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Lassa fever in Nigeria: ALIMA treats patients despite lack of funding

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Nigeria
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ALIMA
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A new outbreak of Lassa fever has been affecting Nigeria since late 2019. Since January, more than 500 confirmed cases have been recorded, and 26 of the country's 36 states are currently affected. ALIMA (The Alliance for International Medical Action) is treating patients at the Owo Federal Medical Center in Ondo State in support of local health authorities.

Since December 2019, our teams have been supporting the free medical care of confirmed Lassa fever patients admitted to the Owo Federal Medical Center,” said Dr. Issaley Abdel-Kader, ALIMA’s medical coordinator in Nigeria. “We are seeing a 33% increase in the number of cases this year, compared to the previous outbreak."

Particularly endemic and contagious during the period from December to March, Lassa fever can be life-threatening. According to the World Health Organization, the number of confirmed cases reported in the country remains high. The Nigeria Centre for Disease Control (NCDC) says that there are more than 500 cases signaled since the beginning of the year. The majority of these cases have been reported in Ondo State, where ALIMA teams are working daily to save lives. Currently, 33 patients are hospitalized within the Infection Treatment Center of the Federal Medical Center in Owo.

As a reminder, in 2019, ALIMA treated 15 patients, among whom 276 were cured. At the national level, ALIMA has thus contributed to the treatment of one third of the patients with Lassa fever. Our activities are a continuation of our first response in 2018, in collaboration with the NCDC.

Lack of funding and staff

The current outbreak is not surprising. According to Jackson Katembo, ALIMA's Lassa project coordinator in Owo: "We have been preparing for several months, but the major difficulty lies in the lack of funding to treat the first confirmed cases.”

Currently, the medical team at the Treatment Centre is composed of 6 doctors, 21 nurses, and 19 hygienists who have benefitted from training before the outbreak.

"Most of the health workers responding to the Lassa outbreak previously participated in capacity-building sessions organized by ALIMA," Jackson said. “Unfortunately, the lack of funding makes the current human resources insufficient given the workload due to the increasing number of cases. The local capacity-building strategy is in line with ALIMA's goal of building on local expertise to provide quality patient care.”

Despite his position as coordinator of the Lassa Fever response, Jackson does not hesitate to put on PPE (Personal Protective Equipment) suits each day, to enter into the "high-risk" zone, where patients are hospitalized. A nurse by profession, Jackson performs medical procedures to assist overworked medical staff.

Survivor care and research hopes

Since the beginning of the year, 89 people have been cured at the Owo Federal Medical Centre. These patients are followed up for a minimum of two months. Each week, they come for a medical consultation at an ALIMA-supported clinic.

Lassa fever is among one of the most neglected tropical diseases. There is only one available treatment, which consists of the use of ribavirin, a high-cost medication. There is currently no vaccine against Lassa.

For a better management of the disease, ALIMA in partnership with the National Institute of Health and Medical Research (INSERM 1219), via the ALERRT consortium (The African coaLition for Epidemic Research, Response and Training) and the University of Oxford, are conducting two research programs.

"The first is an observational study to better understand the dynamics of the disease and the second is to study the pharmacokinetics and cardiovascular components of Lassa fever treatment," explains Camille Le Gal, the Scientific Research Coordinator for ALIMA in Owo. She adds that a clinical trial is planned for 2020, which will aim to identify an alternative treatment to ribavirin. "We remain hopeful, but are only at the beginning stages, as other important steps are needed before a vaccine and/or a treatment drug can be considered," she says.