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- v.11(3); 2021 Sep

COVID-19 in Nigeria: account of epidemiological events, response, management, preventions and lessons learned
Henshaw uchechi okoroiwu.
1 Ph.D, MSc, B.MLS, Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, Arthur Jarvis University, Akpabuyo, Nigeria, Hematology Unit, Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
Christopher Ogar Ogar
2 MSc, B.MLS, Hematology Unit, Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
Glory Mbe Egom Nja
3 Ph.D, MPH, B.Sc, PGDE. Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
Dennis Akongfe Abunimye
4 B.MLS, Hematology Unit, Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria
Regina Idu Ejemot-Nwadiaro
5 Ph.D, M.Sc, B.Sc, Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115 Calabar, Nigeria.
Introduction
After the World Health Organization declared COVID-19 a pandemic, a hand full of cases and deaths have been recorded globally, Nigeria inclusive.
A retrospective analysis of the COVID-19 weekly disease update report by the Nigeria Centre for Disease Control (NCDC) covering February 29, 2020 (Week 9) and March 28, 2021 (Week 12) was adopted for this study. Data were curated from the NCDC database.
As of March 28, 2021, Nigeria is the 5 th most affected African country and the 77 th most affected country globally with 162,593 COVID-19 cases and 2,048 COVID-19 related deaths. COVID-19 has been reported in all 36 States and the Federal Capital Territory. However, Lagos has remained the epicenter of the pandemic accounting for 35.4% of the pandemic in Nigeria while Kogi State is the least affected State (0.003%). The trend showed male predilection while the age bracket 35-39 years was the most affected. The attack rate was found to be 78.8 per 100,000 of the population while the cumulative death per 100,000 of the population was found to be 1.0. The case fatality rate was found to be 1.30. Approximately 1,778,105 COVID-19 tests have been performed while 923,623 doses of vaccine have been administered.
Conclusions
COVID-19 has been reported in all states in Nigeria as well as the Federal Capital Territory with many of the cases involving males. The case trend showed a bimodal form indicating a second wave occurrence. Nigeria government has initiated some combative measures as well as vaccine initiation.
The inception of the COVID-19 pandemic has precipitated a dramatic loss of human life globally and had posed an inestimable obstacle to public health, food security, and economic impact. The socio-economic impact has been devastating as tens of millions of people are at the risk of slipping into extreme poverty with nearly 3.3 billion global workforce at the risk of losing their job. 1 The public health impact includes disruption in the medical supply chain, blood transfusion services, diagnosis and management of chronic diseases. 2 - , 5 The global epidemiological indices as of August 26, 2021, showed 213,752,662 confirmed cases with the African Region being the 6 th most affected region among the World Health Organization (WHO) regions behind the Region of Americas, Europe, South East Asia, Eastern Mediterranean, and Western Pacific. 6 Nigeria like other African countries has had its own share of the impact of the pandemic. Epidemiological indices as of August 26, 2021, showed 188,880 confirmed cases and 2,288 deaths in Nigeria. 6 In Nigeria, the pandemic and the ensuing lockdown/border closure have impacted the food system, economic activities, and poverty. Nigeria was faced with declining remittance and export demand: GDP fell by 23% during the lockdown, while the Agricultural food system fell by 11% owing to restriction on food services. 7 However, Nigeria has put up response and preventive measures to combat the pandemic since the detection of the initial case reported on February 27, 2020.
This present article is aimed at describing the current situation of COVID-19 in Nigeria, the combative measures and lessons learned, one year after the first case.
Study design
We conducted a retrospective analysis of Nigeria Centre for Disease Control (NCDC) surveillance data reported weekly from week 9 (February 29, 2020), which marked the inception of the pandemic in Nigeria, until week 12 of the following year (March 28, 2021).
Study setting
Nigeria is a country in the West African region. Administratively, Nigeria is divided into six geopolitical zones comprising 36 states and the Federal Capital Territory. All 36 states and the Federal Capital territory have reported COVID-19 cases and COVID-19 related deaths from the inception of the pandemic.
Data collection
Epidemiological indices of COVID-19 from February 29, 2020, to March 28, 2021 (week 9, 2020 - week 12, 2021) were downloaded from the official update database of the Nigeria Centre for Disease Control (NCDC). 8 The data were exported to SPSS for analysis. The confirmed cases and deaths were extracted directly while the fatality rates were computed. Also, data were extracted from the WHO weekly report within the same period of this study. 9
Definition of terms
- Confirmed cases/cumulative confirmed cases: This refers to the total number of confirmed COVID-19 cases within the period of study. It is represented as frequency.
- Deaths/cumulative deaths: This refers to the total number of deaths that resulted owing to COVID-19 infection within the study period. It is represented as frequency.
- Percentage of deaths : This refers to the proportion of COVID-19 deaths recorded in a particular State to the cumulative deaths recorded in all the States assessed within the study period. It is represented in percentage.
- Attack rate / Attack rate per 100,000 of population: The index refers to the number of persons infected with COVID-19 per 100,000 of the country’s population. It is represented as frequency per 100,000 of population.
- Case fatality rate: It refers to the proportion of cumulative deaths recorded in a state/country to the cumulative confirmed cases. It is represented in percentage.
Statistical analysis
Data were curated and analyzed using SPSS version 22. Epidemiological indices were represented in frequencies and proportions. Daily trends of epidemiological indices were represented in trend line-graph.
Origin and incidence case
On February 27, 2020, Nigeria recorded its first confirmed case of COVID-19, which was a 44-year-old Italian Citizen who had arrived in Murtala Mohammed International Airport, Lagos, Nigeria at about 10 pm on February 24, 2020, via a Turkish airline from Milan Italy. He subsequently travelled to his company site in Ogun State on February 25, 2020. On 26 th February of same the year, he presented at the staff clinic in Ogun State and there was a high index of suspicion by the managing physician. He was referred to Infectious Disease Hospital (IDH) Lagos and COVID-19 was confirmed on 27 th February. 10 This observation placed Nigeria second on the line of inception of the COVID-19 incident case, second to Algeria that reported her index case on February 25, 2020. The initial cases were mostly with overseas origin. However, Nigeria COVID-19 has progressed to community transmission.
Epidemiological trend/evolution
Figure 1a shows the weekly report of the COVID-19 epidemic in Nigeria within the study period. There was a progressive increase in the number of confirmed cases from week 9 (February 29, 2020) when the index case was reported, until it peaks in week 26 (June 21-27, 2020) and subsequently started to decrease again until week 43 (October 19-25, 2021) where the lowest incidence of the pandemic was recorded within that period. The case incidences were almost stable from week 44 (October 26 – November 1) to week 48 (November 23 – 29, 2020). The incidence of COVID-19 cases then rose from week 49 (November 30 – December 6, 2020) until they peaked again at week 3 of the following year (January 18 – 24, 2021) which recorded the all-round highest case count (11,179) throughout the pandemic. However, after week 3, the reported number of cases started to decline until the time of this report (Week 12: March 22-28, 2021).

Trend of weekly report of COVID-19 morbidity and mortality in Nigeria
Figure 1b shows the weekly trend of COVID-19 related deaths within the studied period. Just like the case of COVID-19 morbidity, data from COVID-19 mortality were also bimodal with peaks at week 25 (June 14 – 20, 2020) and week 6 of the subsequent year (February 8 – 14, 2021). Results however, showed a decline in COVID-19 related deaths after week 6 until the time of this report.

Trend of weekly report of COVID-19 case fatality report in Nigeria
Figure 2 shows the weekly trend of the case fatality rate of COVID-19 in Nigeria. The case fatality rate fluttered; it rose from the inception of the pandemic and continued to flutter within 0 (minimum value) observed in the first week of the pandemic (Week 9) and 5.66 (maximum value) recorded within week 15 (April 7 – 11, 2020).
Since the inception of the index case until March 28, 2021, Nigeria recorded a total of 162,593 confirmed COVID-19 cases ( Table 1 ). Stratification by states showed that Lagos State, Federal Capital Territory, Plateau State, Kaduna State, Rivers State, and Oyo State recorded the highest number of confirmed cases. Lagos State is the epicenter of the pandemic and accounted for approximately 35.4% (n=57,581) of all the COVID-19 cases ( Table 2 ). Figure 3 shows the geographical representation of morbidity by states.
PCR – polymerase chain reaction; RDT – rapid diagnostic test.
FCT – federal capital territory.

Geographical representation of COVID-19 epidemic in Nigeria by state
Demographic consideration showed that males were more affected than women, while the age bracket 25-39 years was the most affected. Specifically, those within the age bracket 35-39 years constituted the majority of the male COVID-19 morbidity while those within the age bracket 25-29 years constituted the bulk of the female COVID-19 morbidities ( Figure 4 ).

