Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021

Oluwatosin Wuraola Akande; Kelly Osezele Elimian; Ehimario Igumbor; Lauryn Dunkwu; Chijioke Kaduru; Olubunmi Omowunmi Olopha; Dabri Olohije Ohanu; Lilian Nwozor; Emmanuel Agogo; Olusola Aruna; Muhammad Shakir Balogun; Olaolu Aderinola; Anthony Ahumibe; Chinedu Arinze; Sikiru Olanrewaju Badaru; William Nwachukwu; Augustine Olajide Dada; Cyril Erameh; Khadeejah Hamza; Tarik Benjamin Mohammed; Nnaemeka Ndodo; Celestina Obiekea; Chinenye Ofoegbunam; Oladipo Ogunbode; Cornelius Ohonsi; Ekaete Alice Tobin; Rimamdeyati Yashe; Afolabi Adekaiyaoja; Michael C. Asuzu; Rosemary Ajuma Audu; Muhammad Bashir Bello; Shaibu Oricha Bello; Yusuf Yahaya Deeni; Yahya Disu; Gbenga Joseph; Chidiebere Ezeokafor; Zaiyad Garba Habib; Christian Ibeh; Ifeanyi Franklin Ike; Emem Iwara; Rejoice Kudirat Luka-Lawal; Geoffrey Namara; Tochi Okwor; Lois Olajide; Oluwafunke Olufemi Ilesanmi; Solomon Omonigho; Ferdinand Oyiri; Koubagnine Takpa; Nkem Usha Ugbogulu; Priscilla Ibekwe; John Oladejo; Elsie Ilori; Chinwe Lucia Ochu; Chikwe Ihekweazu

doi:10.1136/bmjgh-2021-007076

Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021

Oluwatosin Wuraola Akande^*, Kelly Osezele Elimian, Ehimario Igumbor, Lauryn Dunkwu, Chijioke Kaduru, Olubunmi Omowunmi Olopha, Dabri Olohije Ohanu, Lilian Nwozor, Emmanuel Agogo, Olusola Aruna, Muhammad Shakir Balogun, Olaolu Aderinola, Anthony Ahumibe, Chinedu Arinze, Sikiru Olanrewaju Badaru, William Nwachukwu, Augustine Olajide Dada, Cyril Erameh, Khadeejah Hamza, Tarik Benjamin MohammedNnaemeka Ndodo, Celestina Obiekea, Chinenye Ofoegbunam, Oladipo Ogunbode, Cornelius Ohonsi, Ekaete Alice Tobin, Rimamdeyati Yashe, Afolabi Adekaiyaoja, Michael C. Asuzu, Rosemary Ajuma Audu, Muhammad Bashir Bello, Shaibu Oricha Bello, Yusuf Yahaya Deeni, Yahya Disu, Gbenga Joseph, Chidiebere Ezeokafor, Zaiyad Garba Habib, Christian Ibeh, Ifeanyi Franklin Ike, Emem Iwara, Rejoice Kudirat Luka-Lawal, Geoffrey Namara, Tochi Okwor, Lois Olajide, Oluwafunke Olufemi Ilesanmi, Solomon Omonigho, Ferdinand Oyiri, Koubagnine Takpa, Nkem Usha Ugbogulu, Priscilla Ibekwe, John Oladejo, Elsie Ilori, Chinwe Lucia Ochu, Chikwe Ihekweazu

^*Corresponding author for this work

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Abstract

Background: With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria.

Methods: We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13.

Results: There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%).

Conclusion: Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.

Original language	English
Article number	007076
Number of pages	14
Journal	BMJ Global Health
Volume	6
Issue number	11
DOIs	https://doi.org/10.1136/bmjgh-2021-007076
Publication status	Published - 18 Nov 2021

Bibliographical note

Funding Information: We appreciate all the Nigerian frontline health workers for their contribution to the collection of the data used for this study. We acknowledge the leadership and coordination provided by all state commissioners for health, epidemiologists and disease notification and surveillance officers. We are also grateful to colleagues, including members of the Epidemiological Working Group of the Nigeria COVID-19 Research Coalition (NCRC) who provided technical and administrative support for this manuscript. In addition, we acknowledge the African Field Epidemiology Network (AFENET) for providing financial support towards the publication of this manuscript.

