Summary Background The WHO Regional Office for the Africa Regional Immunization Technical Advisory Group, in 2011, adopted the measles control and elimination goals for all countries of the African region to achieve in 2015 and 2020 respectively. Our aim was to track the current status of progress towards measles control and elimination milestones across 15 west African countries between 2001 and 2019. Methods We did a retrospective multicountry series analysis of national immunisation coverage and case surveillance data from Jan 1, 2001, to Dec 31, 2019. Our analysis focused on the 15 west African countries that constitute the Economic Community of West African States. We tracked progress in the coverage of measles-containing vaccines (MCVs), measles supplementary immunisation activities, and measles incidence rates. We developed a country-level measles summary scorecard using eight indicators to track progress towards measles elimination as of the end of 2019. The summary indicators were tracked against measles control and elimination milestones. Findings The weighted average regional first-dose MCV coverage in 2019 was 66% compared with 45% in 2001. 73% (11 of 15) of the west African countries had introduced second-dose MCV as of December, 2019. An estimated 4 588 040 children (aged 12–23 months) did not receive first-dose MCV in 2019, the majority (71%) of whom lived in Nigeria. Based on the scorecard, 12 (80%) countries are off-track to achieving measles elimination milestones; however, Cape Verde, The Gambia, and Ghana have made substantial progress. Interpretation Measles will continue to be endemic in west Africa after 2020. The regional measles incidence rate in 2019 was 33 times the 2020 elimination target of less than 1 case per million population. However, some hope exists as countries can look at the efforts made by Cape Verde, The Gambia, and Ghana and learn from them. Funding None.

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Introduction: Consistent condom use still remains a key strategy in HIV prevention. Studies have demonstrated declining condom use among HIV positive patients on ART. There is paucity of such information among HIV positive individuals on ART in Nigeria. We sought to find the rates and associated factors for condom use among a cohort of PLHIV on ART in Nigeria. Methods:A cross sectional review of PLHIV on ART was carried out in an ART treatment facility. Trained clinic staff administered a checklist to adult patients who had been on ART for a minimum of 9 months. Information was collected on age, sex, marital status, number of sexual partners, condom use and occurrence of sexually transmitted infection.Results: Of the 282 respondents; average age was 35 years. Forty four percent (44%) never used while 25% used condoms consistently in the previous 3 months. Single (OR: 7.23, CI: 2.999-17.446, p= 0.000) and widowed (OR: 3.76, CI-1.179-12.04, p= 0.026) respondents were more likely to use condom always or sometimes. Male respondents were almost twice as likely to use condoms always and sometimes (OR: 1.74, CI-0.988-3.078, p = 0.055). There was no significant association between condom use and history of STI (OR: 0.74, CI-0.444-1.239, p= 0.254), or number of sexual partners (OR: 0.93, CI-0.427-2.01, p = 0.848). Conclusion:Rates of condom use was low particularly among females and married patients on ART. Program and clinic managers should aggressively target females and married couples with varied and appropriate prevention messaging to improve coverage.

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Background:The objective of this study is to evaluate the economic impact of vaccine-based interventions in response to an influenza pandemic, for the city of Chicago, and compare the costbenefit metrics between a dynamic agent-based network model and a static Markov model. Efficient allocation of clinical resources, including vaccination, minimizes the costs of deaths, hospitalizations, and outpatient visits during an influenza pandemic.Methods & Materials: The social contact network is a colocation based synthetic network, generated for the city of Chicago. The transmission dynamics of the influenza-like-illness in the population is simulated using the susceptible-exposed-infectiousrecovered epidemiological model. We compare the costs and benefits of different vaccine-based interventions in control and prevention of an influenza pandemic.Results: We simulated a base case scenario of no vaccine intervention for the city of Chicago with a basic reproductive number of 1.5 for a resultant attack rate of 58.1% and health care cost per capita of $1,124. Applying the vaccine intervention with efficacy of 40% and compliance rate of 40% was a cost saving intervention for both the dynamic agent-based network model and the static Markov model. The net return per capita at 21$ per vaccine is $363 and $261 for the dynamic and static models respectively. Conclusion:We infer that higher number of cases of Influenza are averted in the dynamic agent-based network model in comparison to the static Markov model, as well as the vaccine-based interventions are comparatively more cost effective for all age and risk groups in the dynamic model.