Gender-age representation of COVID-19 morbidity and mortality
The total number of deaths due to COVID-19 in Nigeria from the time of the index case until March 28, 2021, was 2,048 ( Table 1 ). Stratification of mortality by states showed Lagos, Edo, FCT, Oyo, Kano, and Rivers as the most affected with COVID-19 related deaths accounting for 21.43%, 9.03%, 7.62%, 6.00%, 5.37%, and 4.88% of all COVID-19 deaths in Nigeria ( Table 2 ).
Demographic stratification showed male preponderant death relating to COVID-19 within the age range of ≥45 years ( Figure 4 ).
Case fatality rate
The average case fatality rate of COVID-19 from the inception of the index case until March 28, 2020, is 1.30 ( Table 1 ). The results further showed that Kogi, Cross River, Edo, Kebbi, Jigawa and Zamfara States had the top six case fatality rates in Nigeria with relation to COVID-19 deaths ( Table 2 ).
Documented data showed that there were 150,308 documented recoveries from COVID-19 morbidity in Nigeria as of March 28, 2021 ( Table 1 ).
Attack rate per 100,000 population
As of 28 th March 2021, the attack rate per 100,000 of population of COVID-19 in Nigeria is 78.8 ( Table 1 ).
Laboratory testing
As of the time of the study, a total of 1,778,105 COVID-19 tests had been performed in Nigeria. Of these, 1,608,186 (90.4%) were PCR based tests while 169,119 (9.6%) were rapid diagnostic-based tests ( Table 1 ). Within the time of the study, 76 government (non-paid) laboratories 11 and 44 private fee-paying laboratories 12 across the country have been established for COVID-19 diagnosis. The states with the highest proportion of COVID-19 testing in Nigeria as of the time of this study were Lagos (428,499), FCT (242,845), Rivers (1160,199), Kano (91,948), Ogun (69,821), Plateau, (66,908) and Oyo (56,286) ( Table 2 ).
The Nigeria Centre for Disease Control developed interim guidelines for clinical management of COVID-19 with the recommended general principle for the treatment governed by: supplemental oxygen therapy, cautious, and conservative use of fluids (to prevent fluid overload), empiric use of antibiotics, and close monitoring of patients with signs of clinical deterioration. The NCDC however, cautioned on the lack of evidence on the efficacy of chloroquine and hydroxychloroquine (±azithromycin), lopinavir/ritonavir, remdesivir, umifenovir, favipiravir, tocilizumab, interferon-B-1a, except during clinical trials.
The guidelines for the clinical management of complications of COVID-19 are anchored on the two common complications of COVID-19: hypoxemic respiratory failure (HRF) and acute respiratory distress syndrome (ARDS); sepsis and septic shock. 13
Vaccination
As of April 6, 2021, 923,623 vaccine doses had been administered in Nigeria out of the 3.94 million doses of AstraZeneca/Oxford vaccine, manufactured by the Serum Institute of India (SII) received in the country on March 2, 2021. 14 On March 5, 2021, a doctor, Cyprian Ngong became the first person in Nigeria to receive the COVID-19 vaccine. The priorities plans for the administration of COVID-19 vaccines in Nigeria first considered health workers and supporting staff; frontline workers and first responders; persons aged 60 years and above; persons aged 50-59 years; persons aged 18-49 years with co-morbidities; then, the rest of the eligible population aged 18-49 years. Various surveys in Nigeria have shown wide hesitancy and negative perception on uptake of the COVID-19 vaccines in the Nigerian population 15 , 16 with some “No vaccine” advocates believing that vaccines are unwholesome tools for government control over the masses while others had hesitancy due to lack of trust in the government system and perceived risk of side effects of the vaccines.
In response to the pandemic, the Nigeria government on 28 th February 2020 activated a multi-sectoral Emergency Operations Centre (EOC) at Level 3 which is the highest emergency level in Nigeria. This is led by NCDC in close coordination with the State Public Health EOCs (PHEOC) and through the deployment of 52 Rapid Response Teams (RRT) to states.
Currently, response activities include: ongoing technical supports and deployment of diagnostic kits, personal protective equipment, and consumables to various states, activation of government non-paid laboratories and private fee-paying laboratories, support and verification of travelers’ COVID-19 test results and active role in infodemic management.
Preventive measures
In the wake of the pandemic, the Nigerian government made frantic moves towards the prevention of the disease, including screening of passengers at international airports using temperature scanners, implementation of compulsory wearing of non-medical masks in public places and observation of social distancing, temporary border closures, and regulation of public gatherings. 10
The cumulative confirmed cases of COVID-19 recorded in Nigeria within the study period were observed to be 162,593. This value placed Nigeria as the 5 th most-affected African country after South Africa (1,554,466), Tunisia (249,703), Egypt (199,364), and Ethiopia (198,794) and the 77 th most affected country in the world; accounting for 0.12% (162,593/129,359,540) of the global COVID-19 pandemic within the same period of time. 9 Juxtaposed to the global data, United States (29,859,706), Brazil (12,404,414), India (11,971,624), France (4,435,057) Russia (4,519,832) and United Kingdom (4,329,184) had remained the top six most affected countries at same period. 9 However, adjusting for population, the data showed a lower attack rate per 100,000 of the population (78.8) unlike African countries with very high attack rates like Seychelles (4,122.1/100,000), Cape Verde (3,060.9/100,000), South Africa (2,604.1/100,000), Namibia (1,711.9/100,000) and Botswana (1,635.7/100,000). 9
The younger age group of 25-39 years constituted the bulk of the confirmed cases. This could be explained by the fact that young people account for over 60% of Nigeria’s population. 17 More so, children under 5 years and those aged between 5-9 years accounted for 1.26% and 1.65%, respectively of COVID-19 confirmed cases in Nigeria. Although there is no clear reason for the incidence of COVID-19 in children, some authors have suggested a difference in immune system function. 18 , 19
Gender stratification showed male preponderance in the trend of COVID-19 infection in Nigeria. This observation aligns with an earlier report by World Health Organization African Region 20 and studies from China 21 and Italy. 22 This male predilection has been hypothesized to be due to genetic and physiologic factors which include wider distribution of SARS-CoV-2 cellular receptor, angiotensin-converting enzyme 2 (ACE-2) in males than in females. 19 , , 23 In another perspective, in Nigeria society that is largely patriarchal, males are more likely to put up with socioeconomic activities that are outside the confines of home, and subsequently have higher chances of exposure to COVID-19. 19
There was also variation in the incidence of COVID-19 among different states in Nigeria and Federal Capital Territory with Lagos State and Federal Capital Territory sitting far on top of the table, and accounting for nearly half (47.48%) of the total COVID-19 pandemic in Nigeria. This is not surprising as both states house the two busiest airports in the country with the highest number of destinations in Nigeria. The explanations for these variations are possible due to the volume of international travels in the states, variation of populations in each state, the difference in testing capacities of each state, 19 and largely the heterogeneous makeup of the Nigerian state.
Generally, the incidence of COVID-19 in Sub-Saharan Africa (except few cases) is relatively low as compared to the Americas, Asia, Europe, and North Africa. Before now, Africa has been predicted to be the most vulnerable continent in terms of COVID-19 infection and mortality and was predicted as the region where COVID-19 will have a major impact. The prediction was based on the continent’s weak health care system and large immune-compromised population. 24 , 25 However the present reality proved the prediction otherwise. Some researchers have attributed the low impact of COVID-19 in the region to the low volume of air travel, large youthful population, favorable climate and immunity from prior immunizations, and poor report of events. 26 - , 28
The trend in COVID-19 in Nigeria showed a bimodal trend. This shows a pandemic that restarted after flattening, with the second rise representing the second wave of COVID-19.
The cumulative deaths recorded in Nigeria within the study period are 2,058. This value placed Nigeria as the 7 th most-affected African country in terms of COVID-19 related deaths just after South Africa (52,648), Egypt (11,845), Tunisia (8,705), Algeria (3,077), Ethiopia (2,784) and Kenya (2,104) and the 79 th most-affected country globally, accounting for 0.07% of COVID-19 related deaths globally. These values are far from those obtained in the Americas and Asia: USA (543,003), Brazil (307,112), Mexico (300,862) and India (161,552), that sits on top of the mortality table.
When adjusted for population, the cumulative deaths per 100,000 of the population in Nigeria is 1.0. This value is quite low when compared to other African countries such as South Africa (88.8), Tunisia (73.7), Eswatini (57.4), Cape Verde (29.7), and Botswana (21.5). This places Nigeria in the 153 rd position globally on cumulative deaths per 100,000 of population. Higher values have been reported in United Kingdom (186.4), Mexico (155.8), Brazil (144.5), France (143.8), and India (11.7). 9
The cumulative case fatality rate recorded in Nigeria within the study period is 1.30. This value is lower than the global case fatality rate of 2.2% (2,769,473/129,359,540) as of April 6. Higher values have been reported in Yemen (21.0%), Mexico (9.0%), Syria (6.7%), Sudan (6.5%), Egypt (5.9%), Ecuador (5.2%), China (4.7%), Bolivia (4.5%), Somalia (4.5%), Afghanistan (4.3%), Zimbabwe (4.1%), Liberia (4.1%), Tanzania (4.1%) and Bosnia and Herzegovina (3.8%). 10 Generally, the case fatality rate of COVID-19 in sub-Saharan Africa (except few cases) is relatively low as compared to the Americas, Asia, Europe, and North Africa.