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Citation: Akande OW, Elimian KO, Igumbor E, et al. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020–April 2021. BMJ Global Health 2021;6:e007076.

DOI: http://dx.doi.org/10.1136/bmjgh-2021-007076

Keywords

COVID-19
descriptive study
epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Akande, O. W., Elimian, K. O., Igumbor, E., Dunkwu, L., Kaduru, C., Olopha, O. O., Ohanu, D. O., Nwozor, L., Agogo, E., Aruna, O., Balogun, M. S., Aderinola, O., Ahumibe, A., Arinze, C., Badaru, S. O., Nwachukwu, W., Dada, A. O., Erameh, C., Hamza, K., ... Ihekweazu, C. (2021). Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021. BMJ Global Health, 6(11), Article 007076. https://doi.org/10.1136/bmjgh-2021-007076

@article{6f1f67a3e6594bc9ae1704e717777081,

title = "Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021",

abstract = "Background: With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods: We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results: There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion: Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave. ",

keywords = "COVID-19, descriptive study, epidemiology",

author = "Akande, {Oluwatosin Wuraola} and Elimian, {Kelly Osezele} and Ehimario Igumbor and Lauryn Dunkwu and Chijioke Kaduru and Olopha, {Olubunmi Omowunmi} and Ohanu, {Dabri Olohije} and Lilian Nwozor and Emmanuel Agogo and Olusola Aruna and Balogun, {Muhammad Shakir} and Olaolu Aderinola and Anthony Ahumibe and Chinedu Arinze and Badaru, {Sikiru Olanrewaju} and William Nwachukwu and Dada, {Augustine Olajide} and Cyril Erameh and Khadeejah Hamza and Mohammed, {Tarik Benjamin} and Nnaemeka Ndodo and Celestina Obiekea and Chinenye Ofoegbunam and Oladipo Ogunbode and Cornelius Ohonsi and Tobin, {Ekaete Alice} and Rimamdeyati Yashe and Afolabi Adekaiyaoja and Asuzu, {Michael C.} and Audu, {Rosemary Ajuma} and Bello, {Muhammad Bashir} and Bello, {Shaibu Oricha} and Deeni, {Yusuf Yahaya} and Yahya Disu and Gbenga Joseph and Chidiebere Ezeokafor and Habib, {Zaiyad Garba} and Christian Ibeh and Ike, {Ifeanyi Franklin} and Emem Iwara and Luka-Lawal, {Rejoice Kudirat} and Geoffrey Namara and Tochi Okwor and Lois Olajide and Ilesanmi, {Oluwafunke Olufemi} and Solomon Omonigho and Ferdinand Oyiri and Koubagnine Takpa and Ugbogulu, {Nkem Usha} and Priscilla Ibekwe and John Oladejo and Elsie Ilori and Ochu, {Chinwe Lucia} and Chikwe Ihekweazu",

note = "Funding Information: We appreciate all the Nigerian frontline health workers for their contribution to the collection of the data used for this study. We acknowledge the leadership and coordination provided by all state commissioners for health, epidemiologists and disease notification and surveillance officers. We are also grateful to colleagues, including members of the Epidemiological Working Group of the Nigeria COVID-19 Research Coalition (NCRC) who provided technical and administrative support for this manuscript. In addition, we acknowledge the African Field Epidemiology Network (AFENET) for providing financial support towards the publication of this manuscript. The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Citation: Akande OW, Elimian KO, Igumbor E, et al. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020–April 2021. BMJ Global Health 2021;6:e007076. DOI: http://dx.doi.org/10.1136/bmjgh-2021-007076 ",

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Akande, OW, Elimian, KO, Igumbor, E, Dunkwu, L, Kaduru, C, Olopha, OO, Ohanu, DO, Nwozor, L, Agogo, E, Aruna, O, Balogun, MS, Aderinola, O, Ahumibe, A, Arinze, C, Badaru, SO, Nwachukwu, W, Dada, AO, Erameh, C, Hamza, K, Mohammed, TB, Ndodo, N, Obiekea, C, Ofoegbunam, C, Ogunbode, O, Ohonsi, C, Tobin, EA, Yashe, R, Adekaiyaoja, A, Asuzu, MC, Audu, RA, Bello, MB, Bello, SO, Deeni, YY, Disu, Y, Joseph, G, Ezeokafor, C, Habib, ZG, Ibeh, C, Ike, IF, Iwara, E, Luka-Lawal, RK, Namara, G, Okwor, T, Olajide, L, Ilesanmi, OO, Omonigho, S, Oyiri, F, Takpa, K, Ugbogulu, NU, Ibekwe, P, Oladejo, J, Ilori, E, Ochu, CL & Ihekweazu, C 2021, 'Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021', BMJ Global Health, vol. 6, no. 11, 007076. https://doi.org/10.1136/bmjgh-2021-007076

