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Lassa fever: Death of doctors, sign of deplorable medical practice – Tomori

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Oyewale Tomori, a formost virologist, is the Chairman of Biovaccines Nigeria Limited and former President of the Nigerian Academy of Science (NAS). In this interview with APPOLONIA ADEYEMI, he discusses factors fuelling Lassa fever including increasing human-rodent contact, inactions of state governments, and poor attitude of health workers to hygiene, among others

 

What are the factors making Lassa fever to resurge in the country?

Lassa fever for the last 10 years has been a common feature of the disease profile of Nigeria. We record an average of 10 to 15 cases per week, with significantly higher number of cases during the dry season October, November, March and April.

Several factors are responsible for our failure to effectively bring Lassa fever under control, including: the increasing human-rodent contact from our filthy environment which attract rodents; a perpetual lack of awareness of the epidemiology of the disease; failure to institutionalise effective infection control practice in our hospitals and health centers; poor disease surveillance and inadequate laboratory support; and increasing and closer contact with rodents attracted by our filthy environment.

What are the federal and state governments not doing right?

It is more of what the state governments are not doing right. The disease predominantly occurs in rural settings, with attendant transmission within our hospitals in urban centers. Therefore, the first line of detection and response is at the state or local government area (LGA) level.

The Federal Government has rightly set up appropriate committees to advise on the annual outbreaks. Implementing the reports of the Committee is primarily the duty of the Federal Government, which sets up the committees in the first place. This is not to absolve the state governments, which regularly collect their monthly financial allocations, but forget to spend a kobo on disease surveillance, prevention and control

What’s your take on more health workers that are killed by Lassa fever?

For Lassa fever to, annually reap a harvest of health workers – physicians, nurses and others, is not only sad for the nation, but it is also a reflection of the deplorable standard of medical practice in Nigeria. Next year, it will be 50 years since Lassa fever was first reported in Nigeria. We should all hang our heads in shame for the unacceptable occurrence of Lassa fever in Nigeria.

I say all of us, because we all know what to do – the government, the medical profession, the media, and the citizens-. But we will not do what we know is right. When Ebola came visiting, the government immediately declared a national emergency, provided adequate resources and continually provided correct information to the people. As soon as we overcame Ebola, we went back to sleep.

Certainly high government officials were scared to death by the possibility of Ebola Virus Disease (EVD) spreading all over the country. The fear of Ebola brought our nation to her senses, but we have lost “respect” or fear for Lassa fever, and as long as those we deem important have not died of Lassa fever, so we will continue to treat the disease with neglect and disdain

 

What did these dead health workers not do right?

Many things – there is a profound lack of awareness of health workers, of the ever present danger of Lassa fever infection in Nigeria, and it is obvious that health workers are not adhering to the guidelines of infection control in the hospitals and health clinics. Our health workers are needlessly exposing themselves to danger of infection and death from Lassa fever and other diseases.

 

What should Nigeria do to contain this disease?

We need to improve disease surveillance, ensure we have sufficient numbers of well-equipped laboratories provided with adequate supply of diagnostic reagent and provide personal protective equipment (PPE) for health workers in our hospitals and clinics. In addition, we should ensure that our hospitals must have adequate supply of appropriate drugs, public awareness about Lassa fever should be a continuous exercise and it is time Nigeria committed to finding and testing Lassa fever vaccines for preventive campaign.

 

 

Is this disease curable and why is it killing people?

Yes, it is one of the few virus diseases for which there is a drug for treating cases, However, cases must be detected early for treatment to commence on time. Commencing treatment too late in the course of the disease may increase the severity of the disease and lead to death.

 

What is the state of our laboratories for Lassa fever diagnosis?

It is deplorable to say the least. With just two or three labs having competence for Lassa fever diagnosis in Nigeria, we are far from providing rapid diagnostic confirmation for Lassa fever cases.

Most of the samples collected from Lassa fever patients is tested in the Lassa fever center in Irrua, Edo State. Getting samples to Irrua is a difficult venture and experience.

 

What is the role individual, families, health care workers in preventing and containing the spread of Lassa fever?

To prevent Lassa fever: promote good “community hygiene” to discourage rodents from entering homes.

