Nigeria Centre for Disease Control Protecting the health of Nigerians

COVID-19 Response Coordination and surveillance - Kano State experience Kano State Socio‐demographics

o LGAs: 44 o Total population of 14,311,254 o Public health facilities: 1224 o Private health facilities: 156 o International airport

o 8 LGAs in the metropolis o Constitute 30% of total population Kano state COVID-19 Response Structure

xx Team lead Kano State Taskforce on COVID-19 (HE Deputy Governor) (Chairman) IM Support team Coordinator/Incident manager (Dr Tijjani Hussaini) EOC Operations Liaison with partners Lead research Deputy Coordinator Follow up of plans (Dr Sabitu Y. Shuaibu) Data management

Surveillance / Laboratory Case management Infection and Risk Logistics Epidemiology prevention control communication Dr Ibrahim Auwalu Abullahi Pharm. Isah Bala Dr Bashir Lawan Hamza Shuaibu Nashabru Prof. Yusuf Sabo Fagge

Case investigation Sample collection Coordination of COVID-19 frontline Risk communication Inventory treatment in isolation team system management and quarantine Contact tracing and Sample centers Community Commodity pick up team management engagement distribution

Connect Center Quality assurance Welfare of patients Supervision and Public information Commodities and the case monitoring ( 1º,2º storage management team and 3º Active case Sample shipment Media engagement Equipment research maintenance Burial of confirmed Point of entry Sample reporting or suspected cases Stock management

| 3 Key Timelines In Kano Response

7th January 11th April 21st April China confirmed corona Kano detected first case 2017 Inaugurated a new IMS virus, has been (Index case) identified to cause structure COVID 19

th 20th March 12th April 27 February 17th April Kano State activated Response, contact Nigeria detected it’s EOC shut as members & IMS for covid 19 tracing & other first case (Index case) task force team test +ve surveillance activities commenced

NIGERIA CENTRE FOR DISEASE CONTROL 4 Intensified Surveillance Activities

The picture can't be displayed. Case detection and alert management

The picture can't be displayed. Case investigations

Components of intensified Contact tracing surveillance

The picture can't be displayed. Active Surveillance and increased sample collection sites

Data management and reporting

NIGERIA CENTRE FOR DISEASE CONTROL 5 Call Centre (Case detection and alert) o Toll free lines (3) with capacity to receive 120 calls at a time o Operated by 24 trained personnel o 1st responders (18) on 3 shifts o 2nd line responders (6) o Plan to expand to maximize line capacity

Rapid Response Teams (Case investigation) o 23 Rapid Response teams supporting metropolitan LGAs o While 1 Rapid Response Team covering 2 LGAs for non‐ metropolitan LGAs o Team composition: • Clinician • Laboratorian • Sanitary Officer • Driver

NIGERIA CENTRE FOR DISEASE CONTROL Contact Tracing Teams o 4 teams/LGA (2 trained personnel) across all the LGAs o Over 1,290 contacts line listed (98% under follow‐up) o About 70 completed followed‐up o 267 contacts converted to suspected cases (22% highest in Nigeria) o 57 contacts confirmed as cases

Active Case Search o A total of 20 teams (2 persons/team) within metropolitan LGAs and 10 in non‐metropolitan LGAs o About 80 communities & 60 HFs visited o Community Sensitizations o Over 100 Suspected cases identified

NIGERIA CENTRE FOR DISEASE CONTROL Increased sample Collection Sites o 4 sites currently available (Metropolis) o Team (Clinician, laboratorian & Env Health Officer) o Planned scale up to 16 (12 new) • 1 each in all the zones • 4 additional in Metro LGAs

Laboratory Samples Tested 2148 o 3 Functional Laboratories • Aminu Kano TH Samples Positive 703 • BUK Lab • 54 Gene o Capacity to test 270 daily (Planned scale up to 1500 daily) Pending 424 o Trainings on (Biosafety, sample collection & waste Mngt)

NIGERIA CENTRE FOR DISEASE CONTROL Spatial distribution of cases in Kano as at 13/05/2020

Map of Kano State showing Epidemiological summary confirmed cases

suspected 2241 in 25 LGAs cases (92% from 8 municipal LGAs) Confirmed cases 703

Total 57 contacts positive Contacts 3 POI positive

. 90% confirmed cases in 8 metropolitan LGAs . 35% of population lives in the 8 Metro LGAs Age, sex distribution of cases and Death in Kano

Male (N = 516) Alive Dead Female (179)

11 0 11 0-10Yrs 10 0 10

22 0 22 11-20Yrs 12 1 13

70 0 69 21-30Yrs 30 0 30

128 0 128 31-40Yrs 32 1 33

92 2 90 41-50Yrs 26 3 29

81 10 71 51-60Yrs 22 1 23

48 9 39 61-70Yrs 14 0 14 M:F ratio = 3:1

24 5 19 > 70Yrs 9 3 12

40 1 39 Unknown 15 0 15

100 90 80 70 60 50 40 30 20 10 0 0 102030405060708090100 # of cases # of cases

10 NIGERIA CENTRE FOR DISEASE CONTROL Challenges o Coordination • Gaps post initial incidence o Human Resources •RRT • Sample collection sites o Logistics • Lack of enough PPE • Lab consumables o Lack of cooperation and denials • Confirmed cases o Inadequate Isolation/treatment centres

11 NIGERIA CENTRE FOR DISEASE CONTROL Thank you