The prompt response to the COVID-19 pandemic is thought to be enhanced by previous pandemics such as Ebola. 29 Amidst the pandemic and its response in Nigeria, varying lessons have been learned. Social mobilization using a multimodal approach was evident in Nigeria’s response to COVID-19. The efficacy of information dissemination via social media such as Facebook, Twitter, and WhatsApp has been documented 30 and the response to COVID-19 portrayed this too, considering the fact that the use of smart phones and social media has become a norm even in resource-limited settings. This, therefore, calls for full utilization of social media to drive behavioral changes during disease outbreaks 30 given “table full” of rumors that accompany outbreaks. Among these are rumors of the origin of the pandemic and cures for the disease. From the public health perspective, the present pandemic has made significant progressive modifications. Water and other sanitary materials are now provided in public places and hand hygiene has become part of the daily routine among Nigerians. This will go a long way if sustained to reduce the trend of other infectious diseases that anchor on poor hygiene. More so, despite the lockdowns, the use of technology for virtual meetings, teaching, and learning has impacted positively on the social and academic well-being of Nigerians. This has come to stay and is currently adopted in many spheres as the most preferred means for social gathering, business transactions, and educational systems.
This study has provided insight into epidemiological events, responses, combative measures, and lessons learned from the COVID-19 pandemic. Nigeria has a lower impact of COVID-19 on the population when compared to other countries in the Americas, Asia, and Europe. COVID-19 has been reported in all states in Nigeria as well as the Federal Capital Territory with much of the cases involving males. The majority of the cases were found in young persons. The case trend showed a bimodal form indicating a second wave occurrence. Nigeria government has initiated some combative measures as well as vaccine initiation.
Authors’ contributions statement: HUO conceived the study, performed data curation, performed literature search, performed data analysis, wrote the initial manuscript draft and drew all maps. COO performed data curation, performed data analysis, edited the original manuscript. RIE performed quality check and edited the initial manuscript data. DAA performed data curation, performed data analysis and edited the manuscript draft. GME performed quality check and edited the initial manuscript data. All authors read and approved the final version of the manuscript.
Conflicts of interest: All authors – none to declare.
Funding: None to declare.
Ethics approval and consent to participate: This study is based on analysis from secondary data, thus, did not require ethical clearance.
Availability of data and material: Datasets generated and analyzed in this study are within the article. The primary source of data, NCDC database is publicly available.
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Open Access
Peer-reviewed
Research Article
SARS-CoV-2 (COVID-19 pandemic) in Nigeria: Multi-institutional survey of knowledge, practices and perception amongst undergraduate veterinary medical students
Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, Writing – review & editing
* E-mail: [email protected]
Affiliation Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria

Roles Conceptualization, Investigation, Methodology, Project administration, Writing – review & editing
Affiliation Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
Roles Data curation, Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review & editing
Affiliation Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
Roles Investigation, Methodology, Writing – review & editing
Affiliation Department of Veterinary Surgery and Theriogenology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
Roles Data curation, Investigation, Methodology, Writing – review & editing
Affiliation Department of Veterinary Microbiology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
Affiliation Veterinary Council of Nigeria, Federal Capital Territory, Abuja, Nigeria
Affiliation Nigerian Field Epidemiology and Laboratory Training Program, Lagos, Nigeria
Roles Project administration, Supervision, Validation, Writing – review & editing
Affiliation Department of Veterinary Anatomy, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
- Oluwawemimo Oluseun Adebowale,
- Olubukola Tolulope Adenubi,
- Hezekiah Kehinde Adesokan,
- Abimbola Adetokunbo Oloye,
- Noah Olumide Bankole,
- Oladotun Ebenezer Fadipe,
- Patience Oluwatoyin Ayo-Ajayi,
- Adebayo Koyuum Akinloye

- Published: March 15, 2021
- https://doi.org/10.1371/journal.pone.0248189
- Peer Review
- Reader Comments
The novel Coronavirus SARS-CoV-2 (COVID-19) is a global pandemic with an increasing public health concern. Due to the non-availability of a vaccine against the disease, non-pharmaceutical interventions constitute major preventive and control measures. However, inadequate knowledge about the disease and poor perception might limit compliance. This study examined COVID-19-related knowledge, practices, perceptions and associated factors amongst undergraduate veterinary medical students in Nigeria. A cross-sectional web survey was employed to collect data from 437 consenting respondents using pre-tested self-administered questionnaire (August 2020). Demographic factors associated with the knowledge and adoption of recommended preventive practices towards COVID-19 were explored using multivariate logistic regression at P ≤ 0.05. The respondents’ mean knowledge and practice scores were 22.7 (SD ± 3.0) and 24.1 (SD ± 2.9), respectively with overall 63.4% and 88.8% displaying good knowledge and satisfactory practice levels. However, relatively lower proportions showed adherence to avoid touching face or nose (19.5%), face mask-wearing (58.1%), and social distancing (57.4%). Being in the 6 th year of study (OR = 3.18, 95%CI: 1.62–6.26, P = 0.001) and female (OR = 2.22, 95% CI = 1.11–4.41, P = 0.024) were significant positive predictors of good knowledge and satisfactory practices, respectively. While only 30% of the respondents perceived the pandemic as a scam or a disease of the elites (24.0%), the respondents were worried about their academics being affected negatively (55.6%). Veterinary Medical Students in Nigeria had good knowledge and satisfactory preventive practices towards COVID-19; albeit with essential gaps in the key non-pharmaceutical preventive measures recommended by the WHO. Therefore, there is a need to step up enlightenment and targeted campaigns about COVID-19 pandemic.
Citation: Adebowale OO, Adenubi OT, Adesokan HK, Oloye AA, Bankole NO, Fadipe OE, et al. (2021) SARS-CoV-2 (COVID-19 pandemic) in Nigeria: Multi-institutional survey of knowledge, practices and perception amongst undergraduate veterinary medical students. PLoS ONE 16(3): e0248189. https://doi.org/10.1371/journal.pone.0248189
Editor: Adewale L. Oyeyemi, University of Maiduguri College of Medical Sciences, NIGERIA
Received: September 12, 2020; Accepted: February 19, 2021; Published: March 15, 2021
Copyright: © 2021 Adebowale et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The datasets have been deposited in Mendeley data. Adebowale, Oluwawemimo; Adenubi, Olubukola; Adesokan, Hezekiah; Oloye, Abimbola; Bankole, Noah; Fadipe, Oladotun; Ayo-Ajayi, Oluwatoyin; Akinloye, Adebayo (2020), “SARS-CoV-2 (COVID-19 Pandemic) in Nigeria: Multi-institutional Survey of Knowledge, Practices and Perception Amongst Undergraduate Veterinary Medical Students”, Mendeley Data, V1, doi: 10.17632/jy7hh77f8c.1 .
Funding: The author(s) received no specific funding for this work
Competing interests: The authors have declared that no competing interests exist.
Introduction
The COVID-19 pandemic is an ongoing infection that has spread to over 188 countries globally with over 245, 984 new cases, 25,602,665 confirmed, and 852,758 deaths as at September 2 nd 2020 [ 1 ]. The disease was first reported to have originated from Wuhan, China and the causative agent identified as a novel coronavirus, Severe Acute Respiratory Syndrome (Coronavirus‐2 SARS‐CoV‐2) [ 2 ]. This disease is similar to the previously emerged SARS-CoV and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). COVID-19 was announced as a pandemic by the World Health Organization and disease of a public health emergency globally on March 12, 2020 [ 2 ]. Subsequently, countries globally have had to implement global standard control strategies, which had hitherto not been employed since the Spanish Flu epidemic. These measures, which included travel restrictions, lockdowns or curfews, workplace hazard controls, closure of public facilities including pubs, restaurants, gyms, schools and higher institutions, strict hand hygiene practices, social distancing and the wearing of facemasks have impacted lives on a global scale. Despite these mitigation measures, the number of cases is still on the increase globally with the Americas, Europe and South-East Asia badly affected [ 1 ].
Nigeria reported its index case of COVID-19 on February 27, 2020; incidentally, the first in Nigeria and West Africa according to the Nigerian Centre for Disease Control [ 3 ]. Subsequently, a lockdown or curfew in various states was implemented to contain the fast spread of the virus. All citizens except those on essential duties were expected to stay at home and maintain good handwashing hygiene practices, local and international travels were restricted, businesses, offices, public gatherings (including religious places), schools and universities were closed, and public and private sports cancelled. According to the NCDC, more than 286,000 tests, 43,537 confirmed positive cases, 22,567 active cases, 20,087 discharges and 883 human deaths were reported as at the commencement of this study, August 1 st , 2020 [ 3 ] across 36 states in the country, including the Federal Capital Territory (FCT), Abuja. However, the numbers of cases and deaths are on the rise with 56,177 confirmed cases, 1,078 fatalities as at the time of article submission (September 12 th , 2020).
