Enhanced surveillance for covid-19 response in Lagos State, Nigeria: lessons learnt, 2020 (Preprint)

BACKGROUND The SARS-CoV-2, the novel virus which causes the coronavirus disease (COVID-19), has changed the world. No aspect of humanity is untouched from health, aviation, service industry, politics, economy, education, and entertainment to social and personal lives, since the outbreak of influenza-like illness in Wuhan, China, in December 2019. The Lagos State COVID-19 response team deployed enhanced surveillance through Active Case Search (ACS) for Acute Respiratory Infections (ARI) at health facilities and communities in the 20 Local Government Areas (LGAs) of Lagos State. Lagos State was the first state in Nigeria to deploy this specific surveillance strategy for Nigeria’s COVID-19 response. OBJECTIVE We documented the methods, findings, and review of the active case search for acute respiratory infections, part of COVID-19 response in 20 LGAs of Lagos State, between 1st April and 15th May 2020. METHODS We utilized descriptive and quantitative approaches to describe and assess the impact of the Active Case Search (ACS) for Acute Respiratory Infections (ARI) in health facilities and communities in 20 LGAs of Lagos State between 1st April and 15th May 2020. RESULTS We found a significant difference in mean scores of suspected COVID-19 cases (M=60, SD=109, before ACS for ARI compared to M=568, SD=732, after ACS for ARI, P=0.0039), confirmed cases (M=10, SD=19, before ACS for ARI compared to M=144, SD=187, after ACS for ARI, P=0.0028) and contacts (M=56, SD=116, before ACS for ARI compared to M=152, SD=177, after ACS for ARI, P=0.044) before and after ACS for ARI in 20 LGAs of Lagos State, between 1st April and 15th May 2020. CONCLUSIONS The deployment of the Lagos State government’s polio-eradication structure for the COVID-19 response is both innovative and effective. The response to COVID-19 requires robust surveillance, credible and timely communication, collaboration, coordination among government, inter-governmental organizations (e.g., WHO), non-governmental organizations, and citizens to succeed and limit the medical, economic, social, and personal losses to the COVID-19 pandemic.

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Enhanced surveillance for covid-19 response in Lagos State, Nigeria: lessons learnt, 2020

10.31219/osf.io/eu694 ◽

2021 ◽

Author(s):

Gregory Umeh ◽

Khalid Abubakar ◽

Peter Akinmusire ◽

Adamu Isa ◽

Aminu Zauro ◽

...

Keyword(s):

Service Industry ◽

Respiratory Infections ◽

Health Facilities ◽

Acute Respiratory Infections ◽

Surveillance Strategy ◽

Active Case ◽

Governmental Organizations ◽

Significant Difference ◽

Lagos State ◽

The Impact

BackgroundThe SARS-CoV-2, the novel virus which causes the coronavirus disease (COVID-19), has changed the world. No aspect of humanity is untouched from health, aviation, service industry, politics, economy, education, and entertainment to social and personal lives, since the outbreak of influenza-like illness in Wuhan, China, in December 2019. The Lagos State COVID-19 response team deployed enhanced surveillance through Active Case Search (ACS) for Acute Respiratory Infections (ARI) at health facilities and communities in the 20 Local Government Areas (LGAs) of Lagos State. Lagos State was the first state in Nigeria to deploy this specific surveillance strategy for Nigeria’s COVID-19 response. MethodsWe utilized descriptive and quantitative approaches to describe and assess the impact of the Active Case Search (ACS) for Acute Respiratory Infections (ARI) in health facilities and communities in 20 LGAs of Lagos State between 1st April and 15th May 2020.ResultsWe found a significant difference in mean scores of suspected COVID-19 cases (M=60, SD=109, before ACS for ARI compared to M=568, SD=732, after ACS for ARI, P=0.0039), confirmed cases (M=10, SD=19, before ACS for ARI compared to M=144, SD=187, after ACS for ARI, P=0.0028) and contacts (M=56, SD=116, before ACS for ARI compared to M=152, SD=177, after ACS for ARI, P=0.044) before and after ACS for ARI in 20 LGAs of Lagos State, between 1st April and 15th May 2020.ConclusionThe deployment of the Lagos State government’s polio-eradication structure for the COVID-19 response is both innovative and effective. The response to COVID-19 requires robust surveillance, credible and timely communication, collaboration, coordination among government, inter-governmental organizations (e.g., WHO), non-governmental organizations, and citizens to succeed and limit the medical, economic, social, and personal losses to the COVID-19 pandemic.

