Clinical Presentation and Outcome of Ribavirin Treated RT-PCR Confirmed Lassa Fever Patients in ISTH Irrua: A Pilot Study

Background: Lassa fever is a viral hemorrhagic fever that is endo-epidemic in Edo state, with case fatality of 90-100% if not treated. It has been claimed that early treatment with Ribavirin reduces mortality to less than 20%. This study was carried out to assert/confirm or refute/reject this claim.Aim: To review the clinical features, laboratory findings of Lassa fever and the outcome of confirmed cases treated with Ribavirin.Methodology: The study was a case series study of the first 41 cases that were treated with Ribavirin in the Lassa fever isolation ward from 28th November 2010 to 26th May 2011.Results: Up to 63.4% of cases presented late (onset of illness greater than 6 days at presentation). Fever remains the predominant presenting feature of the disease (97.5%). Of the cases that were admitted, 41 were treated, 31 recovered and 9 died, giving a case-fatality rate of 22%. One discharged against medical advice. Conclusion: Lassa fever victims still present late at the hospital and fever remains the predominant presenting feature. Early Ribavirin treatment improves treatment outcome of Lassa fever in confirmed cases.Recommendations: The Federal, States and Local government area council members must make efforts to create public awareness on early presentation, diagnosis and prompt treatment with Ribavirin

Road safety, alcohol consumption and visual function of motor bike riders in Ekpoma, Edo State, Nigeria

Causes of road traffic accidents (RTA) in developing nations have been attributed in part, to poor vision due to excessive alcohol consumption. This cross-sectional study assessed the visual acuity of 230 male motor-bike riders in Ekpoma, Edo State, Nigeria, and their potentials for alcohol abuse, using the cluster sampling technique.A semi-structured interviewer/self administered questionnaire was used to collect data on socio-demographic characteristics, road traffic accidents and alcohol use, while visual acuity was assessed with a Snellens chart. Results showed good right and left eye vision among 68.3% and 71.3% of the riders respectively, but visual impairment was observed among 25.2% (right) and 26.5% (left) of the riders, and the impairment was severe among 6.5% (right) and 2.2% (left) of them. Up to 69.57% had potential for alcohol abuse, while 5.22% and 25.22% had borderline or no potential for alcohol abuse respectively. About half of the respondents (118; 51.3%) have had a road traffic accident in the last one year and there was a statistically significant association between visual acuity and road traffic accidents (P = 0.000). Although majority of respondents had good visual acuity and a high potential for alcohol abuse, there involvement in road traffic accidents was low.Keywords: Poor vision, Visual acuity, Road traffic accident, Alcohol abus

Medical cost of Lassa fever treatment in Irrua Specialist Teaching Hospital, Nigeria

This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South  Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and  Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, between May 2015 and May 2016 were  studied. A checklist was used to collect data on the socio-demographic characteristics and medical cost incurred by the  patients. Data entry and analysis was done using SPSS version 20. The average total direct cost for Lassa fever treatment  was N86,802.63 per patient for the subsidized treatment and N205,558.99 per patient for the unsubsidized treatment.  Medications accounted for the highest unsubsidized payments (N86,929.55; 42.10%) while hospital care accounted for the  highest cost component of he subsidized payments (N19,756.51; 22.76%). Up to 84.28% of medication and 70.8% of  investigations was subsidized making a total of 57.77% subsidy in the average total payments per patient. For an average  Nigerian, direct cost of treatment of Lassa fever is still expensive despite subsidy in medications and investigations.  Therefore efforts geared towards reducing the economic burden of Lassa fever on patients and their families are advocated.Keywords: Lassa fever, medical cost, poverty-reduction, South-South Nigeri

The niche of One Health approaches in Lassa fever surveillance and control

Lassa fever (LF), a zoonotic illness, represents a public health burden in West African countries where the Lassa virus (LASV) circulates among rodents. Human exposure hinges significantly on LASV ecology, which is in turn shaped by various parameters such as weather seasonality and even virus and rodent-host genetics. Furthermore, human behaviour, despite playing a key role in the zoonotic nature of the disease, critically affects either the spread or control of human-to-human transmission. Previous estimations on LF burden date from the 80s and it is unclear how the population expansion and the improvement on diagnostics and surveillance methods have affected such predictions. Although recent data have contributed to the awareness of epidemics, the real impact of LF in West African communities will only be possible with the intensification of interdisciplinary efforts in research and public health approaches. This review discusses the causes and consequences of LF from a One Health perspective, and how the application of this concept can improve the surveillance and control of this disease in West Africa

