Weekly Epidemiological Report

April 2020 Week 15

Editoral

Scaling up COVID-19 testing capacity in Nigeria

Posted: 29-04-2020 07:36:20 PM

The evolving transmission dynamics of the current coronavirus disease (COVID-19) pandemic has continued to put the global public health system to test. In response to this, different countries across the world have devised diverse strategies to timely detect, isolate and successfully manage cases. Currently, the need to conduct more testing is being advocated due to increased cases of community transmission.

According to the WHO COVID-19 transmission characterisation, four transmission scenarios have been described namely: countries with no cases; countries with sporadic cases; countries with cluster of cases; and countries with community transmission. As of the 28th of April, 1532 cases have been confirmed in Nigeria across 34 states with 255 persons discharged and 44 deaths recorded. With the Federal Capital Territory (FCT), Lagos and Kano States having the highest number of cases, there is increasing evidence of community transmission.

Following best practices through the use of molecular RT-PCR testing, the Nigeria Centre for Disease Control (NCDC) recently published the national testing strategy to rapidly scale diagnostic testing for all 36 States and the FCT (see link). Given the global increasing and competitive demand for testing kits, this is an adaptive testing strategy that will continue to evolve and significantly improve access to testing for the most vulnerable persons.

The strategy uses a five-pronged approach namely:

1. Expand existing NCDC laboratory network with molecular RT-PCR: this aims to increase testing capacity from 9 laboratories in states to 15 laboratories in 12 states. Currently, NCDC has a network of 17 COVID-19 testing laboratories in the country.

2. Leverage capacity within the high throughput HIV molecular Testing Laboratories Private laboratories: the country is currently in this phase which integrates laboratory systems to increase testing capacity. This is expected to increase national testing output from 3,000 tests a day to at least 5,000 tests per day.

3. Repurpose point of care tuberculosis testing GeneXpert machines for COVID-19 testing: the objective is to decentralise testing to state level and improve equitable access to testing for all Nigerians thereby reducing the turn-around time by 50%.

4. Private Sector Engagement: this is to ensure private laboratories with molecular testing capability are engaged and supported to provide COVID-19 testing.

5. Future Use of Antigen and Antibody Tests to Learn More about the Disease: this is to explore the role of antigen and antibody tests in the future.

With this strategy, the NCDC remains committed to providing continuous guidance to clinicians, epidemiologists and laboratories across the country on the prioritisation of testing during the various phases of the pandemic i.e. community transmission and widespread transmission.


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 99 suspected cases, ten confirmed cases and no death was recorded from six LGAs in five states

Actions

To date:

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

• Public Health Emergency Operations Centre activated in affected states

• National Rapid Response Teams (RRT) have been deployed to ten states

• Surge staff (Doctors, Nurses, Laboratorians and Hygienist) have been deployed to Irrua Specialist Teaching Hospital (ISTH) and Federal Medical Centre (FMC) Owo

• 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 turnaround time

• The NCDC continues to work closely with states to identify one treatment centre per state, while supporting existing ones required commodities Risk communications and community engagement activities have been scaled up across states using television, radio, print, social media and other strategies


Cerebrospinal Meningitis (CSM)

Key points

There were 11 suspected cases of Cerebrospinal Meningitis (CSM) reported from eight LGAs in four states (Borno – 1, Ebonyi – 1, Katsina – 8 & Kebbi – 1). None was laboratory confirmed and no death was 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 24 suspected cases of Yellow Fever (YF) reported from 21 LGAs in seven 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 are ongoing


Cholera

Key points

• There was 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

Planned:

• Continue follow up and monitoring of previously non-reporting states

• Continue harmonisation of the national line list and SORMAS data


Measles

Key points

• There were 632 suspected cases of Measles reported from 113 LGAs in 21 states. None was laboratory confirmed and one 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 this week.

Actions

To date

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

Planned:

• Enhance surveillance for monkeypox in high burden states

• Continue harmonisation of the national line list and SORMAS data


Acute Flaccid Paralysis (AFP)

Key points

• There were 48 suspected cases of AFP reported from 44 LGAs in 22 states and FCT. None was laboratory confirmed and no death was recorded


Coronavirus disease (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 fouteen (14) COVID-19 diagnostic capacities

• National Rapid Response Team continues to support affected states

• Provide training support across all pillars of response to affected states

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

• Deployed medical commodities to affected states

Planned:

• Continue mobilisation of resources

• Continue to establish surge capacities across all response pillars


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

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