The COVID-19 pandemic has caused significant morbidity and mortality since its emergence in December 2019. In Nigeria, the government inaugurated the Presidential Task Force on COVID-19 to coordinate resources while the Nigeria Centre for Disease Control led the public health response. The Nigeria Ministry of Defence Health Implementation Programme (MODHIP), in partnership with the US Army Medical Research Directorate – Africa/Nigeria, responded immediately to the pandemic by establishing a public health emergency operations center to coordinate the military response in support of national efforts. MODHIP has 5 functional units and 6 pillars that coordinate testing, surveillance, case management, risk communication, logistics, research, and infection prevention and control. It developed an incident action plan and each pillar had its own terms of reference to guide specific response activities while preventing duplication of efforts within the military and the Nigeria Centre for Disease Control. In addition, awareness and sensitization sessions were conducted on preventive practices for COVID-19 and infrastructure was provided for hand hygiene and screening at all military facilities. Military laboratories were configured for SARS-CoV-2 testing while selected military health facilities were equipped and designated as COVID-19 treatment centers. Research proposals aimed at better understanding the disease and controlling it were also developed. The traditional combat role of the military was redirected to complement this public health emergency response. In this article, we highlight gaps, opportunities, and lessons to improve military participation in public health emergency response in the future. More funding and multisectoral collaboration with civilian institutions are key to strengthening military public health emergency preparedness and response capabilities.

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Background: Staphylococcus aureus is one of the most common causes of biofilm associated infections. Identification and differentiation of S. aureus with respect to its biofilm phenotype helps in diagnosis and prevention of infections related to biomedical devices.The aim of this study was to determine the rate of nasal carriage biofilm producing Methicillin Resistant S. aureus (MRSA)among Health Care Workers (HCWs)Methods and materials: A total of 232 nasal swabs were taken from HCWs at Manmohan Memorial Teaching Hospital, Kathmandu. S. aureus was isolated using Mannitol Salt Agar and identified by examination of colony characteristics, gram staining, oxidase, catalase, coagulase (slide and tube method) and Deoxyribonuclease test. Antibiotic susceptibility test was performed using the modified Kirby-Bauer disk diffusion method as recommended by Clinical and Laboratory Standards Institute guidelines. MRSA was detected phenotypically using Cefoxitin disk test. In-vitro biofilm producing capacity of isolated S. aureus was evaluated by tissue culture plate method.Results: A total of 34(14.7%) S. aureus was isolated amongst which 12(35.3%) were MRSA. Overall rate of nasal carriage MRSA was found to be 5.2% (12/232). Among 34 isolated S. aureus, 10(29.4%) were strong, 7(20.6%) were moderate, 8(23.5%) were weak biofilm producers whereas 9(26.5%) were biofilm non-producers.Among 12 MRSA, 10(83.3%) were biofilm producers of which 4(33.3%) were strong, 2(16.7%) were moderate, 4(33.3%) were weak and 2(16.7%) were biofilm-non producers whereas among 22 methicillin susceptible strains, 15(68.1%) were biofilm producers of which 6(27.3%) were strong, 5(22.7%) were moderate, 4(18.2%) were weak and 7(31.8%) were biofilm nonproducers.Incidence of methicillin resistance was higher among biofilm producers i.e. 10/25(40%) with respect to biofilm nonproducers i.e. 2/9(22.2%). All isolated strains were found susceptible to Vancomycin, Tetracycline and Teicoplanin.Conclusion::Our study suggests that the rate of nasal carriage ebiofilm producing MRSA is very high among HCWs with decreased susceptibility to antimicrobials.Hence, proper identification and treatment of carrier HCWs can help to minimize medical device associated as well as other HCW associated infections.

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