Nigeria Centre for Disease Control Protecting the health of Nigerians
Role of NPHIs in Re-Emerging Infectious Diseases Lassa fever: The Nigerian Experience
Dr. Chikwe Ihekweazu Director General Mandatory disclosure slide
No conflict of interest
2 NIGERIA CENTRE FOR DISEASE CONTROL Nigeria’s health and economy
Population ~ 186 million
Annual population growth rate of 2.6%
Recent outbreaks - Lassa fever, Ebola, Monkeypox, Yellow fever, Meningitis
Low expenditure on health as a percentage of GDP
Multiple competing priorities for Government
3 NIGERIA CENTRE FOR DISEASE CONTROL 3 Major outbreaks in Nigeria
4 NIGERIA CENTRE FOR DISEASE CONTROL Lassa fever in Nigeria
Large outbreak in 2018 Ongoing outbreak in 2019 638 confirmed cases 420 confirmed cases 171 deaths 93 deaths 23/36 states affected 21/36 states affected Case fatality: 26% Case fatality: 22% Cases concentrated in three hotspot Cases being detected in new states states
5 NIGERIA CENTRE FOR DISEASE CONTROL Trends of Lassa fever in Nigeria (2016-2019)
6 NIGERIA CENTRE FOR DISEASE CONTROL 7 NIGERIA CENTRE FOR DISEASE CONTROL Improved digital surveillance
WHO, ECOWAS, R-CDC
Aggregated monthly
Nigeria Centre for Disease Control CDC
Aggregated weekly (by Wednesday) State/Regional Health Department
Aggregated weekly (by Tuesday) District / Local Government Area Health Dpt.
Aggregated weekly (by Monday) Local Health Care Facilities
8 NIGERIA CENTRE FOR DISEASE CONTROL Improved digital surveillance
WHO, ECOWAS, R-CDC
Aggregated monthly
Nigeria Centre for Disease Control CDC manual data entry Aggregated weekly (by Wednesday) State/Regional Health Department
Aggregated weekly weekly (by Tuesday) District / Local Government Area Health Dpt.
Aggregated weekly Laboratory (by Monday) Local Health Care Facilities IDSR Field 001A investigator
9 NIGERIA CENTRE FOR DISEASE CONTROL Cases in ‘new states’
2018 2019
LEGEND ≥1 Suspected Cases 1- 50 Confirmed Cases >50 Confirmed Cases 1 dot = 1 Confirmed Case
10 NIGERIA CENTRE FOR DISEASE CONTROL Improved diagnostics- Four new molecular laboratories
11 NIGERIA CENTRE FOR DISEASE CONTROL Improved logistics system
12 NIGERIA CENTRE FOR DISEASE CONTROL Increasing use of EOCs
13 NIGERIA CENTRE FOR DISEASE CONTROL National sample transport system
14 NIGERIA CENTRE FOR DISEASE CONTROL Improved almost real-time sequencing in Nigeria
15 NIGERIA CENTRE FOR DISEASE CONTROL Research activities
• National Lassa fever research plan developed • Research as core pillar of EOC • National Lassa Fever Research Consortium • Lassa fever- critical areas for WHO R&D, CEPI vaccines
16 NIGERIA CENTRE FOR DISEASE CONTROL Improved collaboration PANDORA-ID NET SUPPORT
17 NIGERIA CENTRE FOR DISEASE CONTROL 2019 Lassa fever preparedness
• Training of 1,000 health workers in Nigeria on Lassa fever management, diagnosis and surveillance • Prepositioning of treatment and diagnostic supplies to the 21 states that recorded cases in 2018 • Publication of Lassa fever messages in newspapers, weekly radio shows, and intensive community engagement • High level advocacy visits to State Governments • Review of case management guidelines, initiated a Lassa fever Research Consortium and hosted International Conference on Lassa Fever
18 NIGERIA CENTRE FOR DISEASE CONTROL 19 NIGERIA CENTRE FOR DISEASE CONTROL Nigeria Centre for Disease Control Mandate Prevent, detect, and control spread of communicable diseases
Coordinate surveillance systems to collect, analyse and interpret data on communicable diseases to guide action
Support States in responding to small outbreaks, and lead response to large disease outbreaks
Develop and maintain a network of public health laboratories
Conduct, collate, synthesise and disseminate public health research to inform policy
Coordinate the compliance with international health regulations
20 NIGERIA CENTRE FOR DISEASE CONTROL NCDC’s role in infectious diseases (Lassa fever)
• Coordination of public health surveillance, laboratory and response functions
• Coordination of partners’ support
• Building trust among Nigerians through regular communication
21 NIGERIA CENTRE FOR DISEASE CONTROL Why we need strong NPHIs
1. A public health event can go from local to global very rapidly
2. Global health security can only be assured by local health protection
3. A strong surveillance & response system, managed by a skilled public health workforce, organised in a national public health institute is needed in every country
4. Partnerships matter more than ever before, NPHIs coordinate these
5. Vulnerability for one is vulnerability for all
22 NIGERIA CENTRE FOR DISEASE CONTROL Our posters at ICREID 2019
23 NIGERIA CENTRE FOR DISEASE CONTROL THANK YOU Email: [email protected]
24 NIGERIA CENTRE FOR DISEASE CONTROL