Conference abstract

Assessment of Lassa fever sample and case management preparedness in Nigeria 2017: challenges and way forward

Pan African Medical Journal - Conference Proceedings. 2018:8(33).28 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.33.615

Contact the corresponding author
Keywords: Lassa fever, turn-around-time, case-fatality-rate, ribavirin
Opening ceremony

Assessment of Lassa fever sample and case management preparedness in Nigeria 2017: challenges and way forward

Fatima Saleh1,&, Chioma Dan-Nwafor2,3, Mary Doshima2, Kayode Fasominu4, Assad Hassan1, Elsie Ilori2, Emmanuel Agogo2, Olubunmi Ojo2, Patrick Nguku1, Favour Makava4, Chikwe Ihekweazu2

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Nigeria Centre for Disease Control, Abuja, Nigeria, 3African Field Epidemiology Network, Nigeria, 4University of Maryland Baltimore, Nigeria

&Corresponding author
Fatima Saleh, Nigeria Field Epidemiology and Laboratory Training Programme, Asokoro, Abuja, Nigeria

Abstract

Introduction: Lassa fever remains an important cause of morbidity and mortality in West Africa. In Nigeria, Lassa fever (LF) is endemic with an annual cycle of incident cases across the country. Despite seasonal epidemic preparedness and response efforts, there is still evidence of low clinical index of suspicion, poor sample management and delay in treatment resulting in nosocomial transmission, long turnaround time (TAT) for laboratory diagnosis and high case-fatality-rates (CFR).

Methods: a structured questionnaire on sample and case management preparedness was developed by the multi-sectoral National Lassa Fever Working Group. The questionnaires were administered via telephone calls to all the 37 State epidemiologists. Variables of interest were summarized in frequencies, means and proportions using Epi-info Version 7.

Results: most the states, 36 (97%) collect Lassa fever samples within 24 hours with 31 (83.7%) transporting samples immediately using personal delivery as mode of transportation. Majority (78%), of states routinely use standard triple packaging and 24 (64%) preserve samples in cold box prior to transportation. Two laboratories are designated for testing of viral hemorrhagic fevers in Nigeria (University of Lagos Teaching Hospital (LUTH) and Irrua Specialist Teaching Hospital (ISTH). The median laboratory TAT for LUTH is 48 hours (range 24 - 120) while for ISTH is 48 hours (range 24 - 48). Only sixteen states (43%) have designated Viral Hemorrhagic Fever (VHF) treatment centers with isolation units. Twenty-six states (70%) have trained personnel and a similar proportion (69%) commence presumptive treatment before receipt of laboratory result. Only 3 (8%) States have ribavirin stock-out while 2 (5%) States have short dated Ribavirin stock.

Conclusion: there are nationwide gaps in sample and case management preparedness for Lassa fever outbreaks in Nigeria. Therefore the need for the establishment of designated functional VHF treatment centers in all states, active management of Ribavirin stocks and improvement in laboratory turn-around time.