On 22 July 2014, the first case of the dreaded Ebola virus arrived in Nigeria via an Asky aircraft. However, no one knew it at the time. How did this happen? How had this patient been screened at his port of departure, that is Liberia airport? We can also ask ourselves yet another question. Why is it taking so long to curtail the epidemic? For instance, the World Health Organisation (WHO) recently announced that as at 23 July 2014, the Ebola epidemic had claimed 672 lives. Furthermore, there are currently 1201 suspected and confirmed cases across West Africa. In terms of intervention, the current strategy appears to be related to the use of universal precautions: case isolation, hand-washing, and health worker protection and palliative treatments (such as pain management, and rehydrating fluids). In theory, this strategy may be quite effective.
This is because epidemic control strategies usually aim to reduce person-to-person transmission through avoidance related methods (WHO, 2014). In this case, persons at risk will need to avoid contact with the body fluids of infected person, including sweat, semen, vomit, faeces, urine, blood and saliva (Infection Control for Viral Hemorrhagic Fevers, WHO 2014). In practice, avoidance techniques may not work, as in reality, these are the most basic of preventive measures. Firstly, a high level of hygiene is required and this may be relatively impossible in the urban slums and rural areas of many African countries. Secondly, isolation centres will need to be stationed in every single district or local government area. In many developing African countries, such centres may not be adequately manned, suitably stationed, or reasonably equipped. So, invariably, many infected persons are nursed at home or buried at home. Hence, the cycle of transmission continues.
What then can be done? From a Public Health perspective, there are several ways that epidemics may be subdued: 1). Interrupt the cycle of transmission e.g prevent cross-contamination 2). Protect the susceptible host e.g through vaccination or 3). Eliminate the reservoir of infection e.g. kill all animals that harbour the Ebola virus. Starting from the third option, we immediately encounter the difficulty of which animals to slaughter. Unlike Avian flu, it isn’t clear which animal is involved here? Bats? Rodents? Monkeys? In addition, the Ebola virus has no vaccine to date; so that leaves only one other option: interrupt the cycle of transmission. The question then is ‘Has this been effectively done? How have other nations contained similar epidemics? On 21 September 2008, a woman was admitted at a South African hospital for fever, vomiting and diarrhea, “followed by a rash,” and signs of organ failure (Keeton, 2008).
The woman died the next day. Three more cases were reported, in quick succession, to the National Institute for Communicable Disease in South Africa. They all died within a few days of admission. Three of the patients were medical staff. Researcher Keeton (2008) noted that all cases presented with “ flu-like illness (in a similar way to Ebola) and had fever, headache and muscle pain. When the fifth patient surfaced, the institute had diagnosed an outbreak of an old world arena virus infection. While this specific virus did not cause internal bleeding, it belonged to the same class of viruses that did, e.g West African LASSA fever causes fever and bleeding (Keeton ,2008). According to Keeton (2008), the fifth patient (a nurse) was “treated with Ribavirin, which has been effective in patients with LASSA fever, and she has since made a good recovery” (Keeton, 2008). Ribavirin then was the deciding factor in this case.
All other palliative methods failed, intravenous fluids, etc. Why then should we expect such interventions to work now in 2014? Surely an antiviral, which worked in a similar situation six years ago, should also be a consideration in this case? The virus isolated in South Africa had never been subjected to Ribavirin in a research setting (Keeton 2008). In effect, there was no guarantee that it would work. But this was nevertheless the most logical approach to the impending threat. Ribavirin is a broad-spectrum antiviral agent. It is effective against a wide range of RNA viruses including viral hemorrhagic viruses such as LASSA fever (Crotty, Cameron, & Andino, 2001). According to the trio, Ribavirin was discovered in 1972. It can therefore not be classified as an experimental drug. Ribavirin also acts independently of the viral RNA sequence. Therefore flaviruses (of which Yellow fever is a member) and arena viruses (of which Lassa fever is a member) differ somewhat in structure but are still responsive to the antiviral.
