Weekly Epidemiological Report

March 2020 Week 12

Editoral

Building Capacity for Case Management of COVID-19 in Nigeria

Posted: 08-04-2020 01:52:46 PM

Globally, with over a million cases of COVID-19 recorded in more than 150 countries, the disease has spread at an exponential rate in less than 3months. As of the 7th of April, 254 confirmed cases have been recorded across 17 states, with 44 discharged and 6 deaths recorded. Currently, Lagos State is the epicentre of the outbreak in Nigeria with the highest number of cases followed by the Federal Capital Territory.

Given the increasing number of cases, countries are being confronted by several challenges particularly limited availability of treatment centres to accommodate and effectively treat confirmed cases of COVID-19. This inadequate access to prompt and effective care in healthcare settings could hinder the ability of countries to halt the spread of the disease.

The Nigeria Centre for Disease Control (NCDC) continues to work closely with all states’ government to ensure adequate infrastructures are put in place for timely detection and management of cases. Beyond establishing infrastructural capacity, the NCDC is also building the capacity of the public health and clinical workforce for the management of COVID-19 cases. National interim guideline for clinical management of COVID-19 developed by the NCDC has been useful resource for the training of different cadres of doctors and nurses across Nigeria. This guideline alongside infection prevention and control (IPC) guidelines are being shared with all identified treatment centres in Nigeria and can be accessed here.

Recently, the NCDC conducted a three-day training from the 31st of March – 2nd of April 2020, on case management and infection prevention and control (IPC) of COVID-19 for health workers at the Department of State Services (DSS) Medical Centre. The training was done in two batches; one for treatment of mild and moderate cases and the other on treatment of severe cases. With a total of 96 health workers trained, they serve as ready–to–go surge capacity to be deployed to support States in their preparedness and response activities.

This is in addition to the case management and IPC training conducted for medical colleagues from the National Primary Health Development Agency (NPHCDA) who are now supporting the NCDC-led national Emergency Operations Centre. We continue to pull all resources available to enhance our capacity to effectively respond to the COVID-19 outbreak in Nigeria, using best practices to provide guidance for all frontline healthcare workers.


Summary of Incidents

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 279 suspected cases, 28 confirmed cases and three deaths recorded from 17 LGAs in 11 states and FCT

• No new healthcare workers were affected in the reporting week 12

Actions

To date:

• National Emergency Operations Centre (EOC) has been activated to coordinate response activities across states.

• Of the states with confirmed cases, eight of them have activated state level EOCs

• The five molecular laboratories for Lassa fever testing in the NCDC network are working fully to ensure that all samples are tested, and results provided within the shortest turn-around time

• Enhanced surveillance (contact tracing and active case finding) in affected states

Planned:

• Continue mobilisation of resources

• Finalise the Lassa fever five-year Strategic plan

• In-depth investigation of healthcare worker infections

• Operationalise LGA sanitation desks by Environmental Health Officers in all states


Cerebrospinal Meningitis (CSM)

Key points

There were 46 suspected cases of Cerebrospinal Meningitis (CSM) reported from 16 LGAs in seven states and FCT (Bayelsa – 15, Ebonyi – 1, FCT – 3, Katsina – 16, Kebbi – 1, Plateau – 3, Sokoto - 1 & Zamfara – 6). None was laboratory confirmed and two deaths were recorded

Actions

To date:

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

• Enhanced surveillance in all states

Planned:

• Continue harmonisation of the national line list and SORMAS data

• Continue to ensure that states reporting cases send their line lists and collect CSM samples


Yellow Fever

Key points

• There were 33 suspected cases of Yellow Fever (YF) reported from 28 LGAs in 12 states. None was laboratory confirmed and no death was recorded

Actions

To date:

• National multiagency YF Technical Working Group (TWG) is coordinating response activities

Planned:

• Surveillance and laboratory data harmonisation is ongoing


Cholera

Key points

• There is no suspected case of cholera reported this week

Actions

To date

• National cholera multi-sectoral Technical Working Group (TWG) is monitoring all states and supporting already affected states

• Development of the 2020 cholera preparedness and response plan ongoing

Planned:

• Ensure that reporting states conduct rapid diagnostic test/culture test and send line list of all reported cases to the national level

• Continue follow up and monitoring of non-reporting states

• Continue harmonisation of the national line list and SORMAS data

• Working with states to increase diagnostic testing rate


Measles

Key points

• There were 1069 suspected cases of measles reported from 206 LGAs in 26 states and FCT. None was laboratory confirmed and no death was recorded

Actions

To date

• National Measles Technical Working Group (TWG) is closely monitoring surveillance data and response activities across the country

Planned:

• Intensify follow up with states to update and transmit line list

• Continue the review of measles surveillance data across the country

• Continue harmonisation of the national line list and SORMAS data


Monkeypox

Key points

• There was no suspected case of monkeypox reported

Actions

To date

• National Monkeypox Technical Working Group (TWG) is monitoring activities in all states

Planned:

• Enhance surveillance for Monkeypox in high burden states, working with the animal health colleagues

• Continue harmonisation of the national line list and SORMAS data


Acute Flaccid Paralysis (AFP)

Key points

• There were 104 suspected cases of AFP reported from 97 LGAs in 30 states and FCT. None was laboratory confirmed and no death was recorded


Coronavirus (COVID-19)

Actions

To date:

• National Emergency COVID-19 (LF) multi-partner, multi-sectoral Operations Centre (EOC) activated at level continues to coordinate response activities across states.

• Established 7 COVID-19 diagnostic capacities

• Continuous and timely deployment of national rapid response team to support the affected states

• Deployed Surveillance Outbreak Response Management and Analysis System (SORMAS) to states not using SORMAS but with COVID-19 cases

• Enhanced surveillance (including contact tracing) ongoing in affected states.

• Deployed medical commodities to affected states

Planned:

• Continue mobilisation of resources

• Expand COVID-19 diagnostic capacities

• Establish more isolation / treatment centres

• Continue to establish surge capacities for response activities

• Conduct training on case management and infection prevention and control for staff of COVID-19 treatment centres in Lagos and FCT


National Influenza Sentinel Surveillance

Key points

• The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 0(0.0%), 2(9.5%) and 19 (90.5%) of the total influenza A positive samples respectively. The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 0(0.0%), 8(100%) and 0(0.0%) of the total influenza B positive samples respectively.

• The percentage influenza positive was highest in week 10 with 40%.


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)
  • Coronavirus (COVID-19)
  • National Influenza Sentinel Surveillance
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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