The Forms, Challenges and Strength of the Monkeypox Surveillance System in Nigeria

Abstract

Monkeypox is now a disease of global public health concern, making it cut across boundaries into different countries, continents and spread worldwide. However, it originated in the Democratic Republic of Congo as a human pathogen in 1970, with the first case reported in Nigeria in 1971. The World Health Organization recently declared Nigeria the country with the highest burden of monkeypox-confirmed cases and deaths in Africa for the current outbreak. This study aimed to identify forms, challenges, strengths, and ways to further strengthen the surveillance system of monkeypox in Nigeria. We conducted a rapid narrative review of articles published in English on monkeypox between January 2018 and October 2022. Google Scholar and PubMed were searched with the following terms: "Monkeypox", "Surveillance system", "Strengthening", "Challenges" "Nigeria" and relevant publications were reviewed. The forms of surveillance systems in Nigeria include Indicator-based and Event-based surveillance, contact tracing, laboratory-based surveillance, sero-surveillance, and mortality surveillance. Shortage of highly skilled staff in public health interventions, insufficient testing capacities, power instability, poor healthcare systems and stigmatization from communities with misinformation, and co-epidemic surveillance burden in Nigeria are some of the challenges contributing to weak surveillance in the country. The Nigerian governments must focus on investing in surveillance systems and bolster preparedness to stem the rapid spread of infectious diseases. Strengthening the surveillance system in the country as a response intervention for monkeypox is no longer a matter of option in Nigeria but of necessity to prevent the forecasted effect the incidence portends.

Rise of Marburg virus in Africa: a call for global preparedness

“…Environmental factors including population density and mobility, healthcare infrastructure, outbreak preparedness and response capabilities, disease surveillance, public health measures, and cultural practices and burial rituals are some of the reasons for differences in cases and deaths of MVD among African countries 13 , 14 . African healthcare systems should be prepared and ready to efficiently tackle MVD cases in already affected and yet affected countries by investing in their healthcare system, and implementing early and coordinated measures 40 . Active disease surveillance should be massively expanded through investments in health systems to identify cases, track contacts and communities at risk, and reduce the risks of transmission to others, while appropriate infection prevention and control measures are taken to safeguard them and their contacts 16 , 25 , by establishing isolation centers, mobile laboratories, and a trained rapid response team 41 .…”

“…To avoid misconceptions and stigmatization that could impede contact tracing, cross-border public health education campaigns on MARV should also be carried out urgently and on a large-scale in all Africa 16 . To prepare for the possibility of both multinational and global outbreak of MARV, it is crucial to improve the training of frontline healthcare workers in the areas of timely and accurate diagnosis, effective care and management of patients with MARV 40 . Mental health and psychosocial support by professional counselors should also be offered to survivors of MVD 41 .…”

“…Establishing epidemiology, community involvement, and comprehensive surveillance initiatives, particularly in the impacted region of the continent, is of utmost importance 40 . Regulations on appropriate measures to prevent MVD such as avoiding contact with reservoir animals, ensuring thorough cooking of animal products, maintaining good hand hygiene, WHO developed guidelines for safe management and burial practices as well as options for cremation should be established in all African countries with protocols for strict adherence 17 .…”

Synergistic fight against future pandemics: Lessons from previous pandemics

“…The notion has become more significant as a result of things like population growth, climate change, patterns of land use, and an increase in international travel and trade. One Health tackles zoonotic diseases that can transfer from animals to people and recognizes that animals can act as early indicators of possible human illnesses [68]. [70,71].…”