Africa Disease Intelligence and Surveillance, Communication and Response (Afric DISCoR) Institute, Yaoundé, Cameroon.
Higher Institute of Health Sciences, Universite des Montagnes, Bangangte, Cameroon.
Infect Dis Poverty. 2018 Apr 28;7(1):37. doi: 10.1186/s40249-018-0421-8.
We evaluated the impact of man-made conflict events and climate change impact in guiding evidence-based community "One Health" epidemiology and emergency response practice against re-/emerging epidemics. Increasing evidence of emerging and re-emerging zoonotic diseases including recent Lassa fever outbreaks in almost 20 states in Nigeria led to 101 deaths and 175 suspected and confirmed cases since August 2015. Of the 75 laboratory confirmed cases, 90 deaths occurred representing 120% laboratory-confirmed case fatality. The outbreak has been imported into neighbouring country such as Benin, where 23 deaths out of 68 cases has also been reported. This study assesses the current trends in re-emerging Lassa fever outbreak in understanding spatio-geographical reservoir(s), risk factors pattern and Lassa virus incidence mapping, inherent gaps and raising challenges in health systems. It is shown that Lassa fever peak endemicity incidence and prevalence overlap the dry season (within January to March) and reduced during the wet season (of May to November) annually in Sierra Leone, Senegal to Eastern Nigeria. We documented a scarcity of consistent data on rodent (reservoirs)-linked Lassa fever outbreak, weak culturally and socio-behavioural effective prevention and control measures integration, weak or limited community knowledge and awareness to inadequate preparedness capacity and access to affordable case management in affected countries. Hence, robust sub/regional leadership commitment and investment in Lassa fever is urgently needed in building integrated and effective community "One Health" surveillance and rapid response approach practice coupled with pest management and phytosanitation measures against Lassa fever epidemic. This offers new opportunities in understanding human-animal interactions in strengthening Lassa fever outbreak early detection and surveillance, warning alerts and rapid response implementation in vulnerable settings. Leveraging on Africa CDC centre, advances in cloud-sourcing and social media tools and solutions is core in developing and integrating evidence-based and timely risk communication, and reporting systems in improving contextual community-based immunization and control decision making policy to effectively defeat Lassa fever outbreak and other emerging pandemics public health emergencies in Africa and worldwide.
我们评估了人为冲突事件和气候变化影响在指导基于证据的社区“同一健康”流行病学和应急响应实践方面的作用，以应对重新出现和新出现的传染病。越来越多的新发和再发人畜共患疾病的证据，包括最近在尼日利亚近 20 个州爆发的拉沙热，导致自 2015 年 8 月以来 101 人死亡，175 人疑似和确诊病例。在 75 例实验室确诊病例中，有 90 人死亡，病死率为 120%。该疫情已传入邻国贝宁，贝宁也报告了 68 例病例中有 23 人死亡。本研究评估了拉沙热再次爆发的当前趋势，以了解时空地理储库、风险因素模式和拉萨病毒发病率的制图、固有差距以及卫生系统面临的挑战。结果表明，塞拉利昂、塞内加尔到尼日利亚东部的拉沙热地方性流行的高峰期发病率和患病率与旱季（1 月至 3 月）重叠，并在雨季（5 月至 11 月）减少。我们记录了与啮齿动物（宿主）相关的拉沙热爆发的一致性数据稀缺，文化和社会行为预防和控制措施整合薄弱，社区知识和意识有限，准备能力不足，在受影响国家获得负担得起的病例管理能力有限。因此，迫切需要在建设综合有效的社区“同一健康”监测和快速反应方法实践方面，建立强有力的次区域领导承诺和投资，并结合虫害管理和植物检疫措施，应对拉沙热疫情。这为加强拉沙热早期检测和监测、在脆弱环境中发出警报和快速反应提供了新的机会。利用非洲疾病预防控制中心中心、云计算和社交媒体工具和解决方案的进步，是开发和整合基于证据和及时的风险沟通以及报告系统的核心，以改善基于社区的免疫和控制决策制定政策，有效应对拉沙热疫情和非洲及全球其他新发大流行公共卫生紧急情况。