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141. Implementation of Veterans Affairs Outpatient Antimicrobial Stewardship Interventions for Asymptomatic Bacteriuria and Acute Respiratory Infections, a Stepped Wedge Randomized Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.186 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S81-S82

Author(s):

Grace Mortrude ◽

Mary Rehs ◽

Katherine Sherman ◽

Nathan Gundacker ◽

Claire Dysart

Keyword(s):

Patient Satisfaction ◽

Primary Outcome ◽

Respiratory Infections ◽

Asymptomatic Bacteriuria ◽

Educational Interventions ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Stepped Wedge ◽

Post Intervention ◽

The Impact

Abstract Background Outpatient antimicrobial prescribing is an important target for antimicrobial stewardship (AMS) interventions to decrease antimicrobial resistance in the United States. The objective of this study was to design, implement and evaluate the impact of AMS interventions focused on asymptomatic bacteriuria (ASB) and acute respiratory infections (ARIs) in the outpatient setting. Methods This randomized, stepped-wedge trial evaluated the impact of educational interventions to providers on adult patients presenting to primary care (PC) clinics for ARIs and ASB from 10/1/19 to 1/31/20. Data was collected by retrospective chart review. An antibiotic prescribing report card was provided to PC providers, then an educational session was delivered at each PC clinic. Patient education materials were distributed to PC clinics. Interventions were made in a step-wise (figure 1) fashion. The primary outcome was percentage of overall antibiotic prescriptions as a composite of prescriptions for ASB, acute bronchitis, upper-respiratory infection otherwise unspecified, uncomplicated sinusitis, and uncomplicated pharyngitis. Secondary outcomes included individual components of the primary outcome, a composite safety endpoint of related hospital, emergency department or primary care visit within 4 weeks, antibiotic appropriateness, and patient satisfaction surveys. Figure 1 Results There were 887 patients included for analysis (405 pre-intervention, 482 post-intervention). Baseline characteristics are summarized in table 1. After controlling for type 1 error using a Bonferroni correction the primary outcome was not significantly different between groups (56% vs 49%). There was a statistically significant decrease in prescriptions for bronchitis (20.99% vs 12.66%; p=0.0003). Appropriateness of prescriptions for sinusitis (OR 4.96; CI 1.79–13.75; p=0.0021) and pharyngitis (OR 5.36; CI 1.93 – 14.90; p=0.0013) was improved in the post-intervention group. The composite safety outcome and patient satisfaction survey ratings did not differ between groups. Table 1 Conclusion Multifaceted educational interventions targeting providers can improve antibiotic prescribing for indications rarely requiring antimicrobials without increasing re-visit or patient satisfaction surveys. Disclosures All Authors: No reported disclosures

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Climate indicators and the impact on morbidity and mortality of acute respiratory infections

Advanced Studies in Medical Sciences ◽

10.12988/asms.2018.863 ◽

2018 ◽

Vol 6 (1) ◽

pp. 5-20

Author(s):

Amaury de Souza ◽

Fernanda A. Andrade ◽

Pelumi E. Oguntunde ◽

Milica Arsic ◽

Debora A.S. Silva

Keyword(s):

Respiratory Infections ◽

Morbidity And Mortality ◽

Acute Respiratory Infections ◽

Climate Indicators ◽

The Impact

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Population-Based Study of the Impact of Childcare Attendance on Hospitalizations for Acute Respiratory Infections

