Health
COVID-19 response in southern Nigeria boosts surveillance of other diseases
In many countries, tackling the COVID-19 pandemic has taken cues from other disease approaches, such as lessons from protecting communities against Ebola. But in Nigeria’s Niger Delta, health workers have found inspiration from guarding against the coronavirus.
They have exploited the rigorous surveillance standard set by the COVID-19 response to keep from losing sight of other priority diseases. Mostly what they have learned is how not to divide their attention.
The unifying surveillance strategy they have enveloped is quickly producing significant and – possibly oddly – uplifting results.
“I recorded my first acute flaccid paralysis case since last year while I was following up on the contact of a confirmed case of COVID-19,” says Sarah Oladimeji, a Diseases and Surveillance Notification Officer in charge of finding cases of preventable and infectious diseases in Oredo Local Government Area of Nigeria’s Edo State.
When COVID-19 crept into the southern Delta region in April, health workers had to learn to overcome their worries and hunkered down to the needed work. The odds seemed stacked against the six states that make up the South-South zone: Akwa Ibom, Bayelsa, Cross River, Delta, Edo and Rivers. COVID-19 cases increased daily while community attitudes towards the virus grew lax. Health workers scrambled to manage the time and resources available to respond to both COVID-19 and other endemic-prone diseases.
One solution government teams and health workers hit upon: bring the aggressive COVID-19 surveillance into the systems used to monitor priority diseases.
Across the Niger Delta, the World Health Organization (WHO) and its partners retrained 3874 surveillance officers who had been mobilized to detect COVID-19 cases in hospitals and communities to also look for acute flaccid paralysis (AFP), polio, meningitis, cholera, neonatal tetanus, yellow fever, measles and more.
After the Government decentralized the COVID-19 response in April, some states began also training religious and community leaders – who are often important decision-makers, influencers and informants – to help find and report suspected COVID-19 and other priority diseases in their communities.
Now, four months into the region’s COVID-19 outbreak, health workers are seeing spectacular efficiency. Detected cases of AFP, for example, increased substantially (doubling and even tripling in one state) between the end of March and end of July as the harmonized surveillance ramped up.
Protecting immunization gains
Keeping eyes on both COVID-19 and other diseases, most of which are vaccine-preventable, is an important but challenging task in the Niger Delta where immunization coverage had been low for years. Located along the Niger River and the Gulf of Guinea, the Niger Delta, or South-South zone, comprises a system of coastal communities that rely on farming and fishing. Waterway systems here are often inadequate and moving around is difficult. In the past, residents in the deepest riverine communities, far from a mainland, had little luck accessing a health centre. Many were discouraged by the distance from taking their children for vaccinations, which led the region to its poor immunization coverage and thus heightened risk of disease outbreaks.
Since 2016, community engagement, better access to health care and increased surveillance have led to rising numbers of vaccinated children. Health workers now attend patients in on-sea treatment centres or travel into the deep-river communities by canoe to provide services.
Navigating the creek communities may be hard but health workers accept that medical care has no boundaries, says Dr Edmund Ogbe, WHO Coordinator for Bayelsa State. Public health commitment and resourcefulness seem to be ingrained characteristics of this region.
Increased detection of measles and yellow fever
To protect their gains in immunization coverage and keep from neglecting other worrisome diseases in these times of COVID-19, the integrated surveillance is making a difference. In March, Bayelsa State recorded nine cases of AFP. But 16 new cases were investigated over the next four months – a 180% increase.
With COVID-19 case findings now meshed with the systems used to detect and report priority diseases, more cases of measles and yellow fever are emerging, too. The reported numbers of both diseases increased considerably between the end of March and the end of July. In a couple states, case detection nearly doubled.
The next step will be to accelerate case search throughout the region. State governments in the South-South zone, supported by WHO, continue to train more surveillance officers and community informants on combining COVID-19 and preventable-disease surveillance. Involving communities by educating them and appointing them as public health informants will help ensure that the combined surveillance continues to be a success, says Dr Olubowale Ekundare Famiyesin, WHO Zonal Coordinator of the Niger Delta.
Early detection of any disease is the goal for health workers in the Delta. “All resources for surveillance at our disposal will be deployed to improve early infectious disease detection and reporting, including COVID-19,” Dr Famiyesin promises.
The Oyo State Ministry of Health has closed two hospitals in Saki West Local Government Area following a suspected outbreak of Lassa fever, which has claimed four lives.
The fatalities, confirmed by the Oyo State Rapid Response Team (RRT), include three males and a 32-year-old female who was preparing for her wedding. The closure of the hospitals aims to contain the spread of the disease and ensure thorough decontamination.
In a press statement issued by the Commissioner for Information and Orientation, Dotun Oyelade, the State Commissioner for Health, Dr. Oluwaserimi Ajetunmobi, revealed that the RRT was dispatched to Saki following distress calls from residents reporting mysterious deaths.