TY - JOUR

T1 - Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021

AU - Akande, Oluwatosin Wuraola

AU - Elimian, Kelly Osezele

AU - Igumbor, Ehimario

AU - Dunkwu, Lauryn

AU - Kaduru, Chijioke

AU - Olopha, Olubunmi Omowunmi

AU - Ohanu, Dabri Olohije

AU - Nwozor, Lilian

AU - Agogo, Emmanuel

AU - Aruna, Olusola

AU - Balogun, Muhammad Shakir

AU - Aderinola, Olaolu

AU - Ahumibe, Anthony

AU - Arinze, Chinedu

AU - Badaru, Sikiru Olanrewaju

AU - Nwachukwu, William

AU - Dada, Augustine Olajide

AU - Erameh, Cyril

AU - Hamza, Khadeejah

AU - Mohammed, Tarik Benjamin

AU - Ndodo, Nnaemeka

AU - Obiekea, Celestina

AU - Ofoegbunam, Chinenye

AU - Ogunbode, Oladipo

AU - Ohonsi, Cornelius

AU - Tobin, Ekaete Alice

AU - Yashe, Rimamdeyati

AU - Adekaiyaoja, Afolabi

AU - Asuzu, Michael C.

AU - Audu, Rosemary Ajuma

AU - Bello, Muhammad Bashir

AU - Bello, Shaibu Oricha

AU - Deeni, Yusuf Yahaya

AU - Disu, Yahya

AU - Joseph, Gbenga

AU - Ezeokafor, Chidiebere

AU - Habib, Zaiyad Garba

AU - Ibeh, Christian

AU - Ike, Ifeanyi Franklin

AU - Iwara, Emem

AU - Luka-Lawal, Rejoice Kudirat

AU - Namara, Geoffrey

AU - Okwor, Tochi

AU - Olajide, Lois

AU - Ilesanmi, Oluwafunke Olufemi

AU - Omonigho, Solomon

AU - Oyiri, Ferdinand

AU - Takpa, Koubagnine

AU - Ugbogulu, Nkem Usha

AU - Ibekwe, Priscilla

AU - Oladejo, John

AU - Ilori, Elsie

AU - Ochu, Chinwe Lucia

AU - Ihekweazu, Chikwe

N1 - Funding Information: We appreciate all the Nigerian frontline health workers for their contribution to the collection of the data used for this study. We acknowledge the leadership and coordination provided by all state commissioners for health, epidemiologists and disease notification and surveillance officers. We are also grateful to colleagues, including members of the Epidemiological Working Group of the Nigeria COVID-19 Research Coalition (NCRC) who provided technical and administrative support for this manuscript. In addition, we acknowledge the African Field Epidemiology Network (AFENET) for providing financial support towards the publication of this manuscript. The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Citation: Akande OW, Elimian KO, Igumbor E, et al. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020–April 2021. BMJ Global Health 2021;6:e007076. DOI: http://dx.doi.org/10.1136/bmjgh-2021-007076

PY - 2021/11/18

Y1 - 2021/11/18

N2 - Background: With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods: We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results: There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion: Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.

AB - Background: With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods: We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results: There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion: Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.

KW - COVID-19

KW - descriptive study

KW - epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85120372723&partnerID=8YFLogxK

U2 - 10.1136/bmjgh-2021-007076

DO - 10.1136/bmjgh-2021-007076

M3 - Article

AN - SCOPUS:85120372723

SN - 2059-7908

VL - 6

JO - BMJ Global Health

JF - BMJ Global Health

IS - 11

M1 - 007076

ER -

Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021

Abstract

Bibliographical note

Keywords

UN SDGs

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