COVID-19: Ignoring Lassa Fever, Meningitis Will Cause Medical Disaster – Expert Warns

With the attention on the coronavirus pandemic, Nigeria has struggled with managing Lassa fever and other diseases.

Prof. Galadima Bala Gadzama, the Chairman, Infection Control Committee, University of Maiduguri Teaching Hospital (UMTH), has warned that Nigeria risked medical disaster if appropriate measures were not taken to tackle Lassa fever and prepare for the meningitis season.

According to data published by the Nigeria Centre for Disease Control (NCDC), Lassa fever suspected cases have increased by more than 50 per cent from January 1 to April 5 when compared to the whole of 2019.

That means 4, 287 suspected cases of Lassa fever have been recorded in a little over three months which translates to 963 confirmed cases and 188 deaths from confirmed cases.

Lassa fever has currently affected 27 states and 176 local government areas (LGAs). .This is more than double the spread of 2019 when 21 states and 74 LGAs were affected.

This spike has been attributed to several factors.

However, experts say that the vulnerability of the health system due to coronavirus has led to poor management of the outbreak.

Gadzama told HumAngle that “From March, April, May, that is the time we are expecting the outbreak of meningitis and also, we have been having sporadic breaks of Lassa fever.

“I always have a meeting with my committee and always tell them that we should look out for all these diseases. We should not just look out for COVID-19 alone.”

Globally, Meningitis affects about 2.8 million people each year. This disease remains a major public health challenge affecting countries in the African meningitis belt, where Nigeria falls.

In 2019, 15 states were affected in Nigeria. Meningitis cases have been found to occur throughout the year in the country with an increase during the dry season.

The disease is highly contagious and can kill within 24 hours, so recognising the symptoms early and acting fast is crucial.

Meningitis can affect anyone, however, infants, young children, adolescents and older people are at greatest risk, with major risk factors being overcrowding and poor ventilation.

Gadzama noted that although his centre at (UMTH had taken steps to prepare for Lassa fever, meningitis and COVID-19, on a national scale, Nigeria had not found a balance to tackle all three.

He said, “in our own facility, we have a group that handles bacteria like meningitis and we also have consultants that are virologists so we cannot mix the two, we always look out for all sessions that we have.

“We should not just pay attention to one direction. That could be a very big abnormality and we might overlook other diseases.

“On a national side, the COVID-19 pandemic has taken other medical equipment and personnel and this could be another limitation.

“In Lagos, for instance, I don’t think they can even cater to other diseases because they are now highly concentrated on COVID-19,” Gadzama said.

He suggested that various groups should be set up to tackle different diseases instead of putting all national efforts in one direction.

“We cannot just forget about things like malaria. We should just allow virologists to concentrate on coronavirus and Lassa fever, the bacteriologists should concentrate on meningitis.

“From what I am observing now, even bacteriologists have moved to virology which should not be, especially the experts. Let us allow the specialists to stick to one side and concentrate.

“Malaria, for instance has been with us for long so those people who have been managing it should continue,” Gadzama said.

Experts are also not impressed with the management of COVID-19, especially with the low testing and diagnostics.

With 407 cases in 20 states, Nigeria currently has only 12 diagnostic centres and they are not evenly spread across geo-political zones.

There is a deficiency of testing centres in the North.

Gadzama said, “In terms of management, we have enough manpower but it is a matter of approach.

“When it comes to the diagnostic aspect, I am not happy that the diagnostics centres are concentrated in one area in a deeply populated country like Nigeria.”

However, on Tuesday, the NCDC said that testing for coronavirus (COVID-19) was no longer its problem at the moment as it now had 12 molecular diagnostic laboratories across the country.

It instead said samples collections and other response activities were the major challenges to overcome.

The Director-General of NCDC, Dr Chikwe Ihekweazu, who disclosed this during the briefing of the Presidential Task Force on COVID-19, in Abuja.

Ihekweazu said aside from the country having the capacity to carry out 1,500 tests daily, it planned to increase the number of samples collected daily to 4,000.

He said it would collect 2,000 samples in Lagos, 1,000 in Abuja and 1,000 in the rest of the country.

He said, “never in the history of our nation has its entire future depended on actions of its public health workforce.

“The challenge right now is not the laboratory testing capacity, but how active our public health workforce is in collecting samples, identifying suspect cases, and sending them into the labs for testing.”

According to the NCDC boss, the focus for the government in the next two weeks is to replicate the overall efforts made in Lagos State in other states.

Gadzama told HumAngle that a specimen sent from Maiduguri would take about 72 hours before the result would come out for COVID-19 test.

He noted that the clustering of diagnostic centres in one part of the country would not help the management of the disease across the country.

According to him, the centres, spread all over the country and in rural areas, are important for other disease control apart from COVID-19. These diseases include Lassa fever and meningitis.

Gadzama said, “for instance, if I send my own specimen, it takes about 72 hours before the result would come out. They need to decentralise it.

“The whole of Northeast has no diagnostic centre and the lockdown has made it take at least two days before a sample can leave Maiduguri.

“My advice is that diagnostics centres should be placed in every geo-political zone, not just for coronavirus, to shorten the turnaround time.

“The shorter the turnaround time, the better the approach of managing the issue. We cannot quarantine a patient that you are not sure of his status to continue waiting for up to 72 hours.

“We ought to make these plans because every geo-political zone needs to have a diagnostics centre for most of the common diseases and the rural areas as well,” Gadzama added.