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HIV Drug Resistance: Minister Harps On Surveillance

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The Minister of Health, Prof. Isaac Adewole, last Monday, said surveillance and early identification of HIV drug resistance which necessitated prompt intervention, is required to prevent its effect.
Adewole made this known at a Joint Stakeholders Summit on Drug Resistance Monitoring, early Infant Diagnosis and Viral Load held in Lagos,organised by the National HIV/AIDS Control Programme (NASCP), recently.
Adewole, who was represented by the National Coordinator, National AIDs STIs Control Programme, Dr Sunday Aboje said that since the inception of the national HIV response in Nigeria, the programme had witnessed significant improvement orchestrated by the commitment of the various stakeholders.
“More people are getting to know their status and accessing HIV treatment and care; as a result, HIV related deaths are being averted.
“However, there is still pragmatic challenge such as therapy adherence and retention in care with attending issues such as HIV drug resistance, be it pre-ART or acquired among the different population groups.
“Studies have shown that the surveillance and early identification of these issues which necessitates prompt intervention is required to prevent the untold effect of HIV drug resistance, “he said.
The minister said there were still challenges in the management of HIV despite the commitment of government and donor partners to achieving global targets.
According to him, only about 8.9 per cent of infants born to HIV positive women were being tested.
“This is due to difficulty with tracking babies of HIV positive mothers delivered outside public facilities.
“Also, poor Dried Blood Spots (testing of infant blood samples) and viral load testing sample logistic systems.
“And weak mentorship and supportive supervision at the health facility levels among others, “ Adewole said.
The minister said that a well-coordinated programme involving all major implementers in the country would help solve the challenges.
He said, “Also, surmounting these challenges would require improving the implementation of the programme that will ultimately serve as good practice for other countries.”
Also speaking, a Consultant Haematologist, Prof. Sulaiman Akanmu said that regular monitoring of drug resistance mutations in form of studies carried out by institutions would help inform policies.
“The studies about drug resistance is key and any institution offering anti-retroviral therapy must expect that resistance will naturally evolve.
“We must anticipate it and put measures in place to ensure that we are able to contain it.
“Why the research is key is the fact that, unlike elsewhere, before you put a patient to anti-retroviral therapy, drug resistance testing is done to know what type of drugs the individual is sensitive to before applying the drug.
“That is not feasible in our situation; we really need to give it a public approach system in the sense that we will have to find out what is the common form of resistance that occurs in our patients.
“We use the report of the resistance testing study to inform policy on what we should consider as first line drug, second line drug and how we should manage what we call third line regimen.
“That is the reason why you must be able to do drug resistance testing,” he said.
Also, a Senior Virologist, Institute of Human Virology, Nigeria, Dr Nicaise Ndembi, said there was the need to design surveys where studies in a large scale can provide evidence-driven interventions.
Ndembi however said that the country lacked data that showed the problem of transmitted resistance.
“Basically, the concept is that if you have more exposure to anti-retroviral therapy, the virus will select resistant mutations.
“Thus, the reason why we should worry as a nation is that as we have more people being placed on treatment, we have more resistance, “
“ We need more research studies to be able to know the magnitude of the problem, “ he said.
In her remarks, a Consultant in Public Health, Prof. Phyllis Kanki, identified high cost of laboratory test, lack of patience to treatment by the patients as some challenges facing HIV treatment in the country.
“All the laboratory tests have a certain cost, that is one of the challenges and the other challenge is even though the therapy works pretty well it is still life long.
“So you have to have patience and the healthcare system be ready to support a patient for many years.
“And patients may have issues with taking the drugs, they may want to stop which can be a problem for them, “she said.

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Commissioner Lauds Navy On Covid-19 Containment

