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外文期刊>Frontiers in Public Health
>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
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 morbidity and mortality among hospitalized patients from 2001-2018 in the bid to address this gap. Methods: Observational study of LF morbidity and mortality from 2001-2018 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 means and frequencies were compared using ANOVA, and Χ2 and t-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 (1298/185707, 0.7%; OR [95% CI] = 5.92 [5.25, 6.66], p 0.001). The average CF among patients with confirmed LF declined from 154/355 (43%) in 2001 – 2009 to 183/867 (21.1%) (OR [95% CI] = 2.86 [2.20, 3.74], p 0.001) in 2011 – 2018, following the establishment of a dedicated treatment unit in 2010.The annual CF declined from 94% in 2001 to 15% in 2018 whereas the case load increased from 0.26% to 3.37%. The outbreaks were characterized by irregular cycles of high case load 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 control measures and the search for sustainable solutions are required.
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