Improving Cross-Border Preparedness and Response: Lessons Learned from 3 Lassa Fever Outbreaks Across Benin, Nigeria, and Togo, 2017-2019

Kakaï, Clément Glèlè; Okunromade, Oyeladun; Dan-Nwafor, Chioma; Chabi, Ali Imorou Bah; Martial, Godjedo Togbemabou Primous; Dalhat, Mahmood; Ward, Sarah; Tante, Ouyi; Nguku, Patrick; Assane, Hamadi; Ilori, Elsie; Lokossou, Virgil; Brito, Carlos; Ojo, Olubunmi; Kone, Idrissa; Agbeko, Tamekloe Tsidi; Ihekweazu, Chikwe; Merrill, Rebecca D.

doi:10.1089/hs.2019.0080

Cited by 17 publications

(9 citation statements)

References 8 publications

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“…Remarkably, they received the highest score (first rank) for indicators of source of infection (Mali), route of transmission (Togo), and targeted population (Sierra Leone). These findings are consistent with (i) the OH project recently established in collaboration with the Swiss Tropical and Public Health Institute to tackle sources of zoonotic infections, e.g., as rabies, in Mali [20]; (ii) improvement in cross-border preparedness and response to zoonotic diseases in Togo [36]; and (iii) the establishment of national multisectoral coordination and collaboration mechanisms to prevent, detect, and respond to public health threats in Sierra Leone [37], especially after the bitter experience of the Ebola outbreak response, which served as an important catalyst for increased efforts to build the country's capacity for health security and emergence preparedness. Furthermore, Benin ranked first in three subindicators and a number of height subindicators obtained above average scores, reflecting the country's better performance in indicators of route of transmission and in zoonotic case studies than that of South Africa.…”

Section: Discussionsupporting

confidence: 88%

Assessment of performance for a key indicator of One Health: evidence based on One Health index for zoonoses in Sub-Saharan Africa

et al. 2022

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Background Zoonoses are public health threats that cause severe damage worldwide. Zoonoses constitute a key indicator of One Health (OH) and the OH approach is being applied for zoonosis control programmes of zoonotic diseases. In a very recent study, we developed an evaluation system for OH performance through the global OH index (GOHI). This study applied the GOHI to evaluate OH performance for zoonoses in sub-Saharan Africa. Methods The framework for the OH index on zoonoses (OHIZ) was constructed including five indicators, 15 subindicators and 28 datasets. Publicly available data were referenced to generate the OHIZ database which included both qualitative and quantitative indicators for all sub-Sahara African countries (n = 48). The GOHI algorithm was used to estimate scores for OHIZ. Indicator weights were calculated by adopting the fuzzy analytical hierarchy process. Results Overall, five indicators associated with weights were generated as follows: source of infection (23.70%), route of transmission (25.31%), targeted population (19.09%), capacity building (16.77%), and outcomes/case studies (15.13%). Following the indicators, a total of 37 sub-Sahara African countries aligned with OHIZ validation, while 11 territories were excluded for unfit or missing data. The OHIZ average score of sub-Saharan Africa was estimated at 53.67/100. The highest score was 71.99 from South Africa, while the lowest score was 40.51 from Benin. It is also worth mentioning that Sub-Sahara African countries had high performance in many subindicators associated with zoonoses, e.g., surveillance and response, vector and reservoir interventions, and natural protected areas, which suggests that this region had a certain capacity in control and prevention or responses to zoonotic events. Conclusions This study reveals that it is possible to perform OH evaluation for zoonoses in sub-Saharan Africa by OHIZ. Findings from this study provide preliminary research information in advancing knowledge of the evidenced risks to strengthen strategies for effective control of zoonoses and to support the prevention of zoonotic events.

