Background Lassa fever is a viral haemorrhagic fever endemic in Nigeria. Improved surveillance and testing capacity have revealed in an increased number of reported cases and apparent geographic spread of Lassa fever in Nigeria. We described the recent four-year trend of Lassa fever in Nigeria to improve understanding of its epidemiology and inform the design of appropriate interventions. Methods We analysed the national surveillance data on Lassa fever maintained by the Nigeria Centre for Diseases Control (NCDC) and described trends, sociodemographic, geographic distribution, and clinical outcomes. We compared cases, positivity, and clinical outcomes in the period January 2018 to December 2021. Results We found Lassa fever to be reported throughout the year with more than half the cases reported within the first quarter of the year, a recent increase in numbers and geographic spread of the virus, and male and adult (>18 years) preponderance. Case fatality rates were worse in males, the under-five and elderly, during off-peak periods, and among low reporting states. Conclusion Lassa fever is endemic in Nigeria with a recent increase in numbers and geographical distribution. Sustaining improved surveillance, enhanced laboratory diagnosis and improved case management capacity during off-peak periods should remain a priority. Attention should be paid to the very young and elderly during outbreaks. Further research efforts should identify and address specific factors that determine poor clinical outcomes.
Background: Staphylococcus aureus is one of the most common causes of biofilm associated infections. Identification and differentiation of S. aureus with respect to its biofilm phenotype helps in diagnosis and prevention of infections related to biomedical devices.The aim of this study was to determine the rate of nasal carriage biofilm producing Methicillin Resistant S. aureus (MRSA)among Health Care Workers (HCWs)Methods and materials: A total of 232 nasal swabs were taken from HCWs at Manmohan Memorial Teaching Hospital, Kathmandu. S. aureus was isolated using Mannitol Salt Agar and identified by examination of colony characteristics, gram staining, oxidase, catalase, coagulase (slide and tube method) and Deoxyribonuclease test. Antibiotic susceptibility test was performed using the modified Kirby-Bauer disk diffusion method as recommended by Clinical and Laboratory Standards Institute guidelines. MRSA was detected phenotypically using Cefoxitin disk test. In-vitro biofilm producing capacity of isolated S. aureus was evaluated by tissue culture plate method.Results: A total of 34(14.7%) S. aureus was isolated amongst which 12(35.3%) were MRSA. Overall rate of nasal carriage MRSA was found to be 5.2% (12/232). Among 34 isolated S. aureus, 10(29.4%) were strong, 7(20.6%) were moderate, 8(23.5%) were weak biofilm producers whereas 9(26.5%) were biofilm non-producers.Among 12 MRSA, 10(83.3%) were biofilm producers of which 4(33.3%) were strong, 2(16.7%) were moderate, 4(33.3%) were weak and 2(16.7%) were biofilm-non producers whereas among 22 methicillin susceptible strains, 15(68.1%) were biofilm producers of which 6(27.3%) were strong, 5(22.7%) were moderate, 4(18.2%) were weak and 7(31.8%) were biofilm nonproducers.Incidence of methicillin resistance was higher among biofilm producers i.e. 10/25(40%) with respect to biofilm nonproducers i.e. 2/9(22.2%). All isolated strains were found susceptible to Vancomycin, Tetracycline and Teicoplanin.Conclusion::Our study suggests that the rate of nasal carriage ebiofilm producing MRSA is very high among HCWs with decreased susceptibility to antimicrobials.Hence, proper identification and treatment of carrier HCWs can help to minimize medical device associated as well as other HCW associated infections.
Lassa fever (LF) remains endemic in Nigeria with the country reporting the highest incidence and mortality globally. Recent national data suggests increasing incidence and expanding geographic spread. Predictors of LF case positivity in Nigeria have been sparsely studied. We thus sought to determine the sociodemographic and clinical determinants of LF positivity amongst suspected cases presenting to health facilities from 2018 to 2021. A secondary analysis of the national LF surveillance data between January 2018 and December 2021. Socio-demographic and clinical data of 20,027 suspected LF cases were analysed using frequencies and Chi-square statistics with significant p-value set at p < 0.05. The outcome variable was LF case status (positive or negative). Predictors of LF case positivity were assessed using multiple logistic regression models with 95% confidence intervals (CI). Case positivity rate (CPR) for the four years was 15.8% with higher odds of positivity among age group 40–49 years (aOR = 1.40; 95% CI 1.21–1.62), males (aOR = 1.11; 95% CI 1.03–1.20), those with formal education (aOR = 1.33; 95% CI 1.13–1.56), artisans (aOR = 1.70; 95% CI 1.28–2.27), religious leaders (aOR = 1.62; 95% CI 1.04–2.52), farmers (aOR = 1.48; 95% CI 1.21–1.81), and symptomatic individuals (aOR = 2.36; 95% CI 2.09–2.68). Being a health worker (aOR = 0.69; 95% CI 0.53–0.91), a teacher (aOR = 0.69; 95% CI 0.53–0.89) and cases reporting in the 3rd quarter (aOR = 0.79; 95% CI 0.69–0.92) had lower odds. In a sex-disaggregated analysis, female farmers had higher odds of positivity (aOR = 2.43; 95% CI 1.76–3.38; p < 0.001) than male farmers (aOR = 1.52; 95% CI 1.19–1.96; p < 0.01). Fever (aOR = 2.39; 95% CI 2.00–2.84) and gastrointestinal (GI) symptoms (aOR = 2.15; 95% CI 1.94–2.37) had the highest odds among symptoms. Combination of fever and GI symptoms (aOR = 2.15; 95% CI 1.50–3.10), fever and neurological symptoms (aOR = 6.37; 95% CI 1.49–27.16), fever and musculo-skeletal symptoms (aOR = 2.95; 95% CI 1.37–6.33), fever and cardiopulmonary symptoms (aOR = 1.81; 95% CI 1.24–2.64), and cardiopulmonary and general symptoms (aOR = 1.50; 95% CI 1.19–1.89) were also predictive. Cumulative LF CPR appears high with clearly identified predictors. Targeted interventions with heightened index of suspicion for sociodemographic categories predictive of LF in suspected cases are recommended. Ethnographic and further epidemiological studies could aid better understanding of these associations.
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