The critical success factor, however, may be timely intervention. Ribavirin is contraindicated after organ (e.g. kidney or liver failure) sets in. It may therefore be imperative that treatment be commenced during the early phase of the illness. While the antiviral may not be available as an OTC, (non prescription drug) large orders (in tablet or injectable form) may be made directly from the manufacturers. Fortunately, no fewer than six global pharmaceutical giants, including Sandoz and Roche, are currently manufacturing the antiviral. In terms of potential impact, the Ebola virus is an RNA virus, and a member of the viral hemorrhagic fevers, such as LASSA fever, Rift valley fever, Marburg virus, Crimean Congo hemorrhagic virus and Yellow fever (Crotty et al.,2001; Keeton, 2008). Most of the VHF viruses present with similar symptoms such as flu-like illness, vomiting, diarrhea, high fever, skin rashes and bleeding (Keeton, 2008). Most are invariably fatal without therapeutic intervention, or vaccination (if available). These statistics clearly indicate that the VHF viruses have similar molecular mechanisms. Therefore, in view of the current status of the epidemic, the next logical approach should be related to therapeutic intervention. There is certainly no hard evidence that such an approach would be fruitless, while there is certainly compelling evidence that the outcome may be positive.
References Crotty, S., Cameron, C., & Andino R.(2001).
Ribavirin’s antiviral mechanism of action: Lethal mutagenesis? Journal of Molecular Medicine,(2002) 80 :86-95 Infection Control for Viral Hemorrhagic Fevers in the African Setting. (World Health Organisation and CDC. 2014) Keeton, C.(2008).South African Doctors move quickly to contain a new virus. World Health Organization. Bulletin of The World Health Organisation 86.12(Dec 2008) :912-3 Simbo Davidson (MBBS, MPH, PCQI) is a Public Health specialist working in a private hospital in Lagos, Nigeria.
Rivers, Imo Teachers Shine As Promasidor Marks World Teachers Day With Special Cowbellpedia Teacher’s Mathematics TV Quiz Show
It was a reversal of roles for teachers last weekend as Promasidor Nigeria Limited, makers of “Cowbell, Our Milk”, marked the 2019 World Teachers Day with special (Teacher’s edition) of Cowbellpedia Mathematics Quiz Show to celebrate the teachers.
The twelve teachers, who produced the finalists in the Junior and Senior categories of the 2018 edition of the competition, contested for honours and prizes.
In the Junior category, Mr Paul Fase of Graceland International School, Port Harcourt, Rivers State, outclassed others with 105 points, to win the star prize. Fase was the teacher of Favour Okarike who emerged as second runner-up in 2018 finals.
On the heels of Fase was Kayode Adebayo, a teacher from The Ambassadors College, Ota, Ogun State who garnered 95 points to emerge as first runner-up, while Godwin Udom, his counterpart from the same school, scored 75 point to become the second runner-up.
Adebayo’s student, Master Akinleye Akinfoluhan was the junior category champion in the 2018 edition while Udom’s pupil, Loluwa Abiodun was a finalist.
Other teachers who also participated in the contest but fell by the way side include Beckley Daniel of Welkin International School, Ota, Ogun State; Hamzat Dankanawa a teacher from Nigerian Tulip International College (Boys) Abuja and David Akuru from Jesuit Memorial College, Port Harcourt, Rivers State.
Fase with a five years’ experience in the teaching profession, expressed gratitude to God for winning, maintaining that he now appreciates what the students are going through. “It is very easy to blame the students for lack of speed and for errors, but I now know it is not that easy,” he admitted.
In the Senior category, Ebock Inah-Ngulu, a teacher from Federal Government College, Owerri, Imo State, got the crown with 75 points. His student, Jessica Austine, was a finalist last year.
Christopher Olasupo of Graceland International College, Port Harcourt, Rivers State and Anfani Egbeyemi of The Ambassador College, Ota, Ogun State came second and third respectively. Olasupo’s student, Chinedu Mgbemena was the 2018 senior category champion, while Egbeyemi taught Enoch Adenekan, a 2018 finalist.
The trio successfully shrugged off the challenge from Oladipo Olatunde of The Ambassador College; Olalekan Olowe from Reality High School, Ilesha, Osun State and Samson Otunubi, a teacher from Federal Government Academy, Suleja, Niger State.
All the teachers commended Promasidor for the initiative which they described as a big morale booster for teachers across the country, adding that teaching requires passion, but teaching Mathematics demands a ‘special anointing’ because of the nature of the subject and the misconception by students and parents.
The students will come back to ‘battle’ this weekend as the semi-finals of the Cowbellpedia Quiz Show continues with 36 students jostling for 12 final slots. The airing also continues on DSTV Africa Magic Family Channel, AIT Network and other six television stations across the country.
Aside the N2 million grand prize, Managing Director of Promasidor Nigeria Limited, Mr. Anders Einarsson disclosed that the winner in each category, (Junior and Senior) will enjoy an all-expense paid educational excursion outside the country at the end of the initiative.
In addition, the first and second runners-up in each category will receive N1.5 million and N1 million respectively, while the teachers of the top prize winners will be awarded N500, 000. Those of the first and second runners-up will receive N400, 000 and N300, 000 respectively.