The pandemic has brought about huge negative consequences on business, education, health, and tourism globally [ 4 ]. Presently, primary, secondary and tertiary institutions in Nigeria are still closed and this has seriously affected millions of students in tertiary institutions who have their semesters cancelled or suspended due to the pandemic. While many other countries have switched to virtual learning, many tertiary institutions within Nigeria lack the various online educational platforms or facilities for such method of teaching [ 5 ], which could worsen the situation for students in the country. Several studies have reported students’ mental health becomes greatly affected when faced with a public health emergency and academic delays, which has been positively correlated with anxiety levels [ 4 , 6 – 9 ]. Studies by previous authors had shown that COVID-19 has a profound impact on the public, medical students, dental medical students, and radiology trainees, as well as the knowledge, practices and attitudes [ 10 – 13 ] but none, is known yet about veterinary medical students in Nigeria. Adequate knowledge among individuals measures the first line of defence against this disease [ 14 ]. It is therefore important to understand the knowledge, views, adherence to the Nigerian government control policies among the veterinary student population.
To the best of our knowledge, this is the first study that would investigate the knowledge, preventive practices and perceived impacts (KPP) of COVID-19 pandemic among veterinary medical students in Nigeria.
Materials and methods
Study design and setting.
This cross-sectional, multi-institutional web survey was conducted from August 1 st to 18 th , 2020 among undergraduate veterinary students in Nigeria, a West African country that is comprised of 36 states categorized into six geopolitical zones–South West, South East, South South, North East, North West, North Central and the Federal Capital Territory (FCT). The country runs the Doctor of Veterinary Medicine (DVM) programme, a six-year course in twelve universities and regulated by the Veterinary Council of Nigeria (VCN). The programme is divided into three phases namely, the preclinical (year two and three i.e. DVM 1 and 2), paraclinical (year four i.e. DVM 3) and clinical (year five and six i.e. DVM 4 and 5).
Study population structure, sample size and sampling
The study population included veterinary medical students in 11 veterinary schools in the country. These universities and their respective geopolitical zones are University of Nigeria, Nsukka, Enugu State, Michael Okpara University of Agriculture, Umudike, Abia State (South East); Federal University of Agriculture, Makurdi, Benue State, University of Jos, Plateau State, University of Ilorin, Kwara State (North Central); Ahmadu Bello University, Zaria, Kaduna State, Usmanu Danfodiyo University, Sokoto, Sokoto State (North West); Federal University of Agriculture, Abeokuta, Ogun State, University of Ibadan, Ibadan, Oyo State ((South West); University of Maiduguri, Borno, Borno State (North East); and the University of Abuja (FCT) Fig 1 .
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https://doi.org/10.1371/journal.pone.0248189.g001
The inclusion criteria for the participants were 1) students must be fully registered in any one of the veterinary schools previously listed, 2) and must be in DVM 1 (year 2) to DVM 5 (year 6). One university was excluded from the study as it was yet to reach the clinical phase of the veterinary programme. Similarly, Year 1 students were excluded largely because of non-exposure to core veterinary courses. A total number of all the veterinary medical students who were eligible to participate in the online survey was 3,724. Fig 2 provides the flowchart process for student recruitment for the online survey.
https://doi.org/10.1371/journal.pone.0248189.g002
The sample size for this survey was calculated based on the assumptions that poor levels of knowledge and practices among respondents were 50%, an absolute precision of 95% confidence interval, and an acceptable error of 5%. Using Working in Epidemiology (WinEpi v.2.0), a total of 385 participants was estimated while a 10% non-contingency was added to make up for non-response, giving a minimum target sample size of 423 participants [ 15 ]. The total sample size was divided equally among the veterinary schools (43 students per university). We then conveniently recruited a minimum of nine at each level (DVM 1-DVM 5) across the participating universities while participation was made voluntary. We employed an online survey due to the COVID pandemic and lockdown policy in the country as at the time of study. Briefly, prior commencement of the study, the national president of the Association of Veterinary Medical Students (AVMS) and his counterparts at the various university chapters were contacted. A detailed information on the project focus, aims, and plans for student recruitment were discussed over several online meetings. Following their consent, invitations were sent to students nationwide to participate in the study using the WhatsApp platforms of the Association of Veterinary Medical Students (AVMS) of the various university chapters. The link to the online survey questionnaire was included in the sent invitations and a brief description of the purpose of the study was provided. Also, class coordinators at various levels (DVM 1 to 5) were further assigned to share the questionnaire on their respective class WhatsApp platforms, while three of the authors were delegated to follow up on this process to enhance participation. Also, call credit top up cards were offered as incentives for participation and completion of the survey.
Questionnaire design and pretest
The questionnaire using google forms (Alphabet Inc., California, USA) comprised a total of 41 questions (both open and closed-ended) written in English and adapted from WHO resources and other pertinent studies [ 2 , 4 , 16 – 20 ]. The questionnaire was divided into four sections and comprised questions on students’ demographics, knowledge, practices, and perceptions towards COVD-19.
The first section consisted of questions assessing the socio-demographic profiles of the respondents (further considered as our independent variables). These included age as at last birthday (in years), sex, religion, the name of Institution, programme year, state of residence during the lockdown, number of household members, and type of lockdown instituted by the state government where resident.
To measure students’ general knowledge about COVID-19, an 11-item questionnaire that assessed the source of information about COVID-19 and general awareness questions were provided in section B. Question one addressed the various sources of updates and information on the pandemic were requested. The other ten questions focused on clinical presentation, transmission, prevention, and control strategies of COVID-19. Question asked included the cause of COVID-19 infection, incubation period, risk conditions, country of the first outbreak, modes of transmission, identification of common symptoms of the infection, if it was possible to have asymptomatic individuals, and methods of prevention, control and treatment. Each correct answer weights 1 point and 0 for incorrect or I don’t know answers. Score for each responses was summed up to give 31 points.
Section C of the questionnaire assessed respondents’ practices during the pandemic and comprised 3 Likert-item questions (10) were adopted from recommended guidelines of the WHO and Ministry of Health, Nigeria for the prevention of COVID-19 transmission. These included handwashing/sanitizing, avoiding crowded places, keeping physical/social distance, avoiding touching of face or nose, avoiding handshakes, use of facemasks, and medications. The responses were never, sometimes, all the time each weighing 1, 2, and 3 points respectively. The Score for each response was summed up to give 30 points.
The questions in section D were structured to evaluate respondents’ perceptions. The 5-point Likert item questions (12) were designed to assess students’ perceptions of the infection based on the country’s peculiarity. Some of the questions asked included whether the disease was a scam, affected only the elites, impact on academics and virtual learning in higher institutions, stigmatization, whether participants were optimistic the pandemic would be brought under control, and if they felt depressed. The agreement scale ranged from ‘1’ for “strongly agree” to ‘5’ for “strongly disagree”.
The questionnaire was reviewed by a panel of experts and revised based on their comments. Subsequently, it was pilot-tested (n = 13 students from all the eleven veterinary schools, who were excluded in the main study), to check for its applicability and clarity before commencement of the study. All the necessary modifications were done based on outcome of the pilot study. The completion of the online survey took about 8 minutes and designed to ensure duplicate entries was avoided by preventing users with the same IP address access to the survey twice in the google form settings. Detailed information on the questionnaire is presented in S1 File .
The online survey was conducted based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), and guidelines for good practice in the conduct and reporting of online research [ 21 ].
Ethical approval
The study protocol was approved by the College of Veterinary Medicine, Federal University of Agriculture Research Ethics Committee (reference number: FUNAAB/COLVET/CREC/2020/07/01). After providing detailed description of the study and before invitations, informed consent was obtained from the presidents of the different AVMS chapters. Participants’ consent was obtained verbally and witnessed by the class coordinators of the various levels (HOCs–DVM 1 to 5). Participation in the study was voluntary without any attached penalty for refusal; personal identifiers were not collected and information from respondents was treated confidentially. Every participant was notified of his/her right to discontinue at any stage of the study according to the World Medical Association Declaration of Helsinki, 2001 [ 22 ].
