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.

BackgroundKano is one of the high-risk states for polio transmission in Northern Nigeria. The state reported more cases of wild polioviruses (WPVs) than any other state in the country. The Nigeria Demographic and Health Survey of 2013 indicated that OPV3 coverage in the routine immunization (RI) programmewas 57.9%. Additionally, serial polio seroprevalence studies conducted from 2011 to 2015 in the eightmetropolitan LGAs indicated low immunity levels against all three polio serotypes in children below one year. Areas with sub-optimal RI coverage such as Kanothat fail to remove all tOPV during the tOPV-bOPV switchwill be at increased risk of VDPV2 circulation.MethodsWe assessed the impact of political leadership engagement in mobilizing other stakeholders on the outcomes of the bOPV-tOPV switch in Kano State from February to May 2016 using nationally-selected planning and outcome indicators.ResultsA total of 670 health facilities that provide RI services were assessed during the pre-switch activities. Health workers were aware of the switch exercise in 520 (95.1%) of the public health facilities assessed. It was found that health workers knew what to do should tOPV be found in any of the 521 (95.2%)public health facilities assessed. However, there was a wide disparity between the public and private health practitioners’ knowledge on basic concepts of the switch.There was 100% withdrawal of tOPV from the state and the seven zonal cold stores. Unmarked tOPVwas found in the cold chain system in 2 (4.5%) LGAs. Only one health facility (0.8%) had tOPV in the cold chain. No tOPVwas identified outside the cold chain without the “Do not use” sticker in any of the health facilities.ConclusionThe engagement of the political leadership to mobilize other key stakeholders facilitated successful implementation of the tOPV-bOPVswitch exercise and provided opportunity to strengthen partnerships with the private health sector in Kano State.

Background: Malaria, a vector borne disease that contributes to the 17 percent of the global burden of infectious diseases, is preventable, treatable and completely curable. The disease is endemic in Nigeria, staggering at 27 percent prevalence and contributes up to 29 percent of global burden of the disease. It contributes to the high child mortality in Nigeria, attributed 30 percent of under five deaths. In October 2016, WHO team in Nigeria in collaboration with Nigerian Centre for Disease Control investigated a suspected malaria outbreak in Sokoto state of northwestern Nigeria. Materials and Methods: We reviewed hospital records of 190 patients who presented to the health facility with febrile illness, investigated and treated from 3/10/2016 to 25/10/2016. Data used during the study included age, sex, residential address, signs and symptoms. A cross-sectional survey was carried out in the region of the outbreak to assess the knowledge of the community on malaria control measures. SPSS version 24 was used for the data analyses. Results: Out of the 190 cases, 168 (88.4%) tested positive for RDT and 22 (11.5%) tested negative. The age range of the cases was from three months to 70 years (median: 14 years), the sex distribution was 118 (62.1%) females and 72 (37.9%) males, and the CFR of the RDT positive cases was 2.97% (5/168) with M:F ratio of 1:4. A survey to assess the knowledge of the affected community on malaria preventive measures shows 59.5% (25/42) are aware of at least three out of four measures asked. Conclusion: Although government commitment to malaria control is commendable, this suspected outbreak has clearly brought to fore some gaps in the on-going malaria control in Sokoto state. Thus, there is a need for government to intensify health education programmes on environmental hygiene, state malaria control programme to strengthen awareness campaigns on malaria interventions as well as improve access to the available

Background: Low socio-economic and educational levels of parents are important risk factors for under-nutrition in children. The distribution ofhealth and diseases in childhood had been shown to be strongly influenced by the social characteristics like occupation and educational attainment. The aim of this study was to determine the socioeconomic status among children with Protein Energy Malnutrition and the Controls in Zaria usingthe modification of the method earlier used by Oyedeji. Method: This study was a case control health- based descriptive study to determine the socioeconomic and demographic variables in  undernourished children in Zaria. Using systematic sampling method, a total of 132 children (cases and controls) between 6 and 59 months of age were selected for assessment of socioeconomic and demographic variables. Results: Nineteen (28.8%) of the study group belong to social class III as compared to 12 (18.2%) for the controls. As for the educational levels of the parents, among the cases, 28 (42.4%) had Islamic education, 25 (37.9%) had secondary education, 10 (15.1%), 2 (3.0%) and 1 (1.5%) had primary,  tertiary and no formal education respectively. For the controls, 7 (10.6%) had Islamic education, 34 (51.5%) had secondary education, 13 (19.7%) and 12 (18.1%) had primary and tertiary education respectively. There was none with no formal education, The statistical analysis showed significant  difference (P= 0.0009) between cases and controls for maternal educational levels only among the demographic data. Conclusion: This study has been able to establish low socio- economic factors among undernourished children studied. Keywords: Under-nutrition, socioeconomic factors, educational levels, children