Weekly Epidemiological Report

February Week 5

Editoral

Strengthening Antimicrobial Resistance Surveillance in Nigeria

In 2017, the Nigeria Centre for Disease Control (NCDC) was designated by the Honourable Minister of Health as the National Coordinating Secretariat for Antimicrobial Resistance (AMR)-related issues in Nigeria. This was followed by the constitution of the National AMR technical working group (TWG) to develop and implement the national AMR roadmap. Since then, NCDC has continued to work closely with relevant Ministries, Departments and Agencies (MDAs) as well as key stakeholders on AMR surveillance, awareness, research and other related activities. This collaboration led to the development of the AMR National Action Plan (using a One Health approach) and Nigeria’s enrollment and reporting into the Global Antimicrobial Resistance Surveillance System.

The five AMR thematic pillars of focus are 1) AMR education and awareness; 2) Surveillance; 3) Hygiene, Infection Prevention and Control (IPC) and Biosecurity; 4) Antimicrobial Stewardship; and 5) Research.

As part of efforts to strengthen AMR surveillance in Nigeria, NCDC in collaboration with the Fleming Fund Consortium recently organised the 1st quarter AMR TWG meeting in Ibadan, Oyo State, from 20th -22nd January, 2020. The objectives of the meeting were to:

1. Provide updates on all AMR related activities

2. Develop priority plans for the AMR surveillance, antimicrobial stewardship and IPC pillars

The meeting had forty participants in attendance which included representatives from Federal Ministry of Environment, Federal Ministry of Agriculture, National Agency for Food and Drug Administration and Control, National Environmental Standard Regulations Agency, Environmental Health Officers Registration Council, University College Hospital Ibadan, University of Ibadan, Ahmadu Bello University Zaria, Public Health England, BioMerieux, World Health Organization and the Fleming Fund Consortium.

At the end of the meeting, the objectives were met and the critical next steps are to develop a standard WHONET template for reporting metadata; generate configuration file that meets the sentinel sites requirements; share the data sharing agreement with sentinel sites; deploy an effective mechanism of coordination across board using the one health approach; commence publication of the AMR newsletter and others.

NCDC remains committed to working with all relevant other stakeholders, in the fight against AMR.

Editor’s note: Nigeria is currently strengthening its preparedness for the coronavirus diseases (COVID-19). Frequently Asked Questions can be found on the NCDC website here.


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 531 suspected cases, 104 confirmed cases and six deaths reported from 39 LGAs in 15 states (Ondo, Edo, Ebonyi, Kano, Kogi, Kaduna, Delta, Taraba, Plateau, Bauchi, FCT, Gombe, Enugu, Kebbi and Anambra).

• One new Health Care Worker was affected in Delta state in the reporting week

Actions

To date:

• National LF multi-partner, multi-sectoral EOC continues to coordinate the response activities at all levels

• NCDC National Rapid Response Team (RRT) deployed to Ondo, Ebonyi, Enugu, Kano and Borno states

• Development and implementation of the Incident Action Plan

Planned:

• Mobilise resources

• Finalise the Lassa fever five-year strategic plan

• Conduct IPC training for Health Care Workers

• Continue to review LF mortality

• Carry out in-depth investigation of healthcare worker infection


Cerebrospinal Meningitis (CSM)

Key points

There were 18 suspected cases of Cerebrospinal Meningitis (CSM) reported from ten LGAs in four states (Borno – 1, Edo – 4, Katsina – 12 & Osun – 1). None was 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 34 suspected cases of yellow fever (YF) reported from 25 LGAs in 19 states. None was laboratory confirmed and no death was recorded

Actions

To date:

• National multiagency YF Technical Working Group (TWG) is coordinating response activities

• National YF guideline available on NCDC website

Planned:

Continue to harmonise surveillance and laboratory data


Cholera

Key points

• There were 198 suspected cases of cholera reported from five LGAs (Abakaliki – 105, Ebonyi – 12, Ivo – 48, Ohaukwu - 18 & Onicha – 15) in Ebonyi state. None was laboratory confirmed and nine deaths were recorded

Actions

To date

• National cholera multi-sectoral Technical Working Group (TWG) is monitoring all states and supporting already affected states

• Finalise the development of the 2020 cholera preparedness and response plan

Planned:

• Ensure that reporting states conduct rapid diagnostic test/culture test and send line list of all reported cases to the national level

• Continue follow up and monitoring of non-reporting states

• Continue harmonisation of the national line list and SORMAS data


Measles

Key points

• There were 391 suspected cases of measles reported from 147 LGAs in 30 states. None was laboratory confirmed and one death was recorded

Actions

To date

• National measles Technical Working Group (TWG) is closely monitoring surveillance data and response activities across the country

Planned:

• Continue the review of measles surveillance data across the country

• Continue harmonisation of the national line list and SORMAS data


Monkeypox

Key points

• There was no suspected case of monkeypox reported this week

Actions

• The National Monkeypox Technical Working Group (TWG) is monitoring activities in all states

Planned:

• Enhance surveillance for monkeypox in high burden states, working with the animal health colleagues


Acute Flaccid Paralysis (AFP)

Key points

• There were 102 suspected cases of AFP reported from 89 LGAs in 30 states and FCT. None was laboratory confirmed and no death was recorded


National Influenza Sentinel Surveillance

Key points

• The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for 0(0.0%), 0(0.0%) and 2(100%) of the total influenza A positive samples respectively. The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 0(0.0%), 5(100%) and 0(0.0%) of the total influenza B positive samples respectively

• The percentage influenza positive was highest in week 5 with 20%.


Timeliness and Completeness of Reports


Timeliness and Completeness of Reports by State

Highlight of the week

  • Summary of Incidents
  • Lassa Fever
  • Cerebrospinal Meningitis (CSM)
  • Yellow Fever
  • Cholera
  • Measles
  • Monkeypox
  • Acute Flaccid Paralysis (AFP)
  • National Influenza Sentinel Surveillance
  • Timeliness and Completeness of Reports
  • Timeliness and Completeness of Reports by State

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