Caseload and Case Fatality of Lassa Fever in Nigeria, 2001-2018:A Specialist Center's Experience and Its Implications
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Caseload and Case Fatality of Lassa Fever in Nigeria, 2001-2018:A Specialist Center's Experience and Its Implications. / Akpede, George O; Asogun, Danny A; Okogbenin, Sylvanus A; Dawodu, Simeon O; Momoh, Mojeed O; Dongo, Andrew E; Ike, Chiedozie; Tobin, Ekaete; Akpede, Nosa; Ogbaini-Emovon, Ephraim; Adewale, Adetunji E; Ochei, Oboratare; Onyeke, Frank; Okonofua, Martha O; Atafo, Rebecca O; Odia, Ikponmwosa; Adomeh, Donatus I; Odigie, George; Ogbeifun, Caroline; Muebonam, Ekene; Ihekweazu, Chikwe; Ramharter, Michael; Colubri, Andres; Sarbeti, Pardis C; Happi, Christian T; Günther, Stephan; Agbonlahor, Dennis E.
In: FRONT PUBLIC HEALTH, Vol. 7, 2019, p. 170.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Caseload and Case Fatality of Lassa Fever in Nigeria, 2001-2018:A Specialist Center's Experience and Its Implications
AU - Akpede, George O
AU - Asogun, Danny A
AU - Okogbenin, Sylvanus A
AU - Dawodu, Simeon O
AU - Momoh, Mojeed O
AU - Dongo, Andrew E
AU - Ike, Chiedozie
AU - Tobin, Ekaete
AU - Akpede, Nosa
AU - Ogbaini-Emovon, Ephraim
AU - Adewale, Adetunji E
AU - Ochei, Oboratare
AU - Onyeke, Frank
AU - Okonofua, Martha O
AU - Atafo, Rebecca O
AU - Odia, Ikponmwosa
AU - Adomeh, Donatus I
AU - Odigie, George
AU - Ogbeifun, Caroline
AU - Muebonam, Ekene
AU - Ihekweazu, Chikwe
AU - Ramharter, Michael
AU - Colubri, Andres
AU - Sarbeti, Pardis C
AU - Happi, Christian T
AU - Günther, Stephan
AU - Agbonlahor, Dennis E
PY - 2019
Y1 - 2019
N2 - Background: The general lack of comprehensive data on the trends of Lassa fever (LF) outbreaks contrasts with its widespread occurrence in West Africa and is an important constraint in the design of effective control measures. We reviewed the contribution of LF to admissions and mortality among hospitalized patients from 2001 to 2018 in the bid to address this gap. Methods: Observational study of LF caseload and mortality from 2001 to 18 in terms of the contribution of confirmed LF to admissions and deaths, and case fatality (CF) among patients with confirmed LF at a specialist center in Nigeria. The diagnosis of LF was confirmed using reverse transcription polymerase chain reaction (RT-PCR) test, and medians and frequencies were compared using Kruskal-Wallis, Mann-Whitney and χ2 tests, with p-values <0.05 taken as significant. Results: The contribution of confirmed LF to deaths (362/9057, 4.0%) was significantly higher than to admissions (1,298/185,707, 0.7%; OR [95% CI] = 5.9 [5.3, 6.7], p < 0.001). The average CF among patients with confirmed LF declined from 154/355 (43%) in 2001-09 to 183/867 (21.1%) (OR [95% CI] = 2.9 [2.2, 3.7], p < 0.001) in 2011-18. The annual CF declined from 94% in 2001 to 15% in 2018 whereas the caseload increased from 0.3 to 3.4%. The outbreaks were characterized by irregular cycles of high caseload in 2005-2007, 2012-2014, and 2016-2018, and progressive blurring of the seasonality. Conclusion: LF outbreaks in Nigeria have upgraded spatially and temporally, with the potential for cycles of increasing severity. The strategic establishment of LF surveillance and clinical case management centers could be a pragmatic and cost-effective approach to mitigating the outbreaks, particularly in reducing the associated CF. Urgent efforts are needed in reinvigorating extant control measures while the search for sustainable solutions continues.
AB - Background: The general lack of comprehensive data on the trends of Lassa fever (LF) outbreaks contrasts with its widespread occurrence in West Africa and is an important constraint in the design of effective control measures. We reviewed the contribution of LF to admissions and mortality among hospitalized patients from 2001 to 2018 in the bid to address this gap. Methods: Observational study of LF caseload and mortality from 2001 to 18 in terms of the contribution of confirmed LF to admissions and deaths, and case fatality (CF) among patients with confirmed LF at a specialist center in Nigeria. The diagnosis of LF was confirmed using reverse transcription polymerase chain reaction (RT-PCR) test, and medians and frequencies were compared using Kruskal-Wallis, Mann-Whitney and χ2 tests, with p-values <0.05 taken as significant. Results: The contribution of confirmed LF to deaths (362/9057, 4.0%) was significantly higher than to admissions (1,298/185,707, 0.7%; OR [95% CI] = 5.9 [5.3, 6.7], p < 0.001). The average CF among patients with confirmed LF declined from 154/355 (43%) in 2001-09 to 183/867 (21.1%) (OR [95% CI] = 2.9 [2.2, 3.7], p < 0.001) in 2011-18. The annual CF declined from 94% in 2001 to 15% in 2018 whereas the caseload increased from 0.3 to 3.4%. The outbreaks were characterized by irregular cycles of high caseload in 2005-2007, 2012-2014, and 2016-2018, and progressive blurring of the seasonality. Conclusion: LF outbreaks in Nigeria have upgraded spatially and temporally, with the potential for cycles of increasing severity. The strategic establishment of LF surveillance and clinical case management centers could be a pragmatic and cost-effective approach to mitigating the outbreaks, particularly in reducing the associated CF. Urgent efforts are needed in reinvigorating extant control measures while the search for sustainable solutions continues.
U2 - 10.3389/fpubh.2019.00170
DO - 10.3389/fpubh.2019.00170
M3 - SCORING: Journal article
C2 - 31294014
VL - 7
SP - 170
JO - FRONT PUBLIC HEALTH
JF - FRONT PUBLIC HEALTH
SN - 2296-2565
ER -