Introduction the knowledge of epidemiologic and clinical variables in patients with SARS- CoV-2 infection provides evidence and lessons that are useful for the pandemic response, with consideration of National and sub-National variations. The objective of this study was to characterize and describe the clinical and epidemiologic features of all the hospitalised patients with COVID-19 in Rivers State Nigeria, from March to August 2020. Methods a prospective descriptive multi-center study of patients with positive SARS-CoV-2 RT PCR, who were hospitalised for treatment and self-isolation in four treatment centers in Rivers state, Nigeria. Results the mean age of all the patients was 39.21 ± 12.31 years, with a range of 2 to 77 years. The majority of patients were in the 31 to 40-year (33.0%), 41 to 50-year (23.1%) and 18-to 30-year (22.0%) age groups. The patient population included 474 (73.4%) males and 172 (26.6%) females, with 93 (14.4%) healthcare workers. A history of contact and travel was established in 38.5% and at least one comorbid disease condition was present in 32.8% of patients. Patients with severe disease were 61 (9.45%), while the overall case fatality rate was 2%. The leading comorbid disease conditions were Hypertension in 23.8% and diabetes in 7.7% of patients. Fever (26.0%), dry Cough (17.6%), dyspnoea (12.7%), anosmia (12.7%) and headache (9.9%) were the most common symptoms. The presence of comorbidity and increasing age predicted death from COVID-19. Conclusion the clinical and epidemiologic characteristics of this cohort of hospitalised patients show significant similarities with existing trends from previously reported studies, with contextual peculiarities.

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Background: Frontline health workers are faced with the overwhelming responsibility of caring for patients infected with the Coronavirus and this has seriously affected their physical and mental health status due to the rapid spread of the disease globally and the unprepared state of health workers who were recruited with little or no skills in infectious disease care. This study describes the experiences of healthcare workers involved in the management of COVID-19 patients. Methods: A qualitative study design was employed, using a phenomenological approach. In-depth interviews were conducted by telephone on health workers selected purposively from the four COVID-19 treatment centers. The health workers consisted of seven doctors, three nurses, and two hygienists. Results: Data collected were transcribed and content analysis was done using Atlas. Ti. Some major highlights identified include; the bravery and commitment of health workers despite their proximity to patients, the anxiety and fear of becoming infected, the inconveniencing nature of the PPEs and its effect on their work efficiency, the patients mental and health status on admission (denial, fear, co-morbidities, need for special attention), and other challenges (boredom, shortage of personal protective equipment and medications, the need for special diet and privacy by some patients). Suggestions that emerged were; training, government action, and installing security cameras in patients’ wards.  Conclusion: Findings indicate the need for training health workers to enhance preparedness for future pandemics, provision of psycho-social support for health workers and patients, and government commitment.

Aim: This study assessed the state of infection prevention and control (IPC) with an emphasis on a hospital’s preparedness for mitigating the spread of viral haemorrhagic fevers (VHFs) to staff. Methods: This convergent parallel mixed-methods study obtained data on IPC using an observational checklist in clinical departments and units; key informant interviews of stakeholders; and a structured self-administered questionnaire with frontline health workers. Both qualitative and quantitative data analyses were conducted to determine the IPC practice and level of preparedness of the hospital for the threat of VHFs. Results: The frontline clinical staff who responded to the questionnaires were aged 31 – 40 years (53.8%), male (50.3%) and medical doctors (72.2%). Some of the respondents had received training in hand washing (41.5%), use of PPE (35.1%) and standard precaution for VHFs (26.8%). Fewer respondents consistently used gloves (36.8%), face masks (8.6%), aprons (8.5%) and sharps containers (26.7%) during patient care. Amenities available for IPC varied across the 184 clinical service points in the hospital’s 19 departments. More service points had waste bins (86%), washing sinks (80%) and running water (74%) while a few had a standard operating procedure for hand washing (6%) and cabinets for storing PPEs (12%). The most significant challenge to the use of IPC measures was the inadequacy of amenities such as full PPE gear, respirator, aprons, and face masks within the clinical service points. Conclusion: There is a poor level of preparedness for outbreaks of VHFs and this calls for strengthening administrative, engineering and environmental control in health facilities to stem outbreaks among health.

Background Antimicrobial resistance is a growing global public health concern, and multidrug-resistant tuberculosis is responsible for roughly one-quarter of all antimicrobial-resistant infection-related deaths worldwide. GeneXpert is a rapid, automated molecular test that detects multi-drug-resistant tuberculosis using rifampicin as a predictor. It was recommended by the World Health Organization (WHO) in 2010 for national tuberculosis programs in developing countries; however, it has limitations. Indeterminate results for Mycobacterium tuberculosis indicate that the test was unable to determine whether the bacteria were resistant to rifampicin. This study used Shewhart Control Chart, which has action limits, to investigate the causes of indeterminate results. Methods The control limits on the Shewhart chart are central, upper, and lower. GeneXpert indeterminate results obtained between January 2017 and December 2020 in a tertiary hospital in a low and middle-income country were plotted. Points above the upper control limit were used to determine whether or not the process was under control. Result The proportion of GeneXpert results that were indeterminate varied, with 58% exceeding the upper limit. Only 42% were within the control limit, in comparison. The majority of the laboratory results revealed an out-of-control signal by displaying points outside the control limits or non-random patterns of points known as special-cause variation, according to this study. Conclusions GeneXpert indeterminate results have an impact on patient management by preventing accurate diagnosis and delaying the start of anti-tuberculosis medication. Machine malfunctions, insufficient bacterial load, poor quality samples, operator errors, or faulty laboratory materials could all be to blame. Regular equipment checks by laboratory personnel, program sponsors, or leadership will be extremely beneficial in achieving the desired results and initiating appropriate treatment. Statistical process control is widely used in hospital performance monitoring and improvement, and it is becoming more popular in public health surveillance. Keywords: INDETERMINATE, GENEXPERT, SHEWHART, CONTROL CHARTS