PEDIATRICS ◽

10.1542/peds.2006-0373 ◽

2006 ◽

Vol 118 (4) ◽

pp. 1439-1446 ◽

Cited By ~ 50

Author(s):

M. Kamper-Jorgensen ◽

J. Wohlfahrt ◽

J. Simonsen ◽

M. Gronbaek ◽

C. S. Benn

Keyword(s):

Respiratory Infections ◽

Population Based ◽

Acute Respiratory Infections ◽

Population Based Study ◽

The Impact

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Polusi Udara Kendaraan Bermotor Tidak Berpengaruh Terhadap Penyakit ISPA

JURNAL KESEHATAN LINGKUNGAN: Jurnal dan Aplikasi Teknik Kesehatan Lingkungan ◽

10.31964/jkl.v16i1.157 ◽

2019 ◽

Vol 16 (1) ◽

pp. 697

Author(s):

Sri Neneng Sundari

Keyword(s):

Air Pollution ◽

Community Health Centers ◽

Indoor Air Pollution ◽

Motor Vehicle ◽

Respiratory Infections ◽

Air Pollutant ◽

Exhaust Emission ◽

Acute Respiratory Infections ◽

Vehicle Exhaust ◽

The Impact

Abstract: Motor Vehicle Pollution Doesn't Affect Against ISPA Disease. Air pollution is a problem that often occurs in the big cities, one of which is in the city of Bandung. Air pollution can cause various diseases from the most important ones namely respiratory, cardiovascular diseases, and to other diseases that attack certain organs. Based on the results of the study, air pollution from the transportation sector reached 60 percents, therefore this study will highlight the impact of motor vehicle air pollution on human’s health in Bandung, especially Acute Respiratory Infections (ARI), because the disease is the 2nd largest of the 20 biggest types of diseases in Community Health Centers / Puskesmas in Bandung. From several air pollutant parameters resulting from vehicle exhaust emissions, SO2 compounds were studied, because SO2 can cause irritation to the respiratory tract. This research using descriptive method, it can be concluded that air pollution caused by vehicle exhaust emission gas doesn’t directly affect the occurrence of Acute Respiratory Infections (ARI) in Bandung. The disease can occur due to other factors not examined in this paper, due to indoor air pollution, cigarette smoke pollution, industrial pollution or the continued use of synthetic chemicals.

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102. Effects of an Antimicrobial Stewardship-guided MRSA Nasal Screening Review on Vancomycin Utilization for Respiratory Infections: A Quasi-Experimental Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.147 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ross Pineda ◽

Meganne Kanatani ◽

Jaime Deville

Keyword(s):

