Weekly Epidemiological Report

July 2020 Week 27

Editoral

COVID-19: NCDC Interim Guidelines for Home-based Care

Posted: 22-07-2020 04:59:16 PM

In line with its mandate, the Nigeria Centre for Disease Control (NCDC) has continued to lead the national public health response to COVID-19, working closely with relevant Ministries, Departments and Agencies, as well as key development partners.

NCDC has continued to provide evidence-based guidelines on preventive measures as well as the management of COVID-19 cases in Nigeria. These guidelines are revised intermittently based on evolving knowledge about this virus.

At the beginning of the outbreak, the strategy of many countries was the isolation and management of every confirmed case of COVID-19. However, with increasing knowledge about the disease, countries including Nigeria, in consultation with State Governments are beginning to review their strategy for case management and admission of confirmed cases of COVID-19, given the widespread transmission of the virus.

The NCDC has recently published Interim Guidelines for Home Care of Confirmed COVID-19 Cases . The home care guidelines provide specific guidance on who should receive care at home and how family members and care givers can stay safe, where home care is appropriate. It also defines the circumstances in which homecare is not advised.

Despite the publication of these guidelines, it is important that all COVID-19 positive cases communicate with the State Emergency Operations Centre where they live. The decision on home care for COVID-19 patients is based on the severity of the patient’s symptoms, their age and the existence of co-morbidities, as well as capacity to adhere to the recommended measures. It is important to note that home-based care should only be recommended by medical personnel, and not my patients themselves. The medical personnel must carry out appropriate risk assessment, counselling and agree on an approach to ensure follow up on the patients’ health. Each State is advised to design an appropriate mechanism to continue the clinical supervision of the patients at home.

Home-based care is not recommended for people at any age with severe symptoms; patients with two or more co-morbidities; or any ‘high risk’ patient. This risk should be determined by a qualified physician.

We urge patients undergoing home-based care to practice all recommended preventive measures including strict self-isolation, hand hygiene, physical distancing etc. If condition worsens, you are advised to immediately call your state helpline for immediate transfer to a designated treatment centre.


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 52 suspected cases, three laboratory confirmed cases and no death recorded from three LGAs in two states

Actions

To date:

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

Planned:

• Continue resource mobilisation


Cerebrospinal Meningitis (CSM)

Key points

There were four suspected cases of Cerebrospinal Meningitis (CSM) reported from four LGAs in four states (Adamawa – 1, Borno – 1, Katsina – 1 & Sokoto - 1). There was no laboratory confirmed case 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 12 suspected cases of Yellow Fever (YF) reported from nine LGAs in six 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:

• Continue harmonisation of surveillance and laboratory data ongoing


Cholera

Key points

• There were ten suspected cases of cholera reported from Zaki LGA in Bauchi state. None was laboratory confirmed and no death was recorded

Actions

To date

• National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states

Planned:

• Continue follow up and monitoring of non-reporting states

• Continue harmonisation of the national line list and SORMAS data


Measles

Key points

• There were 92 suspected cases of measles reported from 51 LGAs in 13 states. None was laboratory confirmed and no death was recorded

Actions

To date

• National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners

• Weekly surveillance and laboratory data harmonisation ongoing

Planned:

• Continue monthly measles surveillance data review


Monkeypox

Key points

• There was no case of monkeypox reported this week

Actions

To date

• 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 131 suspected cases of AFP reported from 106 LGAs in 29 states. None was laboratory confirmed and no death was recorded


Coronavirus Disease (COVID-19)

Actions

To date:

• National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across states

• Developed dashboard for national, state and (LGA) level analysis of COVID-19 data in collaboration with partners

• Daily tracking of sample collection by states to monitor case finding efforts

• Activated three new laboratories - Edo Specialist Hospital, Benin, Edo; Abubakar Tafawa Balewa University Teaching Hospital, Bauchi; and Indorama Company Molecular Laboratory, Rivers

• Ongoing optimisation of University of Nigeria Teaching Hospital (UNTH) laboratory, Enugu State

• Supported the Universal Basic Education Commission (UBEC) in the development of a draft handbook for teachers on COVID-19 prevention in schools

Planned:

• Track implementation level of surveillance strategies at the state level

• Meet with hotspot states

• Activate testing laboratories in all other states in the country

• Activate an online COVID-19 results collection platform

• Commence implementation of Event-Based Surveillance (EBS) in six states


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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