Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January-March 2012)
Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki, Nigeria (January-March 2012)
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DOI：
10.1016/j.ijid.2013.05.015
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发表时间：
2013-11-01
影响因子：
8.4
通讯作者：
Ukwaja, Kingsley N.
中科院分区：
文献类型：
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作者：
Ajayi, Nnennaya A.;Nwigwe, Chinedu G.;Ukwaja, Kingsley N.
目标：尽管拉沙热具有流行病的性质，但在资源贫乏的环境中，疫情的细节和应对策略尚未得到很好的记录。我们描述2012年1月至3月期间在尼日利亚埃邦伊州发生的LF暴发过程。方法：我们分析了疫情期间监测记录和医院统计的临床、流行病学和实验室数据。费雪精确检验用于比较比例，t检验用于比较均值差异。结果：疫情应对包括有效协调、实验室检测、积极监测、社区动员、接触和疑似病例评估以及病例管理。疫情期间记录了20例LF病例（10例确诊病例和10例疑似病例）。通过指示病例发生了向六名卫生工作者的医院传播。只有1/110的接触者无症状感染。总体而言，所有病例的病死率都很高（6/20;30%）。接受利巴韦林治疗的患者死亡率低于未接受利巴韦林治疗的患者（p = 0.003）。死亡患者的平均就诊延迟为11 +/- 3.5天，而存活患者的平均就诊延迟为6 +/- 2.6天（p < 0.001）。结论：应对策略控制了疫情。控制工作面临的挑战包括地方实验室能力差、防护材料不足/质量差、卫生工作者的恐惧以及应急准备不足。(C) 2013年国际传染病学会。Elsevier Ltd.出版。版权所有。
Objectives: Despite the epidemic nature of Lassa fever (LF), details of outbreaks and response strategies have not been well documented in resource-poor settings. We describe the course of a LF outbreak in Ebonyi State, Nigeria, during January to March 2012.Methods: We analyzed clinical, epidemiological, and laboratory data from surveillance records and hospital statistics during the outbreak. Fisher's exact tests were used to compare proportions and t-tests to compare differences in means.Results: The outbreak response consisted of effective coordination, laboratory testing, active surveillance, community mobilization, contact and suspected case evaluation, and case management. Twenty LF cases (10 confirmed and 10 suspected) were recorded during the outbreak. Nosocomial transmission to six health workers occurred through the index case. Only 1/110 contacts had an asymptomatic infection. Overall, there was high case fatality rate among all cases (6/20; 30%). Patients who received ribavirin were less likely to die than those who did not (p = 0.003). The mean delay to presentation for patients who died was 11 +/- 3.5 days, while for those who survived was 6 +/- 2.6 days (p < 0.001).Conclusions: The response strategies contained the epidemic. Challenges to control efforts included poor local laboratory capacity, inadequate/poor quality of protective materials, fear among health workers, and inadequate emergency preparedness. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.