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Section: Discussionsupporting

confidence: 88%

Assessment of performance for a key indicator of One Health: evidence based on One Health index for zoonoses in Sub-Saharan Africa

et al. 2022

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“…Lassa fever is endemic in the Mastomys populations of Nigeria, Sierra Leone, Guinea and Liberia. Infected rodents or sporadic human cases have been reported in other West African countries, including Mali, Togo and Benin 10 , 11 . The endemic range of LASV appears to be increasing 12 .…”

Section: Introductionmentioning

confidence: 99%

Lassa fever — the road ahead

Garry

2022

Nat Rev Microbiol

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Lassa virus (LASV) is endemic in the rodent populations of Sierra Leone, Nigeria and other countries in West Africa. Spillover to humans occurs frequently and results in Lassa fever, a viral haemorrhagic fever (VHF) associated with a high case fatality rate. Despite advances, fundamental gaps in knowledge of the immunology, epidemiology, ecology and pathogenesis of Lassa fever persist. More frequent outbreaks, the potential for further geographic expansion of Mastomys natalensis and other rodent reservoirs, the ease of procurement and possible use and weaponization of LASV, the frequent importation of LASV to North America and Europe, and the emergence of novel LASV strains in densely populated West Africa have driven new initiatives to develop countermeasures for LASV. Although promising candidates are being evaluated, as yet there are no approved vaccines or therapeutics for human use. This Review discusses the virology of LASV, the clinical course of Lassa fever and the progress towards developing medical countermeasures.

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“…Disease surveillance systems and comprehensive outbreak response is needed as a public health procedure in cross-border migration. 12 According to a probabilistic model on exported cases by Tuite et al , 7 a low probability of case exportation was quantified using the 2018 LF outbreak; however, countries with close proximity to Nigeria needed to be on the alert for LF importation and ensure prompt epidemic response. 7 Previous cases of LF outbreaks in Nigeria were exported to neighbouring countries and even more distant countries especially via international air travels.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological trends of Lassa fever in Nigeria from 2015-2021: A review

Grace¹,

Egoh

Udensi

2021

Therapeutic Advances in Infection

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Introduction: Lassa fever is a viral haemorrhagic fever with non-specific symptoms that has shown an upward trend in Nigeria and other West African countries, which is depicted by high incidence and case fatality in recent years. There are different reports on the yearly case burden of Lassa fever from the Federal Ministry of Health in Nigeria, through the regulatory body – Nigeria Centre for Disease Control (NCDC). Being the epicentre of the disease, Lassa fever has been exported from Nigeria to both neighbouring and distant countries.Methods: The aim of this review was to carry out a retrospective analysis from January 2015 to 26 September 2021 of the weekly and yearly outbreak of Lassa fever in Nigeria based on selected publications. The focus was on timely diagnosis, treatment option, public health interventions and progress of clinical trials for vaccine candidates, and to identify proactive measures that can be sustained to curb periodic outbreaks. The review was done using percentages, cross-tabulation and graphical charts. Results: The predominant age group infected was 21 to 40 years with a male to female ratio of 1:0.8. A total of 3311 laboratory-confirmed Lassa fever cases out of 20,588 suspected cases were identified from 29 states. Edo, Ondo, Taraba, Ebonyi, Bauchi, Plateau and Nasarawa had yearly Lassa fever incidence over the time frame considered. Contact tracing was done on over 33,804 individuals with about 90% completing follow-up. Case fatality rate within the period ranged from 9.3% to 29.2%. There is a sharp decline in the epidemiological trend of Lassa fever in the yearly seasonal peaks from weeks 1 to 13 with about 75% reduction in incidence between 2020 and 2021. Conclusion: The effective management of Lassa fever needs the implementation of preventive methods, prompt laboratory diagnosis, timely treatment, provision of personal protective equipment, cross-border surveillance, contact tracing, community awareness and vector control in order to minimise spread.

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Improving Cross-Border Preparedness and Response: Lessons Learned from 3 Lassa Fever Outbreaks Across Benin, Nigeria, and Togo, 2017-2019

Cited by 17 publications

References 8 publications

Assessment of performance for a key indicator of One Health: evidence based on One Health index for zoonoses in Sub-Saharan Africa

Assessment of performance for a key indicator of One Health: evidence based on One Health index for zoonoses in Sub-Saharan Africa

Lassa fever — the road ahead

Epidemiological trends of Lassa fever in Nigeria from 2015-2021: A review

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