As the coronavirus pandemic spreads across states in Nigeria, Osun, Ondo and Ekiti States seem to have found reprieve in their medical battle against the scourge.
PREMIUM TIMES checks revealed that their respective isolation/treatment centres have started using a cocktail comprising chloroquine, hydroxychloroquine and azithromycin drugs as effective treatment for infected patients.
Government officials who spoke exclusively and separately with PREMIUM TIMES, admitted that although no drug had been approved for the treatment of the disease, chloroquine particularly has become a viable alternative with encouraging results so far.
Nigeria is grappling with the community spread of the disease which is gradually becoming intractable, with a rapid rise in the number of cases on a daily basis.
Lagos is the epicentre of the disease. However, increased cases and deaths in Kano have become another source of concern in the fight against the disease.
As of 11.25 p.m. on April 22, the country had a total of 873 cases, with 197 patients discharged. About 28 deaths have been recorded so far.
Of the number, Lagos had 504; FCT, 119; Kano, 73; Ogun, 24. Osun has 20 cases, Ondo, 3 and Ekiti, 4.
In Osun, 19 of the confirmed cases have been treated and discharged. Only one is still held back at the treatment centre awaiting when he would be confirmed negative.
The state became affected in March when several persons returned from Ivory Coast; 27 of them, and were immediately isolated and tested for the virus.
Those who tested positive were confined at the Ejigbo Covid-19 Isolation and Treatment Centre where they were provided with treatment.
The Osun State Commissioner for Health, Rafiu Isamatu, told PREMIUM TIMES although there is a lack of a breakthrough in the treatment of the disease worldwide, the efficacy of some already known drugs has aided the medical containment of the virus in the state.
“You have said it all, that there is no known drug for COVID-19,” he said. “Basically everybody is just doing trial and error.”
He added the most important thing guiding the administering of care by the state’s medical team was to ensure that whatever medication was given to patients, will not be injurious to them and should be seen as working.
“I suppose in the U.S. they are using hydroxychloroquine and azithromycin and I think few journals have actually supported it though there is no known empirical evidence that could be adopted as the treatment for COVID-19,” Mr Isamatu said.
“Anecdotal evidence shows that it works. There is this American Journal of Medicine which equally gives credence to the use of hydroxylchloroquine. However, it has not been officially recognised as the best treatment for COVID-19.
“What we did in Osun…remember we had 20 cases and they have been discharged, we only have one patient left. Whatever we did to our patient must have worked and we did our best to ensure that we did not give any drug that has not been known to treat one ailment or the other.
“So, those who had no symptoms, we gave them immune boosters, high dose of vitamin C, Zinc Selenium; and we treated them symptomatically. If anybody develops any temperature or any other thing, we treated them, that is what we, doctors call symptomatic treatment.
“Now, those who were sicker than the rest, those are the ones we treated with hydroxylchloroquine and Azithromycin. Azithromycin is a macrolide in the class of erythromycin and similar drugs.”
The commissioner explained that hitherto, hydroxychloroquine was used to treat gout, which is the accumulation of protein in the joints, adding that it has now been found to be effective in the management of coronavirus.
“For those that did not have any known allergy to chloroquine, they all did well,” he said. “We had no adverse effects to hydroxychloroquine. That was what we did for our patients in Osun.”
Mr Isamatu revealed that the only patient left at the treatment centre has not developed any symptoms at all, but quickly added that his could be deadlier, since he could easily spread the virus if allowed to go into the communities with it.
Mr Isamatu said there were different strains of COVID-19, noting that “the ones that we have in Africa, particularly in Nigeria, seems to be a milder one”.
“Those people we have lost, 99.9 per cent of them had one underlying pathology or the other,” he said. “There is nothing to stigmatise anybody about COVID-19. Some are refusing to come up for test because of that.”
Ekiti State recorded its first death as a result of the virus in the case of a 29-year-old health worker who was also pregnant. She had a caesarean section and had a heart attack, even though she tested positive for the virus.
The state had its index case on March 13 in a 37-year-old man who tested positive for coronavirus after he came in contact with an American tourist.
After weeks of treatment and monitoring at the isolation centre, the man tested negative for coronavirus.
Ekiti Commissioner for Health, Mojisola Yahaya-Kolade, in a telephone interview said the patients were being treated with chloroquine.
“Any medical doctor will go through the investigational drugs that have been used in other countries of the world that had COVID-19 before us, and there are so many write-ups and ways people have put forth on the right way to treat them,” she said.
“We treat them symptomatically, if you have high temperature, we give them something to lower the temperature, if somebody is having pains, we treat the pain. Whatever that is needed, you give it to them.
“More importantly in Ekiti State, we are using chloroquine as it is being used in other countries of the world, and we are supporting chloroquine with what is called azithromycin and that is what we are doing. We also are giving supportive care.
“To the best of our ability, all other patients we have treated, they are improving and getting better. Apart from the lady that had caesarean section and had cardiac arrest,” she added.
“How do we know that they are getting better? We are actually testing the culture again and it turns negative and the moment positive turns negative, that means the person is healed, and we carry out the test at least two times.”
In Ondo, the Commissioner for Health, Wahab Adegbenro, confirmed that chloroquine was the drug administered to the patients at the state treatment centre.
The index case of the disease was a military officer who arrived with symptoms of the virus after an international engagement in India. He was isolated, but the doctor who attended to him at the Army medical centre was later infected.
A third case also happened after an airport worker travelled with the virus from Lagos to Ijoka, in Akure and was promptly picked up for a test. He tested positive.
The index case has since been discharged after officials said he had tested negative twice for the virus after weeks of treatment.
“As you have said, there is no specific treatment now, but we are still relying on symptomatic treatment and we also use hydroxychloroquine and arythromycin,” Mr Adegbenro said, when asked how he had been treating the patients.
He said doctors also treat the patients ‘symptomatically’. He noted that the chloroquine treatment had been effective.
“It is effective, because even the second case now has tested negative,” he said. “It is likely he goes home this weekend.
“We are only waiting for the second test going by the guidelines by NCDC, the patient has to test negative twice before we can discharge him.
“We are hoping that by this weekend or on Monday, if the results come back, we will probably discharge him.
“The third case is also not doing badly. He is recovering, there is no cause for alarm. All of them will go home because the cases were picked up early. When you pick them early, the recovery is faster. The follow up contacts that we did tests on, all of them returned negative.”
Chloroquine, which was widely used in the past to treat malaria patients in Nigeria, was later banned by the authorities.
In March, there were reports of chloroquine poisoning after three persons were hospitalised in Lagos for chloroquine overdose in their alleged attempts to prevent infection.
The Lagos government later issued a statement warning people against self-medication.
This development came after the United States President, Donald Trump, had endorsed the use of the drug for the treatment of the disease in the wake of an avalanche of confirmed cases and deaths in the country.
The U.S. Food and Drug Administration quickly responded saying it was yet to approve its use for that purpose since it was still undergoing clinical tests for a possible use to treat COVID-19.
The FDA had only approved it for emergency use, only applying to certain COVID-19 patients, who must meet specific criteria to access the treatment.