The Nigeria Centre for Disease Control and Prevention (NCDC) has identified delays in seeking medical attention as a critical factor contributing to the rising fatalities associated with Lassa fever. In its latest situation report, the NCDC emphasizes that late presentation of cases significantly elevates the case fatality rate (CFR) of the disease.
The report, released on Wednesday, correlates the increase in death rates to a nationwide trend of poor health-seeking behaviour, primarily driven by the high costs associated with the treatment and clinical management of Lassa fever. It states: “Late presentation of cases leading to an increase in CFR. Poor health-seeking behaviour due to the high cost of treatment and clinical management of Lassa fever and poor environmental sanitation conditions observed in high-burden communities.” Furthermore, it highlights a lack of awareness about the disease in these communities, which exacerbates the situation.
Lassa fever, also known as Lassa haemorrhagic fever, is caused by the Lassa virus and is primarily transmitted to humans through contact with food or household items contaminated with rodent urine or faeces. This disease is endemic to West Africa, particularly Nigeria, where the Mastomys rat—a natural carrier of the virus—thrives in many environments. The WHO estimates that Lassa fever affects approximately 300,000 to 500,000 people annually in West Africa, with around 5,000 deaths each year.
As of September 2024, Nigeria has recorded 170 Lassa fever-related deaths since the beginning of the year. The NCDC has reported a CFR of 16.9% for the disease, consistent with figures from the same period in 2023. Last week alone, 115 suspected cases were reported across Edo, Ondo, and Enugu states, leading to five confirmed cases and one death. This raises the total confirmed cases from 1,000 to 1,005, with 8,251 suspected cases currently recorded. Notably, 67% of confirmed cases originate from Ondo, Edo, and Bauchi states, while the remaining 33% are distributed across 25 other states. The predominant age group affected is between 31 and 40 years old, indicating a significant demographic at risk..
While Lassa fever is endemic in West Africa, the World Health Organization (WHO) assesses the regional and global risks as low, mainly because the primary transmission mode is zoonotic, resulting in minimal human-to-human transmission. WHO recommends robust community hygiene measures to deter rodents from entering homes. Suggested practices include:
- Storing food, such as grains, in rodent-proof containers.
- Properly disposing of waste away from living areas.
- Maintaining overall cleanliness in the household.
- Keeping cats to help control rodent populations.
In healthcare settings, adherence to standard infection prevention protocols is critical. WHO guidelines stress the importance of proper hand and respiratory hygiene, utilizing personal protective equipment to mitigate exposure to contaminated materials, ensuring injection safety, and following protocols for the safe handling of deceased patients.
The NCDC’s findings underscore the urgent need for improved health-seeking behaviour, increased public awareness, and better access to treatment for Lassa fever in Nigeria. Enhanced community education and environmental sanitation efforts are essential in combating the rising fatalities associated with this endemic disease.