Data analysis
Data generated were captured and filtered in Microsoft Excel®, 2013 (Microsoft Corporation, Redmond, WA). Data analyses were conducted by GraphPad Prism 8.0.0 (descriptive statistics and figure presentations) and Stata 12.0 (inferential statistics). Descriptive statistics were conducted for all variables and presented in forms of frequencies and proportions/percentages using Microsoft Excel® (2013). As for the descriptive statistical methods, the following were used: measures of central tendency (arithmetic mean and median), measures of variability (standard deviation), and as absolute numbers (n) and percentage representation. To evaluate the knowledge level of respondents, a numeric pattern of scoring was used by giving a score of “1” for the “correct answer” and “0” for an “incorrect” or “I don’t know” response. Similarly, the practice level was assessed by giving scores of “1” for the “never” and “2” for “sometimes” and 3 for “all the time” responses. The levels of measured outcomes were expressed as mean and standard deviation (Mean ± SD). The measured outcomes were tested for normality using the using Kolmogorov-Smirnov (> 0.05), which informed our use of (Mean ± SD). The scores were thereafter converted to percentages, and based on the students’ mean scores in knowledge and practices categories, cut-off points for good / satisfactory were set at ≥70%, while those below (<70%) were considered to have poor/ unsatisfactory levels. These cut-off points were so set since it is expected that such students on medical profession should have basic knowledge and demonstrate practices towards issues related to health. Besides, such cut-off points had earlier been employed in a similar study [ 23 ]. Mean scores were compared across demographic categories using ANOVA and independent t-tests where appropriate. For post hoc comparision Dunnett’s test was performed.
Associations between the socio-demographics of respondents (independent variables) and binary outcomes of knowledge and practices (dependent variables) using chi-square tests were determined. To determine potential predictors influencing knowledge and practice levels towards COVID-19 prevention among undergraduate veterinary students in Nigerian universities, outcomes significant at p ≤ 0.25 at the univariate analysis were processed further by a stepwise forward likelihood multivariate analysis (logistic regression model) using Stata 12.0 was performed. This was chosen in order to avoid variation in results from individual univariate tests of different measures due to random chance. The decision for a liberal p-value (p ≤ 0.25) at this step was to ensure important potential predictor/risk variables were included in the model. A p<0.05 was considered statistically significant and odds ratios were computed to determine the strength of associations between variables at 95% confidence intervals (CIs). All illustrations were performed with GraphPad Prism 8.0 and Microsoft Excel®.
Demographic information of respondents
A total of 437 respondents participated in this study across Nigeria, which provided a participation rate of more than 100.0%. The mean age of respondents was 22.14 ± 2.99 years, and the median number of members in a household was 6 (min = 1, max = 90). The highest percentage of the respondents (17.2%, 95% CI; 13.9–21.0) were in the Federal University of Agriculture, Abeokuta and DVM 4 (year 5, 23.8%, 95% CI; 20.0–28.0). Majority of respondents resided in the South West (38.9%, 95% CI; 34.6–43.7) and North Central (38.2%, 95% CI; 33.7–42.8) regions of the country. The demographics of the study sample are presented in Table 1 .
https://doi.org/10.1371/journal.pone.0248189.t001
Respondents knowledge level towards COVID– 19
The most preferred source was through social media/internet platforms (n = 403), including Facebook, Instagram, and Twitter. The less employed sources of information were newspapers (n = 126) and classrooms (n = 98).
The respondents showed an overall mean knowledge score of 22.7 (SD ± 3.0; score 0 → 31), suggesting a mean level of 73.4% (SD ± 9.7%, range 38.7–93.5%) on COVID– 19. A total of 277 (63.4%) students had knowledge scores ≥ 70% cut off, however, none responded correctly to all the knowledge items (71–93.5%). Knowledge varied significantly among the age groups (p = 0.0042) with those within groups 21–25 years and 26–30 years having higher scores (p = 0.011). Similarly, knowledge scores significantly varied among DVM levels (p = 0.0001) and Veterinary schools (p = 0.027) with students in DVM 5 (Year 6) outperforming those in the preclinical levels DVM 1 (p<0.0001), DVM 2 (p = 0.024) and DVM 3 (p = 0.042).
High proportions of students correctly identified COVID– 19 as a viral infection (98.9%, n = 432) and that it originated from Wuhan China (99.3%, n = 434), while 27.9% correctly (n = 122) reported it as similar to both SARS-CoV and MERS-CoV. Clinical signs associated with COVID-19 as identified by respondents were as follows: fever (97.5%, n = 426), fatigue (70.9%, n = 310), dry cough (86.5%, n = 378), runny nose (38.0%, n = 166), shortness of breath (91.5%, n = 400), myalgia (35.0%, n = 153), loss of taste (40.0%, n = 175), loss of smell (46.0%, n = 201), and diarrhoea/vomiting (21.3%, n = 93). Only 5 (1.1%) of the respondents correctly identified all the possible clinical presentations. A high proportion (84.2%, n = 368) knew that the COVID-19 virus spreads via respiratory droplets of infected people, and asymptomatic state of infection and transmission is possible (88.3%, n = 386). Also, majority of the respondents knew the application of alcohol-based sanitizers (95.9%), soap and detergent (75.0%), high temperature inactivates or kills the virus (61.1%). Meanwhile, 308 (70.5%) were aware there was no cure for the disease. Table 2 presents details of knowledge components and students’ performance on various questions on COVID-19.
https://doi.org/10.1371/journal.pone.0248189.t002
COVID-19 and self-reported preventive practices of respondents
Majority of the students reported maintaining good personal hygiene (n = 386, 84.2%), while a lower proportion would not touch their face or nose all the time (n = 85, 19.5%). Averagely, respondents observed the stay at home policy (n = 219, 50.1%), face mask-wearing in public (n = 254, 58.1%), and social distancing from people (n = 251, 57.4%). Up to 66.4% (n = 299) reported never self-medicating to prevent COVID- 19 infection. A significant association between the knowledge that there was no cure for COVID-19 and not self- medicating was observed (p = 0.01). Fig 3 further describes in details respondents’ practices towards preventing being infected and community spread.
https://doi.org/10.1371/journal.pone.0248189.g003
The overall preventive practice mean score of students towards COVID- 19 was 24.1 (SD ± 2.9; score 0 → 30), suggesting a mean level of 80.3% (SD ± 9.6%, range 40.0–100.0%). The practice level was generally satisfactory with 88.8% (n = 388) of the respondents having the ≥ 70% cut off, while one student reported observing all the preventive measures. A positive correlation between preventive practice measures and knowledge about COVID– 19 was observed, although weak (r = 0.16, n = 437, p = 0.0009, 95% CI; 6.2–25.0). The practice scores were similar across DVM levels (p = 0.09), geopolitical regions of residence (p = 0.36), and lockdown type (p = 0.10).
Bivariate analysis for the association between sociodemographic profiles of respondents and their knowledge and practice levels on COVID-19 pandemic
The bivariate analysis showed that only age (p = 0.017) and year of study (p = 0.009) were significantly associated with knowledge levels at p ≤ 0.25 ( Table 3 ).
https://doi.org/10.1371/journal.pone.0248189.t003
Similarly, sex (p = 0.012), religion (p = 0.076), and geopolitical region (p = 0.022) were associated factors with practice level of respondents towards COVID-19 pandemic ( Table 4 ).
https://doi.org/10.1371/journal.pone.0248189.t004
Multivariate analysis for the association between sociodemographic profiles of respondents and their knowledge and practice levels on COVID-19 pandemic.
The multivariate logistic regression analysis reveals only the level/year of study (p = 0.014) and sex (p = 0.024) of respondents respectively were significant positive predictors of good knowledge and practice levels towards COVID-19. Respondents in Year 6 (clinical) were about 3.2 times more likely to have good knowledge of COVID-19 pandemic (OR = 3.18, 95%CI: 1.62–6.26, p = 0.001) than those in Year 2 (non-clinical). On the other hand, the female had higher odds of demonstrating satisfactory practices regarding COVID-19 pandemic (OR = 2.22, 95%CI = 1.11–4.41, p = 0.024) than the males ( Table 5 ). Besides, respondents in the regions marked others (OR = 0.37, 95%CI: 0.17–0.78, p = 0.009) had significantly lowest odds of demonstrating satisfactory practices regarding COVID-19 ( Table 5 ).
https://doi.org/10.1371/journal.pone.0248189.t005
Perceptions about COVID– 19
Most of the respondents reported they have seen persons infected with COVID-19 and do not think the pandemic was a scam (68.6%, n = 300), or a disease of the elites (76.0%, n = 332). Also, 73.9% (n = 323) respondents disagreed they had internet facilities to educate themselves with online programmes related to the profession. Averagely, 55.6% (n = 243) students were worried their academic performance would be affected negatively and 50.1% (n = 199) spend more time on social media than studying. A good proportion (71.6%, n = 313) of the students were optimistic about the pandemic being over soon while 44.1% agreed being depressed as a result of the pandemic ( Fig 4 ).
https://doi.org/10.1371/journal.pone.0248189.g004
This study, which aptly reflected the KPP of Veterinary medical student towards the COVID-19 pandemic, is the first in Nigeria and Africa to the best of the authors’ knowledge. The majority of the students had good knowledge and satisfactory practices regarding COVID-19 pandemic; however, there were important gaps in the key non-pharmaceutical preventive measures recommended by the WHO with implications for public health and disease control.
