Prevention of Lassa fever in Nigeria

Inegbenebor, Ute; Okosun, John; Inegbenebor, Josephine

doi:10.1016/j.trstmh.2009.07.008

Cited by 26 publications

(27 citation statements)

References 4 publications

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“…Cases/outbreaks of LF have been reported in different parts of Nigeria , but the peculiarity of this case is that the patient was referred from a city where LF had previously occurred and Ebola recently reported. This put the healthcare team at a crossroads.…”

Section: Discussionmentioning

confidence: 98%

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Lessons learnt from the management of a case of Lassa fever and follow‐up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa

Iroezindu

Unigwe

Okwara

et al. 2015

Tropical Med Int Health

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Abstractobjective To describe our experiences in the management of a case of Lassa fever (LF) and followup of nosocomial primary contacts during the 2014 Ebola outbreak in West Africa.methods Clinical management of the index case and infection control/surveillance activities for primary contacts are described. Laboratory confirmation was by Lassa virus-specific reversetranscriptase PCR.results A 28-year-old man with a 10-day history of febrile illness was referred to a major tertiary hospital in south-east Nigeria from a city that previously experienced a LF outbreak and was recently affected by Ebola. On observation of haemorrhagic features, clinicians were at a crossroads. Diagnosis of LF was confirmed at a National Reference Centre. The patient died despite initiation of ribavirin therapy. Response activities identified 121 primary contacts comprising 78 (64.5%) hospital staff/interns, 19 (15.7%) medical students, 18 (14.9%) inpatients and 6 (5.0%) relatives. Their mean age was 32.8 AE 6.6 years, and 65.3% were women. Twenty (16.5%) had high-risk exposure and were offered ribavirin as post-exposure prophylaxis. No secondary case of LF occurred. Fatigue (43.8%) and dizziness (31.3%) were the commonest side effects of ribavirin.conclusions Response activities contained nosocomial spread of LF, but challenges were experienced including lack of a purpose-built isolation facility, absence of local Lassa virus laboratory capacity, failure to use appropriate protective equipment and stigmatisation of contacts. A key lesson is that the weak health systems of Africa should be comprehensively strengthened; otherwise, we might win the Ebola battle but lose the one against less virulent infections for which effective treatment exists.

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Section: Discussionmentioning

confidence: 98%

“…The seroprevalence of LF in Nigeria is about 21% . Since 1969, several outbreaks have been reported in various states in Nigeria including Plateau, Nasarawa, Taraba, Yobe, Ondo, Edo, Rivers, Imo, Anambra and Ebonyi .…”

Section: Introductionmentioning

confidence: 99%

Lessons learnt from the management of a case of Lassa fever and follow‐up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa

Iroezindu

Unigwe

Okwara

et al. 2015

Tropical Med Int Health

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“…The threat of LF as an epidemicprone disease in Nigeria is indicated by an alert threshold of a International Journal of Infectious Diseases 17 (2013) e1011-e1016 single suspected case and an epidemic threshold of a single confirmed case, by the Nigeria Federal Ministry of Health. 9 Since the identification of the virus in 1969, some outbreaks of the disease have been reported in various parts of Nigeria including Ekpoma, Aboh-Mbaise, Onitsha, Jos, and Lafia, 7,10,11 and more recently in Ebonyi, Taraba, Nasarawa, Yobe, Rivers, Ondo, and Edo states. [12][13][14] Despite the epidemic nature of LF in Nigeria and other African countries, the details of outbreaks and subsequent responses to contain it have not been well documented in these places, and it is difficult to learn from these experiences to improve the management of future outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January–March 2012)

Ajayi

Nwigwe

Azuogu

et al. 2013

International Journal of Infectious Diseases

120

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“…The annual morbidity/mortality rate is high, about 0.1 million cases and 5000 deaths in West Africa6 and 0.25 to 1 million morbidity with 10,000 mortalities across the globe 7. The case mortalities in some parts of Nigeria is as high as 28% 8…”

Section: Introductionmentioning

confidence: 99%

The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection

et al. 2012

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Background:Early diagnosis, prompt treatment, and disease containment are vital measures in the management of Lassa fever (LF), a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, the gold standard for diagnosis, is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF.Patients and Methods:A prospective case–control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM.Results:Of the 37 confirmed cases of LF infection by RT-PCR, 21 (57%) were IgM positive. Amongst the 35 confirmed negative cases (control group), eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57% and 77% respectively. The negative and positive predictive values of the IgM serological assay were 63% and 72%, respectively, while the efficiency of the test was 67%.Conclusion:The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and, hence, the need for a reliable LF “rapid screening kit” since RT-PCR is unavailable in most centers. In the interim, “high clinical index of suspicion,” irrespective of IgM status, requires urgent referral to confirmatory centers.

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Prevention of Lassa fever in Nigeria

Cited by 26 publications

References 4 publications

Lessons learnt from the management of a case of Lassa fever and follow‐up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa

Lessons learnt from the management of a case of Lassa fever and follow‐up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa

Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January–March 2012)

The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection

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