Caseload and Case Fatality of Lassa Fever in Nigeria, 2001–2018: A Specialist Center's Experience and Its Implications

Abstract

Background Lassa fever (LF) is a zoonotic acute viral illness mainly found in West Africa. The disease is endemic in some parts of West Africa including Sierra Leone, Liberia, Guinea and Nigeria; while other neighboring countries at high risk of its outbreak since the animal vectors are distributed throughout the region. Methods This is a retrospective mixed cohort study that analysed the treatment history containing the sociodemographic and clinical characteristics of 52 laboratory-confirmed LF cases that were admitted to the Kenema Government Hospital Lassa Fever Ward (KGHLFW) during 2016 to 2018; i.e. during the post Ebola outbreak in Sierra Leone. The LF patients whose treatment history we analysed came from either within or outside Kenema district were the KGHLFW is located. Results Majority (59.6%, n = 31/52) of the LF cases recorded during the period under review were adults; females (65.4%, n = 34/52). 2016 recorded more (40.4%, n = 21/52) LF cases; 2017 (28.8%, n = 15/52) and 2018(30.8%, n = 16/52). Conclusions We highlighted the significance of LF preventive and control measures that can target its seasonal epidemics. These measures could include strategies that can reduce human contact with the rodent vector as well as raise sensitization and awareness about LF among local residents especially those residing along the LF belt in eastern Sierra Leone.

Antibodies from Sierra Leonean and Nigerian Lassa fever survivors cross-react with recombinant proteins representing Lassa viruses of divergent lineages

“…Cases are reported year round in Nigeria, Sierra Leone, Liberia, Guinea and other West African countries, with peak incidence in the dry season. Case-fatality rates (CFRs) among hospitalized Lassa fever patients vary from approximately 25% in Nigeria 1,2 to greater than 60% in Sierra Leone 3 . Subclinical infections appear to be common 4,5 .…”

Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis

“…However, there were no significant differences between the clinical presentations and outcomes of the two groups of children (Table 1). The diagnosis of LF was confirmed using reverse transcriptase polymerase chain reaction (RT-PCR) test as described previously (Asogun et al, 2012;Akpede et al, 2019). The clinical case management has also been described previously (Akhuemokhan et al, 2017;Akpede et al, 2018), and included supportive care and intravenous ribavirin.…”

“…We assessed the children on presentation for the presence of clinical risk factors associated with mortality including abnormal bleeding, encephalopathy, and septic shock (Asogun et al, 2012;Okokhere et al, 2018;Akpede et al, 2019;Okogbenin et al, 2019). In addition, we also determined the levels of serum transaminases (serum glutamate oxalate transaminase, SGOT or aspartate transaminase, AST and serum glutamate pyruvate transaminase, SGPT or alanine transaminase, ALT).…”

“…If true, its early diagnosis and treatment could improve the survival of pediatric patients with LF. We thus examined the prevalence, diagnosis and impact on outcome among pediatric patients hospitalized at the Institute of Lassa Fever Research and Control, Irrua J o u r n a l P r e -p r o o f Specialist Teaching Hospital (ISTH), which is a reasonably well-resourced center for the diagnosis and treatment of LF in Nigeria (Asogun et al, 2012;Akpede et al 2019). We also assessed the interaction between AKI and other clinical and laboratory indices of illness severity in LF (McCormick et al, 1986;Akpede et al, 2019), as well as correlation of the results of dipstick urinalysis (DUA) with AKI prevalence.…”

“…We thus examined the prevalence, diagnosis and impact on outcome among pediatric patients hospitalized at the Institute of Lassa Fever Research and Control, Irrua J o u r n a l P r e -p r o o f Specialist Teaching Hospital (ISTH), which is a reasonably well-resourced center for the diagnosis and treatment of LF in Nigeria (Asogun et al, 2012;Akpede et al 2019). We also assessed the interaction between AKI and other clinical and laboratory indices of illness severity in LF (McCormick et al, 1986;Akpede et al, 2019), as well as correlation of the results of dipstick urinalysis (DUA) with AKI prevalence. The presence of abnormal results on DUA has a strong correlation with the concentration of urinary biomarkers of AKI (Nardkarni et al, 2017;Raimann et al, 2018) and the risk of AKI (Hoffman et al, 2013).…”