The study revealed a higher number of male respondents than females. This is similar to previous studies which showed a reflection of male dominance in the veterinary profession in Nigeria [ 15 – 17 , 24 ]. Female veterinary students who participated in this study (40.5%), when compared with a similar and recent study conducted among veterinary professionals with 27.2% female respondents seems higher [ 17 ]. Presently, gender shift with more females than males in the veterinary profession especially in the Western world [ 25 – 28 ] and in South Africa [ 29 ] is reported.
The respondents’ mean knowledge score was 22.7 (SD ± 3.0; 73.4%) with an overall 63.4% displaying good knowledge which seems satisfactory and similar to reports for medical students in Jordan with overall 69.5% showing good knowledge [ 30 ] and veterinary professionals in Nigeria (64.0%, [ 17 ]). The knowledge level displayed was higher than reports from two university communities in Pakistan (50.2%, [ 31 ] and Nigeria (59.5%, [ 16 ]) as well as among the public visiting a medical centre in Ethiopia (41.3%, [ 19 ]). However, other studies have recorded higher knowledge level towards the COVID- 19 pandemic among undergraduate students in China (82.3%, [ 32 ]), residents in North central Nigeria (99.5%, [ 33 ]), the United States (80%, [ 34 ]), and China (90.0%, [ 35 ]).
Majority of the veterinary medical students relied on the internet and social media to get information or updates about the pandemic, which might have contributed to the high level of knowledge acquired about COVID-19. This follows similar studies were the internet/social media was reported as the most common source of information for medical and non-medical students [ 10 , 18 , 30 ]. Several guidelines and information on COVID-19 have been uploaded online by WHO and NCDC immediately after pronouncing the guidelines. Also, the public receives constant notifications or reminders about these guidelines by network service providers in the country. It is, however important that government agencies should work towards dispelling misinformation, misconceptions, rumours or hoax news from illicit social media platforms, which have increased 50 times more during the pandemic [ 4 ].
Further, being students in their final year (which corresponds to the clinical year) than in non-clinical was a positive predictor for good knowledge about COVID- 19. This is not surprising because all veterinary schools engage students in clinical courses in veterinary public health, epidemiology of infectious/zoonotic diseases, mechanisms of disease spread and control. It is expected that the greater the exposure to clinical teaching in the final year of veterinary school, the more the students at this level will likely be keen or inquisitive to acquire more information or knowledge than others. Besides, respondents in the North West region had the lowest odds of having good knowledge of COVID-19 pandemic when compared with other geopolitical regions. This finding is very vital to planning an informed disease mitigation programme as such data are required in enhancing targeted educational programmes among university student populations in the country. Multi-stakeholder collaborative efforts and strategies should be promoted within institutions to contain pandemic among university students.
The level of preventive practices among the students (88.8%) was also commendable; however, there were some important gaps in public health concerns. Averagely, respondents (50.1%) observed the stay at home policy, face mask-wearing in public (58.1%), and social distancing from people (57.4%). While these three constitute key non-pharmaceutical preventive measures recommended by the WHO, it appears worrisome that only a little above average of the respondents adhered to these measures. Meanwhile, the issue of face masking is becoming debatable within some groups of people globally. Some see the policy as a bridge of human rights, while some other people feel uncomfortably hot and experience difficulty in breathing when wearing face masks. Our data on face masking is similar to other studies which showed that although people know it is one of the protective guidelines, many do not frequently comply with its use in public places [ 18 , 31 , 33 , 34 , 36 ]. Now that Colleges and Universities will soon be re-opened in Nigeria, targeted education and measures should be in place to ensure students comply with the key protective guidelines especially the wearing of face masks on resumption.
Majority of the respondents practiced good hygiene and did not use any self-medication as prophylaxis. It was observed that knowing that there was no cure for the virus significantly influenced the respondents’ choice not to self-medicate as a prophylactic measure. Female students displayed a satisfactory practice level twice more than male in this study. This is not surprising as the females are viewed to be more cautious than their male counterparts who often dare and take risks. Findings from Pakistan showed literate society, particularly women had good knowledge, optimistic attitudes, and practices towards COVID-19 [ 37 ]. Similar studies conducted in China and Pakistan showed preventative practices were better in the female population than males [ 31 , 35 ]. Other studies, however, reported good practices were associated with age, gender and education [ 37 , 38 ].
Again, the majority of the respondents had right perceptions about COVID-19 pandemic, as 76.0% perceived the disease as not a scam nor a disease of the elites (70.0%). Besides, the majority of the students held an optimistic attitude with 71.6% believing that COVID-19 would finally be successfully controlled. Such perceptions could promote global drive at containing the pandemic since this might eventually rub on their level of adherence to preventive measures. Importantly, the consequent perceived impacts of COVID-19 pandemic on academics in Nigeria by the respondents is a matter of concern. The respondents were worried their academic performance would be affected negatively (55.6%) and that they spent more time on social media than studying (50.1%). Many (74.0%) shared their dissatisfaction about the government tertiary institutions because of the inadequate online facilities or tools to perform virtual education in Nigeria during such a time like this. While many colleges and universities worldwide switch to online teaching to reduce people contact, public universities in Nigeria have not been able to achieve this.
Lastly, over 44.0% of student participants indicated having depression due to the pandemic. Several studies have shown the psychological impact of the epidemic on the general public, patients, medical staff, children, and older adults [ 6 , 39 , 40 ]. Students’ mental health is greatly affected and may worsen existing mental health problems when faced with a public health emergency, social isolation, and economic recession. In times like this, students need attention, assistance, and support from the community, family, and tertiary institutions [ 4 ]. The emotional status of the respondents, as reflected by their response to their perception about marital issues appears to favour disinterest in love relationship and marriage contraction. This might be attributed to more engaging thoughts about overcoming the prevailing pandemic.
Some limitations of the approach utilized in the study were identified. The introduction of enrolment and reporting biases may have resulted from the online survey making it non-representative. For the study, randomization was impossible due to the national lockdown, which could have possibly eliminated some of the biases. The non- probabilistic sampling approach, which is convenience and voluntary may have contributed to in the uneven distribution (coverage and participation) of student respondents from the different universities investigated. Furthermore, the poor internet accessibility or connectivity in the country (which may have varied from one institution location to another) and lack of funds to purchase data as complained by some students may have contributed to the lack of access to online questionnaire and participation. We are therefore cautious in generalizing the sample findings to the whole veterinary student populations in the country due to these limitations.
Although the knowledge and preventive practices of the veterinary students in this study were satisfactory, there were important gaps in some key preventive practices recommended by the WHO. Some of the identified KPP gaps in this study require urgent attention and must be targeted towards promoting strategic educational planning and behavioral changes. Also, e-learning facilities should be provided within the Nigerian universities, which must be constantly upgraded and usage maximized by staff and students where necessary to promote physical distancing as much as possible.
Supporting information
S1 file. questionnaire on the knowledge, practices and perception of undergraduate veterinary students towards covid-19 in nigeria..
https://doi.org/10.1371/journal.pone.0248189.s001
Acknowledgments
We are grateful to the national and chapter presidents of the AVMS for their commitment towards the success of this project. The authors are grateful to all the veterinary students across Nigeria who responded to the survey.
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- 3. Nigeria Centre for Disease Control (NCDC). "First case of Coronavirus disease confirmed in Nigeria", 28 February 2020. Available from: https://ncdc.gov.ng/news/227/first-case-of-corona-virus-disease-confirmed-in-nigeria . (accessed 25 July 2020).
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The COVID-19 era: the view from Nigeria
Affiliations.
- 1 Excellence and Friends Management Care Centre (EFMC), Abuja, Nigeria.
- 2 The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
- 3 Global Health Services Network, Farmington, MI 48335, USA.
- 4 Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
- PMID: 33118021
- PMCID: PMC7665780
- DOI: 10.1093/qjmed/hcaa297
If we were told that one day the entire world would take its guidance for managing a health crisis from empirical thought, nobody would have believed it. However, with the December 2019 arrival of COVID-19 in China, the world subsequently went into a frenzied state that resulted in the widespread adoption of untested strategies or potential cures; circumstantial evidence provided without randomized control trials (RCTs) was published rapidly and widely considered the gold standard in medical research and therapeutics. Nigeria and much of the rest of the world blindly adopted treatments like chloroquine or hydroxychloroquine and various prevention strategies, often without monitoring the efficacy of these treatment and social control strategies. COVID-19 provided Nigeria a critical opportunity to create or strengthen its national laboratory system by building up its Level 3 laboratories in all parts of the country with the capability to perform PCR tests and viral isolation. There was also an opportunity to establish hospitals in every region of a sufficient standard to reduce the numbers of Nigerians travelling abroad to seek medical treatment; to invest in building capacity to develop antiviral medications and vaccines in Nigeria, and to ensure better international health policies. Rather, Nigerian leaders, government and health managers decided (like most other nations of the world) to shut down the society using isolationist policies that were not necessarily tailored to local needs. Despite adopting these methods, COVID-19 cases continued to skyrocket in Nigeria. In the future, before adopting such broad sweeping policies, there should be local tailoring to assess their effectiveness in different communities. Given that the country has much experience in controlling Lassa and Marburg Fever outbreaks, Nigeria should lead by developing new strategies, new protocols and new local guidelines, based on validated and reproducible studies to ensure that the public health authorities are not caught unaware by any new outbreaks of emerging or remerging diseases.
