B y the end of October 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had spread to 6 continents and caused >45 million coronavirus disease (COVID-19) cases and 1.1 million deaths (1). Despite having 15.6% of the worldwide population (2), by October 31, 2020, Africa had only 3.9% (1.76 million) of the world's COVID-19 cases and 3.6% (42,233) of deaths during the pandemic (1). Data suggest that the pandemic is evolving differently in sub-Saharan Africa compared with the rest of the world and that the outbreak started later (3).Of note, severe COVID-19 cases seem to occur less frequently in Africa than in the rest of the world (4). Several factors have been proposed to explain this. Age is likely a major factor because older persons are at higher risk for severe disease, but Africa has an extremely young population; >60% of persons are <25 years of age (5). However, variation of CO-VID-19 severity with age alone does not fully explain the observed differences (4). Clinical cases and deaths in Africa likely are underreported because systematic surveillance is limited and no systematic death registration exists; thus, the true SARS-CoV-2 burden probably is underestimated (4). Nevertheless, local health systems in Africa, which have a lower capacity to deal with COVID-19 patients than healthcare systems in high-resource settings, were not overwhelmed, even at the peak of the epidemic (6). Although potential

BackgroundExposure to biomass smoke is a major cause of morbidity and mortality in Africa. Commercial food vendors in Nigeria and elsewhere in Africa are commonly exposed to biomass smoke from open fire cooking both at work and home. Little is known about the knowledge, attitudes and beliefs of food vendors about the health hazards of biomass smoke exposure in Nigeria.MethodsWe did a descriptive cross sectional survey of the knowledge, attitudes and beliefs of commercial food vendors in the cities of Benin and Calabar in Nigeria. We recruited respondents using a multi-stage approach. Structured interviewer-administered questionnaires were used for data collection.ResultsWe recruited 308 participants (164, 53.2% female). The majority 185(60.2%) were married and had post-primary education 206(67.4%). The average monthly income was <30,000 Naira (US$150). Most 198(64.4%) were not aware that biomass smoke exposure is harmful to human health. About three-quarters (221; 71.8%) were unconcerned as to the effect of exposure to fumes from biomass fuels on their health. Less than half of respondents (110, 41.6%) believed biomass smoke was harmful to health. Male gender, being single, having post-primary education and preferring electricity or gas fuels were associated with good knowledge of the adverse health effects of biomass smoke exposure whilst female gender and having good knowledge of the adverse health effects of biomass smoke were associated with positive attitudes towards preventing exposure.ConclusionCommercial food vendors in our study had limited knowledge about the adverse health effects of biomass smoke exposure and negative attitudes towards preventing these adverse health effects. We suggest an educational intervention is needed to improve this knowledge.

Background: Peripheral arterial disease (PAD) is a risk factor for diabetic foot ulcer, limb amputation as well as coronary heart disease. It is more common in patients with diabetes mellitus (DM) and co-exists with peripheral neuropathy. Prevalence of PAD in type 2 DM patients in northern Nigeria is largely unknown. We investigated the occurrence and factors associated with PAD among patients with type 2 DM in a tertiary hospital in northern Nigeria. Methods: This was a cross-sectional analytic study. We recruited 200 patients with type 2 DM consecutively from the diabetes clinic of the Jos University Teaching Hospital. Ankle brachial index was assessed for each participant. Clinical information, anthropometric indices and blood samples were collected for assay. Data was analysed using CDC Epi-Info and logistic regression analysis was used to determine independent correlates of PAD. RESULTS:PAD was present in 38.5%(n = 77) of subjects and it was associated with the female sex, age ≥ 50 years, Body mass index (BMI) ≥ 25 kg/m 2 and low HDL cholesterol levels. However, on multiple logistic regression, a BMI ≥ 25 kg/m 2 and a low HDL cholesterol level were independent correlates of PAD(adjusted OR = 2.13,95% CI = 1.04-4.36 and adjusted OR = 2.31, 95% CI = 1.04-5.15, respectively). Conclusion: PAD is present in more than a third of patients with type 2 DM in a tertiary hospital in northern Nigeria. A BMI of ≥25 kg/m 2 and low HDL cholesterol levels were independent correlates of PAD.

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