In 2001, the Integrated Disease Surveillance and Response (IDSR) strategy for the World Health Organization Regional Office for Africa (WHO AFRO) was adopted for public health surveillance in Nigeria. In addition to ensuring rational use of resources, the IDSR provides an efficient streamlining and integration of disease surveillance activities. Given the critical importance of their roles, State Epidemiologists (SEs) and Disease Surveillance and Notification Officers (DSNOs) continue to receive IDSR-related training by the Nigeria Centre for Disease Control (NCDC). This is to improve epidemic intelligence and prompt response to disease outbreaks and other public health emergencies.
These training activities have contributed significantly to an improvement in disease surveillance activities. To harmonise various existing training modules and strengthen knowledge management, NCDC developed the Integrated Training of Surveillance Officers in Nigeria (ITSON).
The ITSON is a one-stop single package with modules adapted from the WHO IDSR strategy, Field Epidemiology Training Programmes and the West Africa Disease Surveillance Project. Relevant additions have been made from existing Emergency Operation Centres (EOCs), Infection prevention and control (IPC), and risk communication packages. Training of trainers (ToT) was previously conducted in 2019 in anticipation of the kick-off of ITSON in 2020. However, this was interrupted by the COVID-19 pandemic.
This year, NCDC has resumed activities for the implementation of ITSON. A refresher training was held for trainers from 21st -27th March 2021. The trainers are expected to train and effectively cascade up-to-date knowledge to colleagues at the sub-national level. The objectives of the training were to:
1. Introduce master trainers to the single training package that addresses all the training needs of the LGA surveillance staff
2. Train the master trainers on how to facilitate and manage the regional ToT and regional level training of the surveillance officers
3. Provide the master trainers with knowledge and skills required for a functional disease surveillance system enabling rapid detection of public health threats for prompt action
4. Train potential trainers on capacity building of disease surveillance officers on analysis and interpretation of IDSR data for action
5. Improve participants’ knowledge on outbreak investigation, response and reporting
6. Improve participants’ capacity on supportive supervision, monitoring, evaluation and feedback
Fifty central master trainers from NCDC, partners, and academia were trained based on their capacity as subject matter experts, and the intended objectives were met. The critical next step is for the pool of master trainers to train a regional pool of experts including other personnel such as state laboratory scientists, health educators who will in turn cascade knowledge to the LGA teams in various states.
When fully implemented, it is expected that the ITSON package will contribute significantly to ensure rational use of resources and also bridge knowledge gaps among the states epidemiologists, DSNOs and other frontline public health workforce across Nigeria. We remain grateful to the WHO, African Field Epidemiology Network (AFENET) and US Centres for Disease Control (US CDC) for providing technical support for the training.
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 136 suspected cases, 32 were laboratory confirmed and four deaths were recorded from 16 LGAs in eight states
Actions
To date:
• Conducted 2021 Lassa fever high burden states preparedness/response engagement meeting
• Dissemination of reviewed case management and safe burial practices guidelines
• Risk communication and community engagement activities have been scaled up across states using television, radio, print, social media and other strategies
Planned:
• Finalise Lassa fever five-year strategic plan
Cerebrospinal Meningitis (CSM)
Key points
• There were ten suspected cases of Cerebrospinal Meningitis (CSM) reported from eight LGAs in five states and FCT (Ebonyi – 1, FCT – 1, Katsina – 4, Kwara – 2, Oyo – 1 & Sokoto – 1). None were 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 42 suspected cases of Yellow Fever (YF) reported from 21 LGAs in 10 states. None were laboratory confirmed and no death was recorded
Actions
To date:
• National YF multi-partner Technical Working Group (TWG) continues to coordinate activities across states.
• Daily monitoring and analysis of surveillance data across the country to guide response activities
Planned:
• Continue supporting affected states across all pillars of response
• Continue harmonisation of surveillance and laboratory data ongoing
Cholera
Key points
• There were 71 suspected cases of cholera reported from three LGAs in two states (Bayelsa – 64 & Kebbi – 7). None were laboratory confirmed and seven deaths were 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 192 suspected cases of measles reported from 74 LGAs in 18 states. None were 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
• Ongoing weekly surveillance and laboratory data harmonisation
Planned:
• Intensify follow up with states to update and transmit line list
• Continue monthly measles surveillance data review
Monkeypox
Key points
• There was no suspected case of monkeypox in the reporting 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 52 suspected cases of AFP reported from 46 LGAs in 18 states and FCT. None were laboratory confirmed and no death was recorded
National Influenza Sentinel Surveillance
Avian influenza (H5 series)
Actions
To date:
• A multi-sectoral Emergency Operations Centre (EOC) continues to coordinate the response
• All seven human positive samples have been shipped to WHO coordinating centre for further lab analysis
• National RRT were deployed to all affected states
Planned:
• Continue to intensify surveillance activities and monitor cases across the country
Coronavirus Disease (COVID-19)
Actions
To date:
• National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across states
• Deployed a National Rapid Response Team to support the National Sports Festival in Edo State
• Supported states in testing Nigerian athletes for the National Sports Festival
• Ongoing deployment of commodities, reagents and supplies to the laboratory networks
• Reviewed and updated the zero draft of the IPC policy and strategic framework
Planned:
• Deploy antigen-based rapid diagnostic test (Ag-RDT) kits and sample collection materials to the selected states
• Intensify genomic surveillance activities
• Conduct (Water, Sanitation and Hygiene) WASH assessment across all health facilities
• Finalise Local Government Area (LGA)/State transmission categorisation
Timeliness and Completeness of Reports
Timeliness and Completeness of Reports by State
Monkeypox
Key points
• There was one suspected case of Monkeypox reported in Bayelsa State in Yenagoa LGA and it is not laboratory confirmed
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