Sultan of Sokoto reveals how to end security challenges in Nigeria
President-General of the Supreme Council of Islamic Affairs and Sultan of Sokoto, Alhaji Sa’ad Abubakar, has called for the development and adoption of homegrown solutions to the security challenges facing the country.
Abubakar made the call in Sokoto on Monday, during a Town Hall Meeting on Security Matters organised by the Sultanate Council in collaboration with the Nigeria Union of Journalists (NUJ), Sokoto State council, NAN reports.
Abubakar decried the rising security threats in the northern region.
He emphasized the need for a strong partnership between political leaders and traditional rulers towards finding lasting solutions to the challenges.
The Sultan expressed disappointment over the alleged involvement of some traditional rulers in the activities of armed bandits in parts of Zamfara.
He advocated prosecution of any traditional ruler involved in the supporting banditry and other criminal activities.
Gov. Aminu Tambuwal of Sokoto called for the strengthening of all law enforcement agencies and other institutions that promote peace in the country.
Tambuwal lamented the shortage of manpower in some of the security agencies, stressing the need for a total review of the nation’s security architecture.
He also called for more funding and proper intelligence gathering as well as collaboration with the traditional institution for better results.
News Agency of Nigeria (NAN) reports that three key speakers; Gen. Ishola Williams (rtd), Emir of Zamfara, Alhaji Muhammad Attahiru-Ahmad and Prof. Tukur Baba of Federal University Birnin Kebbi presented papers at the meeting.
The lecturers dwelled on the need for drastic approaches to security matters, overhauling of security structures, community involvement in tracking security breaches, increased professional training and viable economic empowerment at all strata of the society.
Buhari govt insists on VAT increment, gives reason
Mrs. Zainab Ahmed, the Minister of Finance, Budget and National Planning, has insisted that Value Added Tax (VAT) has to increase.
She said this while noting that the nation will not be able to reach 80 per cent revenue performance for 2019.
Ahmed at the public presentation of the 2020 budget proposals, said that as at half year, the actual aggregate revenue for 2019 was N2.04 trillion, which was 58 per cent of the prorate target.
Ahmed said of the figure, oil revenue accounted for N900 billion, Company Income Tax (CIT) N349.11 billion, Value Added Tax (VAT) N81.36 billion and Customs Collections N184.10 billion.
“As to whether we will reach the N8.33 trillion at the end of 2019 is very unlikely and that is why we have to make special efforts to boost revenue performance”, NAN quoted her as saying.
“It is clear that we can not reach even 80 per cent and that is why we have to do several things to make sure that revenue performance is enhanced.
“Releases did not start until late July and as at last week we had scheduled and releases are now up to N650 billion.”
According to her, N294.63 billion was released for capital expenditure as at the end of September, but the target is to be able to reach N900 billion by the end of December 2019.
Ahmed said that of the total appropriation of N8.92 trillion, N3.39 trillion had been spent by June 30, as against the prorated expenditure budget of N4.58 trillion, representing 76 per cent performance.
The News Agency of Nigeria (NAN) reports that the 2019 Appropriation Bill was presented to the National Assembly by President Muhammadu Buhari on Dec. 19, 2018, but was signed into law on May 27, 2019.
The N8.92 trillion budget had a revenue projection of N6.97 trillion, consisting of oil revenue projected at N3.73 trillion while non-oil revenue was estimated at N1.39 trillion.
Estimates for non-oil revenue consisted of N799.52 billion from CIT, N229.34 billion from VAT and Customs Duties of N302.55 billion.
The 2019 budget was predicated on oil production of 2.3 million barrels per day at 60 dollars per barrel and an exchange rate of N305 per dollar.
On the issue of border closure, she said only the main borders that were manned by the Nigerian Customs Service (NCS) and other security operatives were closed.
She added that the nation had seen the benefits of the closure and that though there were some challenges, the NCS and the committee working on the borders closure was looking at how to ease some of the difficulties.
“It has to be Nigeria first and we have to protect our own industries because some of our neighbours have been flagrantly abusing commitments that we jointly signed to and the President has said this is no longer acceptable.
“The border closure is not forever, there will be an end date, the Federal Government is currently in discussion with governments of our neighbouring countries Niger and Benin Republic.
“We are negotiating to make sure that the challenges that led to the closure of the borders are addressed on both sides but, especially that our neighbors meet the commitments that we signed unto several years ago.
“Once those discussions are concluded, the borders will be opened again,” she said.
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