Tuberculosis, HIV/AIDS and Malaria Health Services in sub-Saharan Africa – A Situation Analysis of the Disruptions and Impact of the COVID-19 Pandemic

Background: The unprecedented and ongoing COVID-19 pandemic has exposed weaknesses in African countries’ health systems. The impact of shifted focus on COVID-19 for the past 2 years on routine health services, especially those for the epidemics of Tuberculosis, HIV/AIDS and Malaria, have been dramatic in both quantity and quality. Methods: In this article, we reflect on the COVID-19 related disruptions on the Tuberculosis, HIV/AIDS and Malaria routine health services across Africa. Results: The COVID-19 pandemic resulted in disruptions of routine health services and diversion of already limited available resources in sub-Saharan Africa. As a result, disease programs like TB, malaria and HIV have recorded gaps in prevention and treatment with the prospects of reversing gains made towards meeting global targets. The extent of the disruption is yet to be fully quantified at country level as most data available is from modelling estimates before and during the pandemic. Conclusions: Accurate country-level data is required to convince donors and governments to invest more into revamping these health services and help prepare for managing future pandemics without disruption of routine services. Increasing government expenditure on health is a critical part of Africa's economic policy. Strengthening health systems at various levels to overcome the negative impacts of COVID-19, and preparing for future epidemics will require strong visionary political leadership. Innovations in service delivery and technological adaptations are required as countries aim to limit disruptions to routine services

Lockdown measures in response to COVID-19 in nine sub-Saharan African countries

Lockdown measures have been introduced worldwide to contain the transmission of COVID-19. However, the term ‘lockdown’ is not well-defined. Indeed, WHO’s reference to ‘so-called lockdown measures’ indicates the absence of a clear and universally accepted definition of the term ‘lockdown’. We propose a definition of ‘lockdown’ based on a two-by-two matrix that categorises different communicable disease measures based on whether they are compulsory or voluntary; and whether they are targeted at identifiable individuals or facilities, or whether they are applied indiscriminately to a general population or area. Using this definition, we describe the design, timing and implementation of lockdown measures in nine countries in sub-Saharan Africa: Ghana, Nigeria, South Africa, Sierra Leone, Sudan, Tanzania, Uganda, Zambia and Zimbabwe. While there were some commonalities in the implementation of lockdown across these countries, a more notable finding was the variation in the design, timing and implementation of lockdown measures. We also found that the number of reported cases is heavily dependent on the number of tests carried out, and that testing rates ranged from 2031 to 63 928 per million population up until 7 September 2020. The reported number of COVID-19 deaths per million population also varies (0.4 to 250 up until 7 September 2020), but is generally low when compared with countries in Europe and North America. While lockdown measures may have helped inhibit community transmission, the pattern and nature of the epidemic remains unclear. However, there are signs of lockdown harming health by affecting the functioning of the health system and causing social and economic disruption

Lockdown measures in response to COVID-19 in nine sub-Saharan African countries

Lockdown measures have been introduced worldwide to contain the transmission of COVID-19. However, the term ‘lockdown’ is not well-defined. Indeed, WHO’s reference to ‘so-called lockdown measures’ indicates the absence of a clear and universally accepted definition of the term ‘lockdown’. We propose a definition of ‘lockdown’ based on a two-by-two matrix that categorises different communicable disease measures based on whether they are compulsory or voluntary; and whether they are targeted at identifiable individuals or facilities, or whether they are applied indiscriminately to a general population or area. Using this definition, we describe the design, timing and implementation of lockdown measures in nine countries in sub-Saharan Africa: Ghana, Nigeria, South Africa, Sierra Leone, Sudan, Tanzania, Uganda, Zambia and Zimbabwe. While there were some commonalities in the implementation of lockdown across these countries, a more notable finding was the variation in the design, timing and implementation of lockdown measures. We also found that the number of reported cases is heavily dependent on the number of tests carried out, and that testing rates ranged from 2031 to 63 928 per million population up until 7 September 2020. The reported number of COVID-19 deaths per million population also varies (0.4 to 250 up until 7 September 2020), but is generally low when compared with countries in Europe and North America. While lockdown measures may have helped inhibit community transmission, the pattern and nature of the epidemic remains unclear. However, there are signs of lockdown harming health by affecting the functioning of the health system and causing social and economic disruption