State’s preparedness for coordination of Lassa fever outbreak containment in Nigeria, April 2017

Introduction : lassa fever(LF), an acute viral hemorrhagic feveris endemic in Nigeria with annual recurrent outbreaks in different States and varying levels of mortality and morbidity. In order to prevent such episodes with better preparation for early detection and rapid control of the disease, the Nigeria Center for Disease Control (NCDC) evaluated Nigerian States’ level of preparednesswith a view to defining areas with high disease burden and risk of outbreak. The aim of the study is to assess the level of preparednessfor co-ordination of LF outbreak response activities across the states for informed decision and effective LF outbreak response, planning and implementing of high impact interventions. Methods : a self-administered LF preparednessquestionnaire was filled by 37 State Epidemiologists including the Federal Capital Territoryto assess national preparedness. Data was entered, cleaned and analyzed using Epi-Info 7.2. States were stratified into Very High Risk (VHR), High Risk (HR) and Low Risk (LR) based on having ≥10, 1 - 9 or zero confirmed cases respectively in 2016 and 2017. State-specific level of preparedness, based on a three-staged scoring system was categorized into: Inadequate, 0 - 49%; fairly adequate, 50 - 74%; and adequate ≥75% preparedness. Variables of interest were summarized in frequencies and proportions. Results : six (16.0%) states were classified as VHR, 18 (49.0%) were HR, while 13 (35.0%). Twenty-six states (70.3%) had an Emergency Operations Centre (EOC) while 24 (64.9%) can activate their EOCs within 48 hours. Thirty-two (86.5%) have Emergency Preparednessand Response (EPR) Committees. A maximum of 3 (50%) of VHR states had functional EOCs, ability to activate EOCs within 48 hours and EPR Committees, when compared with 13 - 15 HR and 9-12 LR states, respectively. On the state-specific level of preparednessfor co-ordination, 16 states (43.2%) were inadequate, 9 (24.4%) fairly inadequate, and 12 (32.4%) adequate. Conclusion : preparednessfor co-ordination of Lassa feveroutbreak responses should be improved in all the states, especially the VHR and HR states, to reduce morbidity, mortality, economic cost and psychosocial effect associated with LF outbreaks in Nigeria.