© The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: [email protected].
- COVID-19 Drug Treatment*
- COVID-19* / epidemiology
- COVID-19* / prevention & control
- COVID-19* / therapy
- Change Management*
- Civil Defense / standards
- Communicable Disease Control* / methods
- Communicable Disease Control* / organization & administration
- Culturally Competent Care* / legislation & jurisprudence
- Culturally Competent Care* / methods
- Culturally Competent Care* / organization & administration
- Government Regulation
- Nigeria / epidemiology
- Physical Distancing
- Policy Making*
- Public Health / standards*
Understanding the impact of the COVID-19 outbreak on the Nigerian economy
Subscribe to africa in focus, chukwuka onyekwena , chukwuka onyekwena executive director - centre for the study of the economies of africa mma amara ekeruche mma amara ekeruche senior research fellow - centre for the study of the economies of africa.
April 8, 2020
With 1.39 million coronavirus cases and 79,382 deaths globally, the world continues to battle the COVID-19 pandemic. Even before the outbreak, the outlook for the world economy—and especially developing countries like Nigeria—was fragile, as global GDP growth was estimated to be only 2.5 percent in 2020 . While many developing countries have recorded relatively fewer cases—Nigeria currently has 238 confirmed cases and 5 deaths as of this writing—the weak capacity of health care systems in these countries is likely to exacerbate the pandemic and its impact on their economies.
The impact on the Nigerian economy
Before the pandemic, the Nigerian government had been grappling with weak recovery from the 2014 oil price shock, with GDP growth tapering around 2.3 percent in 2019. In February, the IMF revised the 2020 GDP growth rate from 2.5 percent to 2 percent, as a result of relatively low oil prices and limited fiscal space. Relatedly, the country’s debt profile has been a source of concern for policymakers and development practitioners as the most recent estimate puts the debt service-to-revenue ratio at 60 percent, which is likely to worsen amid the steep decline in revenue associated with falling oil prices. These constraining factors will aggravate the economic impact of the COVID-19 outbreak and make it more difficult for the government to weather the crisis.
Aggregate demand will fall, but government expenditure will rise
In Nigeria, efforts were already being made to bolster aggregate demand through increased government spending and tax cuts for businesses. The public budget increased from 8.83 trillion naira ($24.53 billion) in 2019 to 10.59 trillion naira ($29.42 billion) in 2020, representing 11 percent of the national GDP, while small businesses have been exempted from company income tax, and the tax rate for medium-sized businesses has been revised downwards from 30 to 20 percent. Unfortunately, the COVID-19 crisis is causing all components of aggregate demand, except for government purchases, to fall (Figure 1).

The fall in household consumption in Nigeria will stem from 1) partial (or full) restrictions on movement, thus causing consumers to spend primarily on essential goods and services; 2) low expectations of future income, particularly by workers in the gig economy that are engaged on a short-term/contract basis, as well as the working poor in the informal economy; and 3) the erosion of wealth and expected wealth as a result of the decline in assets such as stocks and home equity. The federal government has imposed a lockdown in Lagos and Ogun states as well as Abuja (which have the highest number of coronavirus cases combined). Subnational governments have quickly followed suit by imposing lockdowns in their states. Nigeria has a burgeoning gig economy as well as a large informal sector, which contributes 65 percent of its economic output . Movement restrictions have not only reduced the consumption of nonessential commodities in general, but have affected the income-generating capacity of these groups, thus reducing their consumption expenditure.
Investments by firms will be impeded largely due to the uncertainties that come with the pandemic-limited knowledge about the duration of the outbreak, the effectiveness of policy measures, and the reaction of economic agents to these measures—as well as negative investor sentiments, which are causing turbulence in capital markets around the world. Indeed, the crisis has led to a massive decline in stock prices, as the Nigerian Stock Exchange records its worst performance since the 2008 financial crisis, which has eroded the wealth of investors. Taking into consideration the uncertainty that is associated with the pandemic and the negative profit outlook on possible investment projects, firms are likely to hold off on long-term investment decisions.
On the other hand, government purchases will increase as governments, which typically can afford to run budget deficits, utilize fiscal stimulus measures to counteract the fall in consumer spending. However, for governments that are commodity dependent, the fall in the global demand for commodities stemming from the pandemic will significantly increase their fiscal deficits. In Nigeria’s case, the price of Brent crude was just over $26 a barrel on April 2, whereas Nigeria’s budget assumes a price of $57 per barrel and would still have run on a 2.18 trillion naira ($6.05 billion) deficit. Similarly, with oil accounting for 90 percent of Nigeria’s exports, the decline in the demand for oil and oil prices will adversely affect the volume and value of net exports. Indeed, the steep decline in oil prices associated with the pandemic has necessitated that the Nigerian government cut planned expenditure. In fact, on March 18, the minister of finance announced a 1.5 trillion naira ($4.17 billion) cut in nonessential capital spending.
The restrictions on movement of people and border closures foreshadow a decline in exports. Already, countries around the world have closed their borders to nonessential traffic, and global supply chains for exports have been disrupted. Although the exports of countries that devalue their currency due to the fall in the price of commodities (like Nigeria), will become more affordable, the limited markets for nonessential goods and services nullifies the envisaged positive effect on net exports.

What are the policy responses by the Nigerian government?
Already, the Central Bank of Nigeria (CBN) has arranged a fiscal stimulus package, including a 50 billion naira ($138.89 million) credit facility to households and small and medium enterprises most affected by the pandemic, a 100 billion naira ($277.78 million) loan to the health sector, and a 1 trillion naira ($2.78 billion) to the manufacturing sector. In addition, the interest rates on all CBN interventions have been revised downwards from 9 to 5 percent, and a one-year moratorium on CBN intervention facilities has been introduced, effective March 1.
With oil being Nigeria’s major source of foreign exchange, amid the steep decline in oil prices, the official exchange rate has been adjusted from 306 to 360 naira. The exchange rate under the investors and exporters (I&E) window has also been adjusted from 360 to 380 naira in order to unify the exchange rates across the I&E window, Bureau de Change, and retail and wholesale windows. Furthermore, the government has introduced import duty waivers for pharmaceutical companies and increased efforts toward ensuring that they receive forex.
What other policy responses can be implemented?
Given the size and scope of the economic impact of the pandemic, there is the need to implement other recovery strategies to stimulate demand. Thus, we recommend the following fiscal and monetary policy measures:
- Although there is a cash transfer program in place, the federal government should improve efforts towards enhancing the efficiency and effectiveness of the distributive mechanisms to reach households that are worst-hit by the pandemic.
- The Federal Inland Revenue Service (FIRS) as well as State Inland Revenue Services (SIRS) should waive payments on personal and corporate income tax for the second quarter of 2020, considering that the shock has affected the income and profits of households and businesses.
- The CBN’s decision to increase the cash reserve ratio (CRR) from 22.5 percent to 27.5 percent in January 2020 should be revisited to provide liquidity for banks so that banks can, in turn, create credit to the private sector.
- FIRS and SIRS should delay tax collection for the worse-hit sectors including tourism, the airline industry, and hoteliers in order to enable them recover from the steep decline in demand.
- To provide additional liquidity in the forex market, the CBN should establish a swap facility with the U.S. Federal Reserve and/or the People’s Bank of China, as was done in 2018, to provide dollar and yen liquidity to financial institutions, investors, and exporters. This move would ease up forex shortage in the financial market and economy.
- While the naira has been adjusted as a result of the forex shortage, it is important that the CBN maintains exchange rate stability by deploying external reserves in order to avoid investors selling off naira-denominated assets.
The COVID-19 pandemic is a wake-up call to policymakers as the unusual and unprecedented nature of the crisis has made it impossible for citizens to rely on foreign health care services and more difficult to solicit for international support given the competing demand for medical supplies and equipment. A more integrated response spanning several sectors—including the health, finance, and trade sectors—is required to address structural issues that make the country less resilient to shocks and limit its range of policy responses. In the long term, tougher decisions need to be made, including but not limited to diversifying the country’s revenue base away from oil exports and improving investments in the health care sector in ensuring that the economy is able to recover quickly from difficult conditions in the future.
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The imperative of research in Nigeria: Lessons from the COVID-19 pandemic
by David Bradley, Inderscience

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The COVID-19 pandemic has demonstrated how different (even conflicting) interventions on nature can be scientifically justified: interventions can be deemed "effective" only in relation to specific target variables - in relation to variables the values of which we seek to control. Choosing the "right" target variables, in turn, depends on our values and pragmatic aims. This essay is based on a presentation given at the symposium "Multidisciplinary Perspectives on the COVID-19 Pandemic", organised at the Helsinki Collegium for Advanced Studies on 16 June 2020.
