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

Autor:	Akpede GO; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria.; Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Asogun DA; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria.; Department of Community Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Okogbenin SA; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria.; Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Dawodu SO; Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Momoh MO; Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Dongo AE; Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Ike C; Department of Community Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Tobin E; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Akpede N; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Ogbaini-Emovon E; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Adewale AE; Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Ochei O; Department of Community Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Onyeke F; Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Okonofua MO; Department of Nursing Services, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Atafo RO; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria.; Department of Nursing Services, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Odia I; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Adomeh DI; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Odigie G; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Ogbeifun C; Department of Medical Records, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Muebonam E; Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria., Ihekweazu C; Nigeria Centre for Disease Control, Abuja, Nigeria., Ramharter M; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Colubri A; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, United States., Sarbeti PC; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, United States., Happi CT; Department of Biological Sciences and African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria., Günther S; Department of Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany., Agbonlahor DE; Department of Microbiology, Ambrose Alli University, Ekpoma, Nigeria.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2019 Jun 25; Vol. 7, pp. 170. Date of Electronic Publication: 2019 Jun 25 (Print Publication: 2019).
DOI:	10.3389/fpubh.2019.00170
Abstrakt:	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.
Databáze:	MEDLINE
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