Conference abstract

Lassa fever outbreak, Edo State, Nigeria, 2016

Pan African Medical Journal - Conference Proceedings. 2018:8(55).05 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.55.637

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Keywords: Lassa fever, haemorrhagic, epidemic-prone, viral
Opening ceremony

Lassa fever outbreak, Edo State, Nigeria, 2016

Bosede Agnes Alowooye1,&, Jude Onwujei1, Bountain Tebeda1, Ephraim Ogbaini2, Danny Asogun2, Adebola Olayinka1, Patrick Nguku1

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Irrua Specialist Teaching Hospital, Edo State, Nigeria

&Corresponding author
Bosede Agnes Alowooye, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

Abstract

Introduction: Lassa fever (LF) is endemic in Nigeria with an average five-year mortality of 26%; 72.5% of confirmed cases occurred in Edo State. In January 2016, an outbreak of LF was reported in Edo State. We conducted a laboratory-based investigation to confirm, characterize and control the outbreak.

Methods: we investigated the outbreak from January to February 2016 in eight Local Government Areas in Edo State. A case was any person living in Edo State with 38°C fever for at least 2 days and some or one of the following symptoms: chest pain, sore throat, muscle pain, vomiting, and diarrhea between January and February 2016 who tested positive to Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) using S-gene and L-gene primer at Irrua Specialist Teaching Hospital (ISTH), Edo state. We line- listed cases, conducted contact tracing and assessed infection, prevention and control (IPC) at the isolation ward, ISTH. We carried out a case-control study and determined risk factors. Public health actions taken include community sensitization and stakeholders’ dialogue.

Results: of 359 suspected cases, 29 (8%) tested positive to Lassa virus. Commonest signs observed were red eyes, haematuria and facial edema. Median age of confirmed cases was 30 years (Interquartile range: 25 – 47 years). Majority 11 (37.9%) were aged 20 - 29 years, 17 (58.6%) were males and 13 (44.8%) were students. Overall, case fatality rate was 31%. Etsako West Local Government accounted for 12 (41.4%) of cases with fatality. Altogether, 179 contacts were monitored with no secondary cases. L-gene primer increased detection rate by 46.1%. Notably, IPC was below standard at the isolation ward. Late referral and development of renal complications were associated with greater likelihood of death (p < 0.005).

Conclusion: outbreak was confirmed to be Lassa fever. Late referral and renal complications were risk factors of mortality. The outbreak was similar in profile to other outbreaks in the state except for the shift from highest incidence and mortality from Esan West to Etsako West Local Government Area. Community sensitization helped to control the outbreak. We recommended continuous active surveillance and continuous sensitization.