Antimicrobial Stewardship ◽

Respiratory Infections ◽

Intervention Group ◽

Small Sample ◽

Post Intervention ◽

Predictive Values ◽

Days Of Therapy ◽

Significant Difference ◽

Quasi Experimental ◽

The Impact

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant pathogen in patients with respiratory infections. Guidelines recommend empiric MRSA coverage in patients at increased risk, resulting in substantial vancomycin use. Recent literature highlights the use of MRSA nasal assays as a rapid screening tool for MRSA pneumonia, demonstrating high negative predictive values and allowing for shorter empiric coverage. We aimed to evaluate the impact of MRSA nasal screening review by the antimicrobial stewardship program (ASP) on vancomycin utilization for respiratory infections. Methods This was a retrospective, quasi-experimental, pre-post intervention study. The intervention saw the addition of an MRSA screening review tool into the ASP electronic record, highlighting patients on vancomycin (actively or recently administered) with a negative MRSA screening. Vancomycin days of therapy (DOT) was collected for all orders indicated for a respiratory infection in the two weeks following a negative screening. Additional outcomes include vancomycin total dose and DOT per 1,000 patient days. Outcomes were compared via independent samples t-tests. Results 1,110 MRSA screenings resulted across 2 months, of which the majority were excluded for either not having vancomycin ordered, or for having vancomycin ordered for a non-respiratory indication, leaving 37 and 35 evaluable screenings in the pre- and post-intervention groups, respectively. Regarding vancomycin DOT, we did not identify a significant difference between pre- and post-intervention groups with respective means of 2.45 (SD=1.52) and 2.14 (SD=1.12) (p=0.35). We identified a total 8.78 vancomycin DOT per 1,000 patient days in the pre-intervention group versus 6.69 in the post-intervention group. Conclusion ASP-guided review of MRSA screenings was associated with a nonsignificant decrease in mean vancomycin DOT and lower total DOT per 1,000 patient days for respiratory infections following a negative screen. Given the recent implementation of our intervention, our analysis covered a small sample size, highlighting the need for continued data collection. MRSA screenings are not always fully or immediately utilized in our institution, demonstrating room to de-escalate MRSA-targeted antibiotics. Disclosures All Authors: No reported disclosures

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The impact of COVID-19 pandemic on the health-seeking behaviour of an Asian population with acute respiratory infections in a densely populated community

BMC Public Health ◽

10.1186/s12889-021-11200-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hwee Mian Jane Tan ◽

Mui Suan Tan ◽

Zi Ying Chang ◽

Kee Tung Tan ◽

Guan Liang Adrian Ee ◽

...

Keyword(s):

Visual Cues ◽

Respiratory Infections ◽

Circuit Breaker ◽

Health Belief ◽

Asian Population ◽

Rank Test ◽

Acute Respiratory Infections ◽

Health Seeking Behaviour ◽

Health Seeking ◽

The Impact

Abstract Background The COVID-19 pandemic led to the implementation of various non-pharmaceutical interventions (NPI) as the Singapore government escalated containment efforts from DORSCON Orange to Circuit Breaker. NPI include mandatory mask wearing, hand hygiene, social distancing, and closure of schools and workplaces. Considering the similar mode of transmission of COVID-19 and other pathogens related to acute respiratory infections (ARI), the effects of NPI could possibly lead to decreased ARI attendances in the community. This study aims to determine the year-on-year and weekly changes of ARI attendances across a cluster of polyclinics following the implementation of NPI. Methods The effect of the nation-wide measures on the health-seeking behaviour of the study population was examined over three periods: (1) 9 weeks prior to the start of Circuit Breaker (DORSCON Orange period), (2) 8 weeks during the Circuit Breaker, and (3) 9 weeks after easing of Circuit Breaker. Data on ARI attendances for the corresponding periods in 2019 were also extracted for comparison and to assess the seasonal variations of ARI. The average weekly workday ARI attendances were compared with those of the preceding week using Wilcoxon signed rank test. Results ARI attendances dropped steadily throughout the study period and were 50–80% lower than in 2019 since Circuit Breaker. They remained low even after Circuit Breaker ended. Positivity rate for influenza-like illnesses samples in the community was 0.0% from the last week of Circuit Breaker to end of study period. Conclusions NPI and public education measures during DORSCON Orange and Circuit Breaker periods appear to be associated with the health-seeking behaviour of the public. Changing levels of perceived susceptibility, severity, benefits and barriers, and widespread visual cues based on the Health Belief Model may account for this change. Understanding the impact of NPI and shifts in the public’s health-seeking behaviour will be relevant and helpful in the planning of future pandemic responses.

