Addressing Lassa Fever through Increased Funding

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Out of the five major diseases burdens under the purview of the Nigerian Centre for Disease Control, Lassa fever has continued to be a reoccurring burden with outbreaks and deaths still having its toll on Nigerians. Ayodeji Ake writes that with increased funding, the health challenge can be eradicated or reduced significantly

Lassa fever was first described in the 1950s, but virus causing Lassa disease was unidentified until researchers discovered a single stranded Ribonucleic Acid (RNA) virus belonging to the virus family Arenaviridae in 1969.

It became a heart aching disease that about 80 per cent of people infected by the virus at that time could rarely show symptoms of the disease, whereas their vital organs like the liver, spleen and kidney were being severely affected.

According to World Health Organisation (WHO), Lassa Fever is a zoonotic disease, which interprets that it could infect humans when they get in contact with infected animals. Not all animals but rodents.

However, animal reservoir, or host, of Lassa virus is a rodent of the genus Mastomys known as the ‘multimammate rat’. Mastomys rats infected with the virus do not become ill, but they shed the virus in their urine and faeces.

This has become a viral illness that occurs in Nigeria and other West African countries, which is transmitted to humans mainly through food or household items contaminated by infected rat’s urine or feaces and also by handling infected rat.

Lassa Fever symptoms, according to the world health body run between six and 21 days. Phase one of the symptoms include fatigue, general weakness and fever; the second phase includes headache, sore throat, vomiting, and diarrhea; the third phase symptoms are: face swelling, low blood sugar and nose bleeding.

Lassa Fever is known to be endemic in Guinea, Liberia and Mali, where it was diagnosed for the first time in February 2009. In 2011, it was first diagnosed in Ghana, and in Benin for the first time in November 2014.

Because the clinical course of the disease is so variable, its detection in affected patients has been difficult.

Outbreaks of Lassa Fever in Nigeria
Lassa fever from historic facts is as old as Nigeria’s independence. The first case was reported in the Lassa village, Borno State, Nigeria. Over the years there has been mortality which became louder as the year unfolds.

Since January 2019, 93 deaths and over 1279 suspected cases have been recorded by NCDC. In the reporting week, 52 new confirmed cases were reported; Edo had 23, Ondo had 11, nine from Ebonyi, one in Bauchi, Nasarawa recorded two, Plateau had, Taraba had four, as well as Delta State.
Intervention

The Nigeria Centre for Disease Control (NCDC) said it has since inception been involved in eradicating or minimising the impact of disease outbreaks.

The center added that it has lately been involved in engaging in both national multi-partner and multi-sectoral Emergency Operations Centre (EOC) to coordinate response activities, deploy national rapid response teams (NCDC, Federal Ministry of Agricultural and Federal Ministry of Environment) to Ondo, Edo, Ebonyi, Bauchi and Plateau and Taraba, as well as the establishment of state EOCs activated in Ondo, Edo, Ebonyi, Plateau states, among other interventions.

Preventions
On Lassa fever prevention, an epidemiologist, Dr. Lawal Bakare emphasised that the best and simplest ways are to ensure houses are crack free, floors are concreted and most importantly that Nigerians avoid keeping refuse in the home and beside where foodstuffs are kept.

“We need to be sure that rodents do not come in contact with human directly or indirectly. Bushmeat seekers should be extra careful. By indirectly, we mean do not let the blood, urine and feaces of rodents come in contact with your foods. Make your environment clean, sweep and mop floors when necessary.

“People should also ensure that their houses are rodents free. So those that have cracks in their houses should seal them up,” he said.

Curbing Outbreak Through Funding
The Chief Executive Officer, NCDC, Dr. Chikwe Ihekweazu told THISDAY that increased funding will enable the centre perform excellently in terms of availability of resource to carryout preventive and healthcare treatment functions.

He said: “Nigeria is a very large country with factors that increase our vulnerability to outbreaks; therefore our mandate to protect the health of Nigerians depends largely on availability of adequate resources. With increased funding, the centre will be in a better position to implement its functions.

“We can rapidly escalate activities such as acquiring improved technology for public health laboratory services, ensure full roll out of our digital surveillance system in all states, LGAs and health facilities, supporting establishment of state level public health EOCs, improved risk communications activities, among others. These will contribute to the prevention, early detection, quick response and control of disease outbreaks,” he said.

Ihekweazu noted that funding will also enable NCDC to provide optimum priority to preparedness and response activities. “We can conduct more simulation exercises to test our level of preparedness.

“It is important to note that increased funding for NCDC should be matched by state level allocation to health security as well. Ultimately, the mandate to respond to outbreaks starts with states and limited funding at the sub-national level will only lead to an over-dependence on NCDC’s capacity”, he said.

Also speaking on funding, the President, Nigerian Medical Association, Dr. Francis Faduyile concurred that funding will lead to improvement and curbing of disease outbreak.

“I believe there will be improvement in terms of controlling disease outbreak but the important thing is to channel the funds appropriately. For example, when we started having yellow fever in Nigeria, we did not have enough vaccine around and it is about how proactive we are as government in this country.

“On Lassa fever, we need to have a barrier between the animal that is causing Lassa infection and human being which has to do with educating the public most especially those living in the rural area,” he said.

NCDC Act

President Muhammadu Buhari in November 2018 signed the Bill for an Act to establish the NCDC, which was established since 2011.

On this note, Professor of Virology, Prof. Oyewale Tomori said the Act will aid in improving the funding capacity needed for running of the centre. He said this Act makes the centre a fully fledged parastatal that will now have its own budget line provided in the national budget annually.

Speaking further, he said the act permits the board of NCDC to create partnerships and fund raising capabilities for successful project implementation.

“This means the centre shall establish and maintain a fund to which the annual federal allocation will be credited. The NCDC can also get funds through fees and charges for services rendered by the centre; fees from publications; and such other sums accruing to the centre by way of gifts, grants, endowments, bequests, donations or voluntary contributions by persons or organisations including foreign aid and assistance from multilateral and bilateral organizations or agencies.

“One other source of funds could be allocations from other extra budgetary allocations from the Basic Health care Provision Fund (BHCPF),”he said.