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Rivers State Commissioner for Health, Prof Princewill Chike, has lauded efforts made so far by the Naval Command at Borokiri, Port Harcourt, towards checking the trend of the Covid-19 pandemic in the State.
Making the commendation recently when the naval medical team paid him a courtesy call in his office, the commissioner stated that the state government and Rivers people appreciate the fact that the naval health facility is made accessable to people living in their environment and beyond.
“The  Rivers State Government appreciates all your effort aimed at curbing the spread of the Corona Virus in line with your corporate social responsibility for host communities in the state by making your (health) facility accessible”, he said.
Prof Chike continued that, “the job of every health personnel is humanitarian. Lives of citizens of our country are paramount and should therefore not be compromised”.
While assuring that the state government is doing everything possible to fight the spread of the pandemic, the commissioner stated that he’ll personally pay occasional visits to the naval healthcare facility, and also assured of the preparedness of the state ministry of health to partner with other private healthcare delivery services.
“The State Ministry of Health (MOH) is committed in partnering with other private health facilities in the state to curb the spread of the ravaging pandemic”, he said.
Speaking earlier, the Commander, Naval Medical Centre Borikiri, Navy Captain U. O. Nzeribe-Agbangwu, said the navy health services were not restrained to its personnel but extended to other individuals who need to access the facility for heart care. 
The commander said, “over 70 percent of our patients are civilians, and, in line with our corporate social responsibility, we constructed a borehole for supply of water to the host community”.
Nzeribe-Agbangwu also expressed satisfaction over the support the Naval healthcare facility got from the ministry in the heat of the pandemic in 2020.

By: Sogbeba Dokubo

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Covid-19: Pregnant Woman, 15 Others Die In Edo

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The Edo State Government has confirmed the death of a 33-year-old pregnant woman at Stella Obasanjo Hospital in Benin and 15 other persons across other Covid-19 facilities.
Head of the state’s Coronavirus Case Management, Dr Ebomwonyi Osagie, who disclosed this at the daily press briefing on the virus, however, said that the victims were not vaccinated.
“This particular patient came in and died about three hours after presentation at the Stella Obasanjo Hospital; late presentation is a major issue in managing crisis.
“She is about 28 weeks pregnant, already having pre-eclampsia, so, the debate is actually if it is the pre-eclampsia that killed her or Covid-19.
“The woman has Covid-19, which pushed her more toward developing pre-eclampsia and then death. Some other women have pre-eclampsia and are successfully managed.
“Late presentation is an issue, because the patient died three hours after presentation, which means that there is little that would have been done to manage the situation, so, we are appealing to private hospitals to let patients go very early for treatment.
“So far, a total of 537 samples were collected, with a total of 1,004 confirmed cases, 103 recovered and were discharged and 16 deaths recorded within 48hours.
“We have 70 people in admission, 296 people in home care, 344 discharged and 50 deaths, since the outbreak of the pandemic,” Osagie said.
The Permanent Secretary, Ministry of Health, Dr Osamwonyi Irowa, said that the cases were rising, with more people being admitted, just as the state was recording very high mortality from COVID-19.
Irowa further said that vaccination was fighting the pandemic and appealed to residents to avail themselves the opportunity of taking COVID-19 vaccines made available by the Federal and state governments.

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Agency Trains 40 Health Officers On Emergency Response

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The United States Centers for Disease Control and Prevention (US-CDC) on Monday kicked off a two-week capacity building programme in Lagos for Nigerian experts on public health emergency response.
The training seeks to certify the first cohort of 40 participants drawn from the Nigeria Centre for Disease Control (NCDC), state-level ministries of health, Nigeria Port Health Services, and  Nigerian military in the Public Health Emergency Management Professional Certification (PHEM PC).
The US-CDC Nigeria Country Director, Mary Boyd, said: “The devastating impact of the Covid-19 pandemic illustrates now more than ever the importance of ensuring the public health and health care systems can adequately prevent, respond to, and recover from health emergencies.
“Particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities,”  a statement by the mission in Lagos, quoted.
The Tide source reports that PHEM PC training, a first of its kind in Nigeria, adapted from US-CDC Atlanta, equips emergency managers, incident managers, state epidemiologists, first responders, watch managers, and other public health experts with the knowledge, competencies and skill sets they need to respond to public health emergencies.
During the intensive programme, participants will receive specialised training in crisis and emergency risk communication as well as public health emergency management functions and operations.
The PHEM training is part of the U.S. Government’s efforts to support pandemic preparedness globally.
The US-CDC, NCDC, and Georgetown University are collaborating to deliver this training.
In 2019, Nigeria became a Global Health Security Agenda (GHSA) partner country committed to achieving GHSA 2024 targets and International Health Regulations (IHR) requirements.
US-CDC supports the Government of Nigeria (GON) to achieve these targets by strengthening workforce development, surveillance, emergency response, and laboratory capacity among other areas.

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