Weekly Epidemiological Report

July 2019 Week 28

Editoral

Resource Mapping for Sustainable Implementation of the National Action Plan for Health Security in Nigeria

Posted: 30-07-2019 02:50:50 PM

In 2018, Nigeria developed a National Action Plan for Health Security (NAPHS) with coordination by the Nigeria Centre for Disease Control (NCDC) as the International Health Regulations (IHR) National Focal Point (NFP). Since then, relevant Ministries, Departments and Agencies (MDAs) are currently at different levels of implementation of the 19 technical areas and over 600 activities.

When developed, the estimated cost of the five-year strategy for health security in Nigeria was 135 billion Naira ($439 million USD). To ensure proper planning and increased allocation of resources for Nigeria, the World Health Organization (WHO) supported MDAs involved in health security in Nigeria, to identify and map out resources that will support the implementation of NAPHS. This was done at national level and for the first time in any country, at sub-national level as well.

To validate the data collected, a validation workshop was held from July 23 -23 2019 to review feedback from sub-national and national levels, on resources available. The objectives of the workshop were to:

1. Validate data on available resources for NAPHS at national and sub-national levels

2. Institutionalise the resource mapping process in Nigeria for similar activities

3. Identify current and prospective donors for NAPHS related activities

4. Analyse gaps in resources along different technical areas

5. Strengthen support for improving Nigeria’s IHR Core Capacities

6. Ascertain key NAPHS activities for adequate resource mobilization to support implementation.

The workshop had the 36 state epidemiologists, representatives from the Federal Ministry of Health and other national institutions with critical roles in the NAPHS, WHO, World Bank, United State Centre for Disease Control, Pro Health International, Resolve to Save Lives Initiative and Global Health Advocacy Initiative in attendance. Through interactive sessions and plenary sessions, the workshop provided an opportunity to priortise key activities and identify potential resources based on the four broad IHR core technical areas of “Prevent, Detect, Respond and Other IHR related hazards”.

The next steps from the meeting include, to finalise the validation of data collected on resource mapping and initiate process of tracking NAHPHS activities at the state level, sustain advocacy, resource mapping and mobilisation.

In conclusion, as the focal national coordinating institution for IHR in Nigeria, NCDC will continue to work closely with all relevant stakeholders both at national and state levels to identify and unlock available resources for sustainable 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 100 suspected cases of Lassa Fever reported from 30 LGAs in 10 States plus FCT (Edo - 47, Ondo - 23, Ebonyi - 7, Bauchi – 3, FCT – 1, Kogi – 13, Enugu – 1, Delta – 1, Kebbi – 1, Osun - 2 & Borno - 1). Seven cases were laboratory confirmed and one death recorded.

Actions

To date:

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

• Conducted Psychosocial Support Guideline Development Workshop

Planned:

• Conduct zonal (North and South) AAR meetings

• Support indigent patients with treatment cost through Basic Health Care Provision Funds

• Harmonisation of LF Laboratory and surveillance data into one database .


Cerebrospinal Meningitis (CSM)

Key points

• There were 18 suspected cases of Cerebrospinal Meningitis reported from nine LGAs in six states (Delta – 1, Ebonyi – 2, Kaduna – 1, Katsina – 8, Kogi – 4 & Nasarawa - 2). None was laboratory confirmed and no death recorded.

Actions

To date:

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

Planned:

• Training of Cross River State on case and data management

• Development of final outbreak Report

• Development and submission of a proposal to the Ethical Committee on the use of blood samples to diagnose CSM.


Yellow Fever

Actions

To date:

• The multiagency YF TWG is coordinating national response activities

• On-site support provided by NCDC Rapid Response Teams (RRTs) to Kogi, Katsina, Nasarawa, Abia, Imo and Osun States

• Off-site support currently being provided to Ebonyi State

• Third draft of YF National Guideline on Preparedness and Response completed

Planned:

• Finalise the YF Action Plan for 2019 -2021

• Develop risk communications assessment plan

• Train state surveillance teams on YF surveillance, reporting and documentation

• Operationalisation of the three new laboratories added to the YF Laboratory Network.


Cholera

Key points

There were 114 suspected cases of Cholera reported from six LGAs in three states (Adamawa – 63, Borno - 48 & Kano - 3). None was laboratory confirmed and no death was recorded.

Actions

To date:

• Adamawa state EOC is leading the response to cases in the state

• Rapid Diagnostic Test kits (RDTs) distributed to all LGA DSNOs and health facilities in high risk areas

• Technical Working Group members with a team from John Hopkins universities visited four states to conduct training on the use of cholera RDTs

Planned:

• Follow up with states to ensure continued vigilance and early reporting

• Conduct state level training on sample management and RDT testing for other high priority states

• Conduct community sensitization across all LGAs of Adamawa State.


Measles

Key points

• There were 793 suspected cases reported from 29 States. None was laboratory confirmed and six deaths were recorded

Actions

To date:

• The multi-agency National Measles TWG is monitoring and coordinating response activities across the States

• A Rapid Response Team (RRT) has been deployed to Kaduna state following media and political concern of measles outbreak in Igabi LGA

Planned:

• Continued review of measles surveillance data across the country

• Continued planning for AAR and measles guideline review meeting.


Monkeypox

Key points

• There was one confirmed case of Monkeypox reported from Lagos Island LGA, Lagos State.

Actions

To date:

• Surveillance has been enhanced in all affected states

• Offsite support given to affected states

• Investigation of confirmed cases in Mushin LGA, Lagos State has been concluded

Planned:

• Regional Monkeypox Surveillance Training to be conducted in South-East and South-South Zones in August

• Supportive supervision to non-reporting states in North-Central, South-East, South-West and South-South zones.


Acute Flaccid Paralysis (AFP)

Key points

• In the reporting week, 195 suspected cases of AFP were reported from 112 LGAs in 27 States and FCT

Actions

Planned:

• Complete documentation by the states on polio certification and present to National Committee on Certification for review from 5th – 9th August 2019.


National Influenza Sentinel Surveillance

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

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