Findings and Immediate Actions
The RRT, comprising health officials, representatives from WHO and the Red Cross, and local health authorities, conducted a comprehensive investigation into the outbreak.
Preliminary findings suggest that an apprentice at one of the affected hospitals, who had recently returned from Iwajowa Local Government Area, might have introduced the infection.
The team disclosed that the deceased exhibited symptoms consistent with Lassa fever, such as craniofacial bleeding. The hospital owner, who was among the deceased, initially self-medicated with antimalarials and antibiotics before seeking hospital care when his condition worsened.
Containment Measures
Both the hospital where the fatalities occurred and the facility that admitted the hospital owner were shut down for decontamination.
Contact tracing efforts are ongoing, focusing on high-risk individuals who had contact with the deceased during their illness or burial.
Affected health workers were trained on Infection Prevention and Control (IPC) protocols, and public awareness campaigns were conducted to educate residents about Lassa fever.
Samples have been collected from a symptomatic individual, pending laboratory confirmation. Line-listing of contacts is underway to identify potential cases and prevent further spread.
Collaborative Efforts
The RRT also paid an advocacy visit to the Okere of Saki’s palace to brief traditional authorities on the situation. Local government officials in Saki West were engaged to coordinate containment strategies.
Reports indicate that while the outbreak initially affected Saki West, it has extended to Iwajowa and Kajola Local Government Areas.
Disease Surveillance and Notification Officers (DSNOs) in the affected LGAs have been instructed to commence preliminary containment measures as the State RRT ramps up its response.
Call for Vigilance
The Ministry of Health has urged residents to remain vigilant, report any symptoms suggestive of Lassa fever, and adhere to preventive measures.
These include proper hygiene practices, avoiding contact with rodents, and seeking medical attention promptly if symptoms arise.
A member representing Ibarapa East/Ido federal constituency of Oyo State at the House of Representatives, Engr. Aderemi Oseni, has announced a plan to launch a “Mobile Clinic” programme aimed at providing essential healthcare services directly to rural communities across the constituency.
Scheduled to begin in the first quarter of 2025, this initiative underscores Oseni’s commitment to expanding healthcare access, particularly for underserved populations.
Speaking on Saturday at the 10th-anniversary celebration of God’s Knot Hospital in Ologuneru, Ibadan, the lawmaker, who also chairs the House Committee on the Federal Roads Maintenance Agency (FERMA), highlighted the programme’s primary objective: bringing healthcare closer to the people.
“Every community deserves attention; healthcare should never be bound by geographical barriers,” Oseni stated.
He explained that the mobile clinics would deliver essential health check-ups, screenings, and preventive care in remote areas, allowing residents to access quality healthcare without traveling long distances.
As part of his broader healthcare agenda, Oseni informed, through a statement by his media aide, Idowu Ayodele, that he has already facilitated the construction of two fully equipped maternity centers within his constituency, both slated for commissioning before December 2024. He also disclosed plans to establish two modern general hospitals in 2025, further strengthening his commitment to building a healthier community.
The lawmaker expressed interest in collaborating with God’s Knot Hospital on the mobile clinic project, calling for partnerships to support sustainable healthcare initiatives that enhance the quality of life for vulnerable populations in the constituency.
“I resonate deeply with the mission of God’s Knot Hospital,” Oseni shared, adding that such partnerships would significantly improve healthcare in Oyo State”.
The anniversary event attracted distinguished guests, including former Ondo State Governor Dr. Olusegun Mimiko, whom Oseni commended for his contributions to healthcare, particularly through the Mother and Child Hospitals that transformed maternal and child healthcare in Ondo State.
Oseni urged philanthropists, government bodies, and international organizations to support healthcare projects like the upcoming mobile clinics, emphasising that the improvement of healthcare services is a shared responsibility.
The National Agency for Food and Drug Administration and Control (NAFDAC) has ordered the immediate closure of the Gomboru drug market in Maiduguri following severe flooding that submerged the area and contaminated the drugs sold within the market.
In a statement posted on its official X handle, NAFDAC disclosed that the decision was made after reports surfaced that contaminated drugs, which had been washed and sun-dried for resale, were being sold at the market.
“After the recent flooding in Maiduguri that submerged the Gomboru drug market where contaminated drugs were washed and sun-dried for resale, the @DGatNAFDAC ordered the immediate closure of the market to conduct a thorough shop-to-shop removal of these compromised drugs,” the agency wrote.
The flooding, which ravaged Maiduguri, was triggered by the rupture of the Alau dam on the Ngadda River, located 20 kilometers (12 miles) south of the city.
The floodwaters claimed at least 30 lives and displaced 400,000 residents, leaving large parts of the city and surrounding areas in devastation.
NAFDAC’s intervention is aimed at safeguarding public health by preventing the sale and consumption of contaminated drugs.
The agency has mobilized teams to inspect the market and ensure the removal of all compromised pharmaceutical products.
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