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Screening for Ebola must continue in Nigeria

by hr

From time to time we have to revisit the issue of Ebola. Although Nigeria has been declare ‘Ebola Free’ recently by World Health Organization (W.H.O), nevertheless we should not go to sleep. This is because 3 countries in West Africa that aren’t far from Nigeria are still harboring the disease. As a country we should never lose sight of the bigger picture of how porous our borders could be and intensify surveillance as well as Ebola screening in our domestic and international airports as well as sea ports and our road borders.

As a regular traveler traversing both domestic and international wings of our airports in Nigeria, I notice laxity in the Ebola screening, sometimes passengers are screen and sometimes not, this attitude is risky and can make a difference between ‘Free Ebola country’ and ‘Ebola Country’. If one infected person passes through the airport terminals without been screened, that’s enough to lead to outbreak. I call on the Airport Management and Port Health Directorate of the Federal Ministry of Health not to relent in ensuring all passengers at all-time are screen for Ebola.

Having said that, let me provide a summary of what is going on in West Africa regarding Ebola as reported in detail by W.H.O. “A total of 18 603 confirmed, probable, and suspected cases of Ebola Virus Disease (EVD) have been reported in five affected countries (Guinea, Liberia, Mali, Sierra Leone, and the United States of America) and three previously affected countries (Nigeria, Senegal and Spain) in the seven days to 14 December (week 50). There have been 6915 reported deaths.

Reported case incidence is fluctuating in Guinea and declining in Liberia. In Sierra Leone, there are signs the increase in incidence has slowed, and that incidence may no longer be increasing. The case fatality rate in the three intense-transmission countries among all cases for whom a definitive outcome is recorded is 70%. For those patients recorded as hospitalized, the case fatality rate is 60% in each of Guinea and Sierra Leone, and 58% in Liberia.”

W.H.O reported that interventions in the three most-affected countries continue to progress in line with the UN Mission for Ebola Emergency Response aim to isolate and treat 100% of EVD cases and bury safely and with dignity 100% of EVD-related fatal cases by 1 January, 2015. At a national level, there is now sufficient bed capacity in EVD treatment facilities to treat and isolate all reported EVD cases in each of the three countries, although the uneven distribution of beds and cases means serious shortfalls persist in some districts. At a national level, each country has sufficient capacity to bury all people known to have died from Ebola, although it is possible that in some areas capacity remains inadequate.

Taking into account the number of cases as a proportion of an affected country’s population, there have been 22 reported cases and 14 deaths per 100 000 population in Guinea, 197 cases and 83 deaths per 100 000 population in Liberia, and 145 cases and 36 deaths per 100 000 population in Sierra Leone.

A stratified analysis of cumulative confirmed and probable cases indicates that the number of cases in males and females is about the same. There have been 65 reported cases per 100 000 population in males, compared with 66 per 100 000 in females.

Overall, compared with children, people aged 15 to 44 are three times more likely to be affected (83 per 100 000 population, compared with 28 per 100 000 population). People aged 45 and over are almost four times more likely to be affected (106 reported cases per 100 000 population, compared with 28 per 100 000). This applies to all three intense-transmission countries.

  1. In Guinea specifically a total of 76 new confirmed cases were reported nationally during the week to 14 December ad reported by WHO . The national trend in Guinea has been fluctuating since September, with between 75 and 148 confirmed cases reported each week. There is no clear upward or downward trend in national case incidence.
  2. In Liberia case incidence has been declining at a national level, with 6 districts reporting new confirmed or probable cases in the week to 14 December. A total of 8 confirmed cases were reported, but this case count accounts for only two days.
  3. In Sierra Leone, EVD transmission remains intense in Sierra Leone, with 327 new confirmed cases reported in the week to 14 December. While there are signs from the country situation reports that the increase in incidence has slowed and the incidence may no longer be increasing. WHO, UN partners and the Government of Sierra Leone have implemented the Western Area Surge, an operation to intensify efforts to curb the disease in the western parts of the country. The response targets Freetown and neighboring areas to break chains of transmission, and increase the number of beds to ensure patients with clinical symptoms of EVD are isolated and receive appropriate treatment. WHO is training national surveillance officers, epidemiologists and clinical teams to staff new treatment centres. WHO is also assessing infection prevention and control standards in health-care facilities, to maximize the protection of health-care workers and patients.

It is wise to conclude that with these development in the neighboring countries, we must be vigilant and intensity screening of all visitors at all time and to equally lend our support to our neighboring countries to also tame the spread of Ebola.

!st published in Daily Trust Newspaper of 23rd Dec 2014 by  Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)  

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