A case study of high burden disease lassa fever in resource constrained setting implementing primary health care services
1African Field Epidemiology Network (AFENET) -CDC-NSTOP Kano State, Nigeria.
2State Emmergency Routine Immunization Coordination Center, State Primary Health Care Board, Kaduna, Nigeria.
3Department of Paediatrics, University of Jos/ Jos University teaching Hospital, Jos, Nigeria.
4Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Bingham University, Jos Campus, Nigeria.
5 Department of Community Medicine & Primary Health Care, College of Medicine and HealthSciences, Bingham University, Jos Campus, Nigeria.
6 National Primary Health care Development Agency, Abuja, Nigeria.
7Accident and Emergency Department, Federal Medical Center Azare, Bauchi State, Nigeria.
8Department of Microbiology, Kaduna State University, Nigeria.
Short Communication
World Journal of Biology Pharmacy and Health Sciences, 2020, 02(03), 051-057.
Article DOI: 10.30574/wjbphs.2020.2.3.0035
Publication history:
Received on 28 May 2020; revised on 17 June 2020; accepted on 18 June 2020
Abstract:
The challenge of hyperendemicity of Lassa fever in tropics amidst the current covid -19 pandemic is more devastating. Nigeria and the entire west coast of Africa needs more research, advocacy and welfare support in order to curb the narrative. A 43 year old multiparous pregnant woman at term was referred from a Clinic in Kamuru Ikulu, Zangon kataf LGA to a Mission Hospital in Zonkwa, Kaduna State, Nigeria on February 2016. She exhibited overt vaginal bleeding and absence of foetal movements at presentation. Placental previa was revealed through ultra sound that necessitated an emergency Caesarean Section on the patient by the Medical practitioner, assisted by his team a Nurse and a Community Health Worker. The patient’s Glasgow Coma Scale post up was 6/15. The patient died after the surgery while the doctor and the nurse manifested symptoms of Lassa fever. Following the observation, the doctor and the nurse eventually died after 2 and 3 days respectively. Contact tracing involving 33 persons that had physical contact with the index case was carried out in Lisiru, the clinic in Kamuru as well as the Hospital in Zonkwa using structured verbal interviews and blood sample testing. Seventeen (17) of the 33 persons however, exhibited suspected indices of Lassa fever. Blood samples of the index case, 3 health personnel that were involved in the surgery were sent to the Laboratory at Irrua Specialist Hospital, Edo State, Nigeria for Lassa virus molecular investigations. The ELISA test confirmed the index case, the doctor, nurse and one of the 17 suspected contacts as Lassa virus positive while the community health worker and rest 16 turned out to be negative. The positive contact patient was transferred to the contact. Furthermore, the Lassa positive individual was withdrawn to the Infectious Disease Control Centre Kaduna for effective medical care. She recovered and was discharged after 10 days of management with Ribavirin and other supportive therapeutic agents. However, the other 16 and the health worker were followed up for 14 days in other to ascertain their health status. There was delay in the diagnosis of the index case as a result of emergent circumstance that required urgency. The epidemiological knowledge gathered from this case is that Lassa fever is likely endemic in Zangon Kataf LGA and that Ribavirin proved to be the effective drug used in the management of the female positive case that survived the Lassa fever.
Keywords:
Delayed Diagnosis; Multiparous Pregnant Woman; Ultrasound; Vaginal Bleeding, Health Workers; Contact Tracing; Lassa Fever; Endemic
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Copyright © 2020 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0