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Cognición sobre infecciones respiratorias agudas de madres con niños preescolares: una intervención de enfermería

Revista de Investigaciones Altoandinas - Journal of High Andean Research ◽

10.18271/ria.2016.224 ◽

2016 ◽

Vol 18 (3) ◽

Author(s):

Helibio Alan-Mamani ◽

Denices S. Abarca-Fernández ◽

Tita Flores-de-Quispe

Keyword(s):

School Children ◽

Respiratory Infections ◽

Hypothesis Test ◽

Educational Institution ◽

Nursing Intervention ◽

Acute Respiratory Infections ◽

Significance Level ◽

Study Results ◽

Post Test ◽

The Impact

La investigación se realizó con el objetivo de determinar el impacto de la intervención enfermería en la cognición sobre prevención de infecciones respiratorias agudas en madres con niños pre escolares y el diseño de un programa de intervención, que propicia el aprendizaje significativo en las madres. El estudio fue de tipo pre experimental con diseño pre y post test. La población estuvo conformada por 50 madres de niños pre-escolares, y la muestra por 33 madres de estudiantes de la Institución Educativa Inicial N° 1357 “Señor de los Milagros” – Juliaca-2015. La recolección de datos se realizó con la encuesta, mediante la aplicación de un cuestionario en el pretest y el postest, 15 días después de concluir con las intervenciones. El análisis de datos se realizó en forma porcentual y la contrastación de la hipótesis con la prueba Z calculada. Los resultados del estudio demuestran que antes de la intervención de enfermería, la cognición de las madres sobre las infecciones respiratorias agudas, el 64% fue deficiente, 27% regular y 9% bueno mientras que, después de la intervención la cognición prospera a bueno al 70% y 30% a regular. Por tanto, la intervención de enfermería con el modelo Andragógico es efectiva para optimizar la cognición, confirmada, con un nivel de significancia de p<0.05. ABSTRACT<pre>The research was conducted in order to determine the impact of nursing interventions on cognition on acute respiratory infections in mothers with pre school children. The study was pre experimental, with pre and post test design; The population for the study was composed of 50 mothers with pre school children, the sample consisting 0f 33 mothers from students of initial educational institution 1357 “Señor de los Milagros” Juliaca-2015. Data collection was performed with the survey, by applying a questionnaire in the pretest and posttest, 15 days after concluding interventions. Data analysis was performed on a percentage basis and the testing of the hypothesis test with the Z calculated. The study results show that before the nursing intervention, cognition of mothers on acute respiratory infections, 64% was poor, 27% regularly and 9% good while after intervention cognition thrives well at 70% and 30% regulate. Therefore, the nursing intervention with Andragogic model is effective to optimize cognition, confirmed, with a significance level of p = 0.05.</pre><pre>Keywords: Nursing care, educational intervention, cognition, acute respiratory infections, children</pre>

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Acute respiratory infections in children from a deprived urban population from Uruguay

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651994000100009 ◽

1994 ◽

Vol 36 (1) ◽

pp. 51-57 ◽

Cited By ~ 4

Author(s):

Maria Hortal ◽

Myriam Contera ◽

Cristina Mogdasy ◽

José Carlos Russi

Keyword(s):

Respiratory Infections ◽

Target Population ◽

Original Data ◽

Base Line ◽

Acute Respiratory Infections ◽

Upper Respiratory Tract ◽

Community Based ◽

The Impact ◽

Base Line Data

To obtain base line data on incidence, duration, clinical characteristics and etiology of acute respiratory infections (ARI), 276 children from deprived families living in Montevideo were followed during 32 months. The target population was divided into two groups for the analysis of the results: children aged less than 12 months and those older than this age. During the follow-up period 1.056 ARI episodes were recorded. ARI incidence was 5.2 per child/year. It was 87% higher in infants than in the older group, as was the duration of the episodes. Most of the diseases were mild. Tachypnea and retractions were seldom observed, but 12 children were refered to the hospital, and 2 infants died. Viral etiology was identified in 15.3% of the episodes. RSV was the predominant agent producing annual outbreaks. Moderate to heavy colonization of the upper respiratory tract by Streptococcus pneumoniae (32.3%) and Hemophilus sp. (18.9%) was recorded during ARI episodes. This community-based study furnish original data on ARI in Uruguay. It enabled to asses the impact of these infections on childhood.

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