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Lessons from co-production of evidence and policy in nigeria’s covid-19 response, attachments.

Ibrahim Abubakar, Sarah L Dalglish, Chikwe A Ihekweazu, Omotayo Bolu, Sani H Aliyu
Correspondence to Professor Ibrahim Abubakar; [email protected]
In February 2020, Nigeria faced a potentially catastrophic COVID-19 outbreak due to multiple introductions, high population density in urban slums, prevalence of other infectious diseases and poor health infrastructure. As in other countries, Nigerian policymakers had to make rapid and consequential decisions with limited understanding of transmission dynamics and the efficacy of available control measures. We present an account of the Nigerian COVID-19 response based on co-production of evidence between political decision-makers, health policymakers and academics from Nigerian and foreign institutions, an approach that allowed a multidisciplinary group to collaborate on issues arising in real time. Key aspects of the process were the central role of policymakers in determining priority areas and the coordination of multiple, sometime conflicting inputs from stakeholders to write briefing papers and inform effective national decision making. However, the co-production approach met with some challenges, including limited transparency, bureaucratic obstacles and an overly epidemiological focus on numbers of cases and deaths, arguably to the detriment of addressing social and economic effects of response measures. Larger systemic obstacles included a complex multitiered health system, fragmented decision-making structures and limited funding for implementation. Going forward, Nigeria should strengthen the integration of the national response within existing health decision bodies and implement strategies to mitigate the social and economic impact, particularly on the poorest Nigerians. The co-production of evidence examining the broader public health impact, with synthesis by multidisciplinary teams, is essential to meeting the social and public health challenges posed by the COVID-19 pandemic in Nigeria and other countries.
Summary box
In Nigeria, policymakers used a co-production model linking political decision-makers, health policymakers and academics from diverse disciplines to maximise the speed, relevancy and impact of scientific data and evidence to respond to COVID-19.
This model allowed a multidisciplinary group to collaborate on issues arising in real time, with demonstrated impact on national decision making and apparently limiting the virus’ spread.
Challenges of the co-production model included limited transparency, bureaucratic obstacles and an overly epidemiological focus on direct impacts of the disease compared with the social and economic effects of response measures.
Integration of epidemiological, social science and economic analyses by multidisciplinary teams, in concert with policymakers, provides a strong path to meeting the twinned social and public health challenges created by COVID-19.
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Northeast nigeria - camp management bi-weekly tracker report no. 80 | 22 july - 04 august 2023, weekly epidemiological record (wer), 25 august 2023, vol. 98, no. 34, pp. 365–374 [en/fr], visita a nigeria - informe de la experta independiente sobre el disfrute de todos los derechos humanos por las personas de edad, claudia mahler* (a/hrc/54/26/add.1), visite au nigéria - rapport de l’experte indépendante chargée de promouvoir l’exercice par les personnes âgées de tous les droits de l’homme, claudia mahler* (a/hrc/54/26/add.1).
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Expository essay on controlling hiv/aids in nigeria.
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IMAGES
COMMENTS
PMID: 32525389 DOI: 10.1037/tra0000743 COVID-19 / prevention & control* Developing Countries* Health Services Needs and Demand Humans Mental Health Nigeria Public Policy Socioeconomic Factors
According to the Nigeria Centre for Disease Control (NCDC) as on September 5, 2020, 162 new confirmed cases of coronavirus disease 2019 (COVID-19), and three deaths were confirmed in Nigeria. Currently, 54,905 cases have been recorded, 42,922 cases have been discharged, and 1054 deaths have been documented in 36 states and the capital territory ...
Nigeria is a country used to controlling outbreaks of highly infectious viral infections successfully, including Lassa fever, Ebola and Marburg virus diseases, and given the low death rates, it would appear that there has been some success with COVID-19 transmission . However, there is a need to assess the applicability of COVID-19 policies in ...
Of the three episodes of COVID-19 in Nigeria, the easing up phases witness the highest cases of the virus with the addition of over 13,000 in just 41 days. ... Transmission control: The present figures show the case of COVID-19 is still significantly on the high side with the most cases recorded in the easing up phases of lockdown. This is a ...
The European Union has contributed 50 million euros to the basket fund to strengthen the Nigerian COVID-19 response. In addition, the private sector in Nigeria, after being called upon by the ...
Epidemiological indices as of August 26, 2021, showed 188,880 confirmed cases and 2,288 deaths in Nigeria. 6 In Nigeria, the pandemic and the ensuing lockdown/border closure have impacted the food system, economic activities, and poverty.
COVID-19 in Nigeria: account of epidemiological events, response, management, preventions and lessons learned Germs. 2021 Sep 29;11 (3):391-402. doi: 10.18683/germs.2021.1276. eCollection 2021 Sep. Authors Henshaw Uchechi Okoroiwu 1 , Christopher Ogar Ogar 2 , Glory Mbe Egom Nja 3 , Dennis Akongfe Abunimye 4 , Regina Idu Ejemot-Nwadiaro 5
The spread of the novel Coronavirus disease (COVID-19) has continued to rise in Nigeria despite all scientifically proven preventive measures. Factors militating against preventive and control efforts are yet to be addressed thus the study examined COVID-19 pandemic in Nigeria within the first two m …
On 26 January, Nigeria Centre for Disease Control (NCDC) established a national emergency response system with multiple workstreams and close liaison with state- level centres. 3 The first case of COVID-19 in Nigeria was declared on 27 February 2020 in Ogun State. 4 A Pres-idential Taskforce (PTF) on COVID-19 was inaugurated
Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs.
We present an account of the Nigerian COVID-19 response based on co-production of evidence between political decision-makers, health policymakers and academics from Nigerian and foreign institutions, an approach that allowed a multidisciplinary group to collaborate on issues arising in real time.
Brief #1 March 24 2020 Many countries across the global community, are facing unprecedented challenges as a result of the COVID-19 pandemic. Nigeria and her people are no exception. It is now,...
The arrival of COVID-19 in Nigeria poses a public-health challenge for which the country was not fully prepared. On February 27, 2020, Nigeria reported its first confirmed case of COVID-19, making it one of ... curfews were brought in to try and control the spread of COVID-19 in Nigeria (Dixit, Ogundeji, & Onwujekwe, 2020). Some measures were ...
The novel Coronavirus SARS-CoV-2 (COVID-19) is a global pandemic with an increasing public health concern. Due to the non-availability of a vaccine against the disease, non-pharmaceutical interventions constitute major preventive and control measures. However, inadequate knowledge about the disease and poor perception might limit compliance. This study examined COVID-19-related knowledge ...
Cumulative incidence of COVID-19 and case fatality in Nigeria, 27 February-6 June 2020. The overall CI of COVID-19 infection and CF in Nigeria during the study period was 5.6 per 100 000 population and 2.8%, respectively . Lagos State (39.9 per 100 000), followed by the FCT (19.4 per 100 000), recorded the highest CI in Nigeria during this ...
Nigeria and much of the rest of the world blindly adopted treatments like chloroquine or hydroxychloroquine and various prevention strategies, often without monitoring the efficacy of these treatment and social control strategies. COVID-19 provided Nigeria a critical opportunity to create or strengthen its national laboratory system by building ...
Unfortunately, the COVID-19 crisis is causing all components of aggregate demand, except for government purchases, to fall (Figure 1). The fall in household consumption in Nigeria will stem from 1 ...
The COVID-19 pandemic has, the team suggests, reinforced "the imperative for Nigeria to significantly and urgently increase its R&D spending not only to combat subsequent health challenges but...
The COVID-19 pandemic in Nigeria was a part of the worldwide pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The first confirmed case in Nigeria was announced on 27 February 2020, when an Italian national in Lagos tested positive for the virus. On 9 March 2020, a second case of the virus was reported in Ewekoro, Ogun State, a Nigerian ...
The COVID-19 pandemic has demonstrated how different (even conflicting) interventions on nature can be scientifically justified: interventions can be deemed "effective" only in relation to specific target variables - in relation to variables the values of which we seek to control. Choosing the "right" target variables, in turn, depends on our values and pragmatic aims.
In February 2020, Nigeria faced a potentially catastrophic COVID-19 outbreak due to multiple introductions, high population density in urban slums, prevalence of other infectious diseases and poor ...
The expository essay on controlling HIV aids in Nigeria is given below. Explanation: Human immunodeficiency virus is the virus that causes AIDS. As a member of a group of viruses known as retroviruses, HIV infects human cells and uses the energy and nutrients provided by these cells to grow and multiply.
Speech barack obamas night place with video nov its obama be victory nov on barack obama victory speech to help you write your own essay nov 7, 2012. expository essay on controlling hiv/aids in nigeria A guide to apa referencing style for murdoch university students and staff.