Clement Glèlè Kakaī, MD, is Director of Epidemiological Surveillance and Border Health Surveillance Service, and Godjedo Togbemabou Primous Martial, MPH, is Division Director of Epidemiology and Integrated Disease Surveillance; both in the National Directorate of Public Health, Ministry of Health, Cotonou, Benin. Oyeladun Funmi Okunromade, MBBS, is Assistant Director Surveillance/IHR, Department of Surveillance and Epidemiology; Chioma Cindy Dan-Nwafor, MPH, is Deputy Incident Manager, Lassa fever, Department of Surveillance; Elsie Ilori, MSc, is Director and Incident Manager, Lassa fever, Department of Surveillance; Olubunmi Eyitayo Ojo, MSc, is Director, Disease Surveillance and Epidemiology; and Chikwe Ihekweazu, MD, is Director General; all in the Nigeria Centre for Disease Control, Federal Ministry of Health, Abuja, Nigeria. Ali Imorou Bah Chabi, MPH, is Health Program Coordinator, Health Program, and Idrissa Kone, MBA, is Executive Secretary; both in the Abidjan Lagos Corridor Organization, Cotonou, Benin. Mahmood Muazu Dalhat, MBBS, is Technical Advisor to the National Centre for Disease Control, Public Health Technical Department, and Patrick Mboya Nguku, MSc, is Senior West Africa Regional Technical Coordinator; both at the African Field Epidemiology Network (AFENET) Nigeria, Abuja, Federal Capital Territory, Nigeria. Sarah Ward, MPH, is a Health Scientist, and Rebecca D. Merrill, PhD, is an Epidemiologist; both in the Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA. Ouyi Tante, a public health engineer, is National Cholera Officer and Other Diarrheal Diseases, Division of Disease Control; Assane Hamadi, MD, is Head of the Division of Integrated Surveillance of Health Emergencies and Response, Directorate of Disease Control and Public Health Programs; and Tamekloe Tsidi Agbeko, DrPH, is Director, Division of Disease Control; all in the Ministry of Health, Lomé, Togo. Virgil Lokossou, MPH, MSci, is Head of Division and Team Lead, Emergency Preparedness and Response Division, and Carlos Brito, MD, is Director, Public Health and Research; both in the West Africa Health Organization, Bobo Dioulasso, Burkina Faso. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention or other participating agencies.
Health Secur. 2020 Jan;18(S1):S105-S112. doi: 10.1089/hs.2019.0080.
Long-standing cultural, economic, and political relationships among Benin, Nigeria, and Togo contribute to the complexity of their cross-border connectivity. The associated human movement increases the risk of international spread of communicable disease. The Benin and Togo ministries of health and the Nigeria Centre for Disease Control, in collaboration with the Abidjan Lagos Corridor Organization (a 5-country intergovernmental organization) and the US Centers for Disease Control and Prevention, sought to minimize the risk of cross-border outbreaks by defining and implementing procedures for binational and multinational public health collaboration. Through 2 multinational meetings, regular district-level binational meetings, and fieldwork to characterize population movement and connectivity patterns, the countries improved cross-border public health coordination. Across 3 sequential cross-border Lassa fever outbreaks identified in Benin or Togo between February 2017 and March 2019, the 3 countries improved their collection and sharing of patients' cross-border travel histories, shortened the time between case identification and cross-border information sharing, and streamlined multinational coordination during response efforts. Notably, they refined collaborative efforts using lessons learned from the January to March 2018 Benin outbreak, which had a 100% case fatality rate among the 5 laboratory-confirmed cases, 3 of whom migrated from Nigeria across porous borders when ill. Aligning countries' expectations for sharing public health information would assist in reducing the international spread of communicable diseases by facilitating coordinated preparedness and responses strategies. Additionally, these binational and multinational strategies could be made more effective by tailoring them to the unique cultural connections and population movement patterns in the region.
贝宁、尼日利亚和多哥之间长期存在的文化、经济和政治关系，使得它们之间的跨境互联互通变得复杂。这种相关的人口流动增加了传染病国际传播的风险。贝宁和多哥卫生部以及尼日利亚疾病控制中心与阿比让-拉各斯走廊组织（一个由 5 个国家组成的政府间组织）和美国疾病控制与预防中心合作，通过定义和实施双边和跨国公共卫生合作程序，努力将跨境疫情暴发的风险降到最低。通过 2 次跨国会议、定期的双边地区会议以及实地考察以确定人口流动和连通模式，这些国家改善了跨境公共卫生协调。在 2017 年 2 月至 2019 年 3 月期间，贝宁或多哥连续发生了 3 次跨境拉沙热疫情，三国改进了对患者跨境旅行史的收集和共享，缩短了从病例发现到跨境信息共享的时间，并简化了应对期间的跨国协调。值得注意的是，三国利用从 2018 年 1 月至 3 月期间贝宁暴发疫情中吸取的经验教训，改进了合作努力，该次疫情的 5 例实验室确诊病例中有 100%的病死率，其中 3 例在生病时从尼日利亚经多孔边境迁移而来。协调各国对共享公共卫生信息的期望，将有助于通过促进协调的防备和应对战略来减少传染病的国际传播。此外，通过针对该地区独特的文化联系和人口流动模式来调整这些双边和跨国战略，可以提高它们的有效性。
