume as early as possible and also ensure that poorer economies are not obliterated. Aim is to cushion unfavourable effects on the weakest of the society.
3. There should be joint collaborative work by scientists, medical practitioners, policy makers, and manufacturers. This should have a command structure that will boost a workable governance arrangement for implementing workable solutions.
4. There should be an identified push for local industrialists to switch to produce needed materials and be engaged early to facilitate prompt and adequate response. The lesson from this pandemic shows that the near total dependence on supply from a certain region of the world made it difficult to provide prompt and adequate supplies in timely fashion. The case of inadequacy of PPE, Testing kits for Covid 19, and Ventilators for respiratory care were examples of items in short supply as a result of lock down of factories in China  where these items are produced for world comsumption. This resulted in world wide scarcity and compromised care which no doubt contributed to the escalating mortality and morbidity figures heartily and gleefully reportd by journalist whose trademark is to shock and create sensation.
5. There should be the blue print models for production of Corona virus vaccine when possible scultured from archive scientific models. This should be the mantra for scientists who I believe in our present world have enough know how to achieve this feat. If the desire is strong with emphasis and hunger by all concerned are harnessed, then this goal can be achieved. This is a clarion call  for national governments to focus on adequate research funding ringfenced to achieve this goal.

CONCLUSION  & SUMMARY

The WHO has done the good job of tracking the epidemiology of the infection and proactively engaged stakeholders at every path of the way. The organisation correctly classified the outbreak as a Pandemic and also provided useful information to all countries detailing the spread and advice on how to minimise and control it. There were regular briefings by the DG of WHO and his team who have good knowledge base and support teams that were able to liaise with member nations and supported them with technical advice. All countries should regard the support and advice as the building block for building resilience within their domains in Pandemic situations.

The future world order after the Covid 19 pandemic will make all to note that:-

• We all live in an interdependent world
• No one country is immune to the effect of Pandemics
• Pandemics has no respect for Nuclear or Non-Nuclear Countries, they all need masks, testing kits and ventilators. The most sophisticated healthcare system can be reduced to standards of developing countries if adequate equipments are not provided as needed.
• The casualty figures did not distinguish between the rich and the poor nor was there a racial disparity.
• The current pandemic exposed the inadequacy of health provisions and policy across countries. The developed world failed to see and plan while the developing countries constantly failed to pay attention or fund their health institutions adequately, which exposed their vulnerability with near catastrophic anticipation. There is therefore a clarion call to them to build robust health intitutions that can stand the test of future Epidemics and Pandemics. The current way of doing things in relation to health is not sustainable and will need thorough appraisal for the better. If countries like Nigeria fail to learn from this and respond appropriately then posterity will not look kindly to the future generation who will be recipient of such inaction or failure of doing the good for the many,
• Health is a precious commodity that is more valuable than wealth. A healthy person has the time to acquire wealth while a sick wealthy person will spend their time and money to be healthy. In some cases their money may not guarantee the attainment of the good health they may desire.

To come clean and survive the current Pandemic, Please WASH OR SANITIZE YOUR HANDS, MAINTAIN SOCIAL DISTANCE , STAY AT HOME & FOLLOW MEDICAL ADVICE.

Visit the WHO website on Covid 19 for useful tips and updates on the Pandemic.

Do visit this platform for informed writeups  on Covid 19.

Reference:-

1. Newey S, Gulland A; What is coronavirus, how did it start and how big could it get? :The Telegraph; 5^th April 2020
2. WHO ; who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Dr Benjamin Odeka is the CEO of the Lady Helen Child Health Foundation and the Director for Research of the organization. He has conducted research projects in Universities and pharmaceutical industries as Chief Investigator in a Pan European study on a new drug treatment for childhood constipation. He has also headed many research studies in Paediatric medicine as Principal Investigator. He was an Honorary Senior Lecturer at the University of Manchester for many years and an approved trainer for post graduate and undergraduate studies by the General Medical Council UK.

He is a peer reviewer for notable journals and evidence based practice forums in the medical field and has also published original research articles that has advanced medical knowledge.

He is a Fellow of the Royal College of Physicians of London & Fellow of Royal College of Paediatrics & Child health (UK)

He is an examiner for the medical school of Manchester University and the Royal College of Paediatrics and Child Health UK.  In addition to his medical degrees at undergraduate and post graduate levels, He also holds a Masters degree in Law (health care law).

His clinical and managerial skills was recognized for clinical excellence and earned him the Bronze award for excellence in the NHS UK. He continues to provide clinical service as a Consultant in Paediatrics and Gastroenterology. As part of his contribution to health care governance, he is a Performance assessor to the General Medical Council of UK and a Professional and Clinical Advisor to the UK Care Quality Commission.

He is now devoting his skills in Research under the auspices of the Lady Helen organization to add value to the Nigeria Research base.