Weekly Epidemiological Report

October Week 40

Editoral

Towards Nigeria’s Mid-Term Joint External Evaluation

In 2017, the Nigeria Centre for Disease Control in collaboration with various Ministries, Departments and Agencies (MDAs), as well as relevant development partners carried out a Joint External Evaluation (JEE) of Nigeria’s International Health Regulations (IHR 2005) capacities.

The 2017 JEE highlighted critical gaps in Nigeria’s health security system. Out of that, a National Action Plan for Health Security (NAPHS) was developed and launched in 2018. Since the 2017 JEE, NCDC as the IHR National Focal Point, as well as other MDAs have invested resources in closing the gaps identified. Towards this, Nigeria intends to hold a mid-term JEE to answer the critical question on “What progress has been made across the 19 IHR technical areas in Nigeria since 2017?” The mid-term JEE will be carried out from November 18 - 22 2019, supported by the World Health Organization.

Since the first JEE in Nigeria in 2017, changes have been made including the introduction of a JEE 2.0 tool. To ensure technical leads are better prepared for the process, the US Centers for Disease Control (US-CDC) and World Health Oragnisation (WHO) supported NCDC to train officers on the new JEE 2.0 tool. In attendance were representatives from the Federal Ministry of Health, Ministry of Agriculture and Rural Development, Ministry of Finance, Office of the National Security Adviser etc. The workshop provided a unique opportunity to introduce the new tool as well as brainstorm on strategies to ensure a successful mid-term JEE.

A major outcome from the workshop was that the cross-sectoral technical leads have improved understanding and capacity to provide support in the following desired mid-term JEE outputs:

1. Objectively revise the JEE scores using the new tool

2. Document a narrative describing major accomplishments and challenges since the JEE was conducted

3. Develop a one-year operational plan, using JEE scores to identify the Benchmark Actions (approximately three Benchmark Actions per technical area)

4. Map partner areas of support to selected benchmarks, with identification of gap areas that should be prioritised for resource mobilization

As the national focal point for IHR implementation in Nigeria, NCDC remains committed to fulfilling its obligations in ensuring national health security. This is in collaboration with other MDAs in Nigeria and partners. It is hoped that the forth-coming mid-term JEE review will provide another opportunity for diverse stakeholders to come together to review progress made and ultimately develop a one-year operational plan for a seamless implementation of NAPHS.


Summary of Incidents

Ongoing Incidents are defined as confirmed cases where a national EOC or equivalent has been activated.

Other incidents are those confirmed cases for which EOC is not activated.

Notes

1. Information for this disease was retrieved from the Technical Working Group and Situation Reports

2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only

3. Information for this disease was retrieved from IDSR 002 data

4. CFR for this disease is reported for total cases i.e. suspected + confirmed

5. Information for sentinel influenza was retrieved from the laboratory.


Lassa Fever

Key points

• There were 88 suspected cases of Lassa Fever (LF) reported from 15 LGAs in 10 states (Edo – 54, Ondo – 22, Ebonyi – 2, Bauchi – 3, Plateau – 2, Benue – 1, Enugu – 1, Oyo – 1, Delta – 1, Lagos – 1). There were seven confirmed cases and one death was recorded

Actions

To date:

• National Lassa Fever multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate the response activities at all levels

• Lassa Fever treatment centres assessment visits to Bauchi, Taraba and Plateau states

• Implementation of targeted risk communication and enhanced surveillance activities in affected states

Planned:

• Support indigent patients with treatment cost via basic health care provision funds

• Conduct a meeting to finalise the LF psychosocial guideline in October 2019

• Review LF case management and surveillance tools, and SOPs in October 2019


Cerebrospinal Meningitis (CSM)

Key points

There were 15 suspected cases of Cerebrospinal Meningitis (CSM) reported from eight LGAs in six states (Kano – 1, Katsina – 8, Kebbi – 1, Oyo – 3, Sokoto – 1, & Yobe – 1). None was laboratory confirmed and no death was recorded

Actions

To date:

• The national CSM TWG meets weekly to review reports from states and plan appropriately

Planned:

• Continue harmonisation of the national line list and SORMAS data

• Establish a mechanism for getting weekly feedback from states.


Yellow Fever

Key points

There were 126 suspected cases of Yellow Fever (YF) reported from 75 LGAs in 19 states. None was laboratory confirmed and one death was recorded

Actions

To date:

• The multiagency Yellow Fever (YF) Incident Management System (IMS) has been de-activated to YF Technical Working Group to continue with the coordination of the response activities

• Following up with the new states with confirmed cases (Taraba and Plateau states)

• Operationalisation of the three new laboratories added to the YF laboratory network

Planned:

• Continue on-site and off-site support to affected states

• Conduct preventive mass vaccination campaign at Rivers, Ekiti & Anambra states in the fourth week of November 2019

• Notify all North- Eastern states to officially begin to send samples to National Reference Laboratory Gaduwa, Abuja.


Cholera

Key points

There were 24 suspected cases of Cholera reported from two LGAs in two states (Adamawa – 1 & Borno – 23). None was laboratory confirmed and no death was recorded

Actions

To date:

• Cholera multisectoral preparedness meeting held with partners in Borno state

• National cholera TWG continues to coordinate activities in states in collaboration with Federal Ministry of Water Resources (FMWR) and support from partners

• Adamawa state EOC continues to coordinate response activities with support from partners

Planned:

• Follow up with states with active outbreak and monitor non-reporting states.


Measles

Key points

• There were 270 suspected cases of measles reported from 121 LGAs in 29 states and FCT

• None was laboratory confirmed and no death was recorded

Actions

To date

• Measles TWG closely monitoring surveillance data and response activities across the country

• The TWG is working closely with NPHCDA towards measles Supplemental Immunization Activity in Nigeria

• Following up with states still reporting more than 50 cases of measles

• Conducted measles surveillance guideline consolidation meeting from 15th – 17th October 2019

Planned:

• Continue the review of measles surveillance data across the country

• Follow up with Katsina state on the next line of action


Monkeypox

Key points

• There were two suspected cases of monkeypox reported from two LGAs in one state (Oyo) and the FCT

• None was laboratory confirmed and no death was recorded

Actions

To date:

• Rapid Response Team deployed to Akwa Ibom state to support surveillance activities

• Surveillance has been enhanced in all affected states

Planned

• Follow up with affected states on completing missing information in the Case Information Form

• Follow up to ensure all contacts are line listed and monitored for 21 days.


Acute Flaccid Paralysis (AFP)

Key points

• There were 110 suspected cases of AFP reported from 91 LGAs in 29 states and FCT. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

There were 53 processed samples positive for influenza, with 49 for influenza A, 3 for influenza B and 1 for influenza A & B


Timeliness and Completeness of Reports


Timeliness and Completeness of Reports by State

Highlight of the week

  • Summary of Incidents
  • Lassa Fever
  • Cerebrospinal Meningitis (CSM)
  • Yellow Fever
  • Cholera
  • Measles
  • Monkeypox
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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