Weekly Epidemiological Report

October Week 42

Editoral

Training Needs Assessment for State Level Surveillance Officers- Implementation of ITSON

State Epidemiologists and Local Government Disease Surveillance and Notification Officers (DSNOs) play critical roles as the frontline soldiers for epidemic intelligence and emergency response in Nigeria. As part of our mandate, NCDC supports the training and capacity building of this workforce. Over the last few years, surveillance training opportunities have been provided in different states by various partners and NCDC. Following a review of this training approach, NCDC is introducing the Integrated Training of Surveillance officers in Nigeria (ITSON).

The ITSON is a single harmonised package for more robust and effective training of surveillance officers at state and LGA levels in Nigeria. To kickstart ITSON, NCDC is utilising funds from the World Bank Regional Disease Surveillance Enhancement System (REDISSE) project.

An important step towards the development of this package is an ongoing needs assessment through advocacy visits by officers from NCDC supported by counterparts from World Health Organisation (WHO) and African Field Epidemiology Network (AFENET) to the 36 states in Nigeria. The objectives of the assessment are to:

1. Conduct advocacy to the State Ministry of Health before the training and understand the structure and supervisory MDA for surveillance in the State

2. Identify the trainings gaps, training needs and peculiarities of each State

3. Determine the availability and functionality of laptop computers and other surveillance tools required for effective reporting in all the LGAs and States of the federation

4. Advocate for better conditions of service, greater consistency and longevity in post for the DSNOs after the training in order to ensure institutionalization of the investments in training

5. Agree with the state on the basic competencies required for the DSNOs to be nominated for the training

The expected outcomes from the assessment are that the State Ministry of Health is better informed of the project, and provides better ownership to ensure sustainability.

When completed, it is expected that the ITSON package will contribute significantly to bridging knowledge gaps among the state epidemiologists and DSNOs across the country.


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 113 suspected cases of Lassa Fever (LF) reported from 12 LGAs in nine states and FCT (Edo – 72, Ondo – 18, Ebonyi – 5, Bauchi – 11, Nasarawa – 1, Plateau – 1, FCT – 2, Adamawa – 1, Benue – 1 & Ogun – 1). There were 13 confirmed cases and two deaths were recorded

Actions

To date:

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

• A Rapid Response Team (RRT) has been deployed to Benue state

• NCDC, Federal Ministry of Environment (FMoEnv) and WHO conducted Lassa Fever National Environmental Response in Edo and Ondo states

Planned:

• Review LF case management and surveillance tools and SOPs in November 2019

• Implement rodent control measures in hotspot LGAs (Phase 2)


Cerebrospinal Meningitis (CSM)

Key points

There were 43 suspected cases of Cerebrospinal Meningitis (CSM) reported from 18 LGAs in 11 states (Benue – 2, Cross River – 1, Kaduna – 2, Kano – 1, Katsina – 30, Kebbi – 1, Ogun – 2, Oyo – 1, Plateau – 1, Sokoto – 1 & Zamfara – 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

• The CSM risk assessment tool and CSM preparedness & response checklist for 2019/2020 were sent to states to reflect 2018/2019 CSM response

Planned:

• Continue harmonisation of the national line list and SORMAS data


Yellow Fever

Key points

There were 118 suspected cases of Yellow Fever (YF) reported from 64 LGAs in 24 states and FCT. There were five laboratory confirmed cases and no death was recorded

Actions

To date:

• The national Yellow Fever (YF) Technical Working Group continues to coordinate response activities

Planned:

• Continue off-site support to all affected states

• Scale up risk communication activities


Cholera

Key points

• There were 23 suspected cases of cholera reported from five LGAs in three states (Abia – 1, Adamawa – 11 & Borno – 11). There were ten laboratory confirmed cases and no death was recorded

• There has been an increasing number of Acute Watery Diarrhea (AWD) cases reported in Borno state from week 40

Actions

• The national cholera multisectoral Technical Working Group (TWG) is monitoring all states and supporting already affected states

• Lagos state epidemiology team investigating suspected outbreak with deployment of Rapid Response Team to the affected LGAs

• 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

• Follow up and support Lagos state team on reported suspected cases

• Support activities of the World Toilet Day led by the Federal Ministry of Environment


Measles

Key points

• There were 378 suspected cases of measles reported from 137 LGAs in 31 states and FCT. None was laboratory confirmed and no death was recorded

Actions

To date

• The national measles TWG is closely monitoring surveillance data and response activities across the country

• Follow up with Katsina state with regards to high number of reported measles cases by leveraging on the ITSON needs assessment team currently in the state

Planned:

• Continue the review of measles surveillance data across the country

• Follow up with Katsina state surveillance team to obtain measles line list


Monkeypox

Key points

• There were three suspected cases of monkeypox reported from two LGAs in two states (Akwa Ibom – 2 & Bayelsa - 1). There was one laboratory confirmed (Bayelsa) and no death was recorded

• One sample from Akwa Ibom is awaiting pickup from Tranex (sample-transporting company)

Actions

• The national monkeypox TWG is monitoring activities in all states

• Conducted surveillance and case management regional training in South East and South West regions

• Surveillance has been enhanced in all affected states

Planned

• Continue regional monkeypox surveillance training in South East, South West and North Central geopolitical areas in November 2019

• Follow up with the laboratory and Tranex for prompt sample delivery

• Follow up to ensure all contacts of reported cases are line listed and monitored for 21 days

• Capture monkeypox data into SITAWARE for real time reporting


Acute Flaccid Paralysis (AFP)

Key points

• There were 113 suspected cases of AFP reported from 98 LGAs in 32 states and FCT. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

There were 67 processed samples positive for influenza, with 61 for influenza A, 5 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

Connect Centre

  • Toll Free Number: 0800 9700 0010
  • Whatsapp: +234 708 711 0839
  • SMS Number: +234 809 955 5577
  • Call: +234 703 670 8970