• store grain and other foodstuffs in rodent-proof containers,

• dispose of garbage far from the home,

• maintain clean households and keep cats off the homes.

• avoid contact with blood and body fluids while caring for sick persons.

In health-care settings, when caring for patients, regardless of their presumed diagnosis, apply standard infection prevention and control precautions – basic hand hygiene, respiratory hygiene, use of PPE and apply safe injection practices.

While in the laboratory, samples taken from humans and animals for investigation of Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories.

Similarly, while at home, ensure safe practices for burying dead people.

To conclude, governments at the at state and federal levels need to do more on the issue of disease surveillance and laboratory diagnosis, not just for Lassa fever, but also for other diseases. We have the resources to do this, but we will not because we value the health and life of our people much less than the health and life of cows.

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Health

National hospital receives 2nd cancer treatment machine

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The National Hospital, has taken delivery of the second Radiotherapy machine for Cancer treatment,  in Abuja on Monday. The Elekta machine for Linear Accelerator (LINAC) is made up of several components to be coupled and installed soon.

Speaking in a brief interview at the hospital, the Chief Medical Director (CMD), National Hospital, Dr. Jeff Momoh, said the Abuja Radiotherapy centre would be the only centre in West Africa running two Linear accelerators at the same time. This, the CMD explained, was to avoid running down the 1st machine which has currently treated over 200 patients.

Describing the arrival of the 2nd machine as a major breakthrough for the country, the CMD said its installation would further check medical tourism as patients who travelled abroad for cancer treatment would return home to receive treatment at the centre.

In his words, “A cancer patient has returned from India for treatment at the centre and we will soon see patients from other sub-regions receiving cancer treatment in the hospital because with the state of the art equipment available, it will be the best Cancer treatment centre in West Africa”

Commending the Minister of Health, Professor Isaac Adewole, for seeing to the delivery of the machine, Dr. Momoh informed that the procurement of the second machine was made possible by the unflinching commitment of the minister who had earlier made a pledge to the hospital in that regards.

According to Momoh, similar machines would soon be installed in each of the six geopolitical zones in the country.

On the maintenance and optimum functionality of the Cancer machine, the CMD said the Hospital has fully trained the First set of Nigerians on the maintenance and supervision of the Linear Accelerator under the supervision of Engr. Ikede John, a Deputy Director in the National Hospital, Abuja, to ensure its proper use.

To ensure safe delivery of the machine was, the representative of its manufacturer, JNC International Ltd, Engr. Wale Akinola.

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UNICEF says world is failing newborn babies

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Global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries, UNICEF said today in a new report on newborn mortality.

Every year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born.

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report said. In high-income countries, that rate is three deaths per 1,000.

“While we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old,” said Henrietta H. Fore, UNICEF’s Executive Director.

“Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”

The report notes that eight of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. With the newborn mortality rate of 29 deaths per 1,000 births, the global estimates rank Nigeria as the 11th highest on newborn deaths.

In the recent Multiple Indicator Cluster Survey (MICS) conducted by the Government of Nigeria in 2016/17, the rate of newborn deaths per 1000 births is 37. This national average hides the differences between the 36 states and the slow progress in some of them.

“A fair chance in life begins with a strong, healthy start. Unfortunately, many children in Nigeria are still deprived of this,” said Mohamed M Fall, UNICEF Nigeria’s Representative. “MICS data tells us that the trend is improving but urgent action needs to be taken for Nigeria to reach the Sustainable Development Goals (SDGs). It cannot afford to fail its newborns today.”

More than 80 per cent of newborn deaths are due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis.

These deaths can be prevented with access to well-trained midwives during antenatal and postnatal visits as well as delivery at a health facility, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact, proper cord care, and good nutrition.

 However, a shortage of well-trained health workers and midwives means that thousands don’t receive the life-saving support they need to survive.

This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns. Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by:

Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;

Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;

Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and

Empowering adolescent girls, mothers and families to demand and receive quality care.

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Health

New blood test shows promise for early autism detection

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Scientists yesterday said a new blood and urine test that could detect autism early in children’s urine and blood, was underway.

 

The researchers from the University of Warwick, United Kingdom (UK), said their test could lead to earlier diagnosis of autism spectrum disorders (ASD), a major factor that was key in the management of children living with the condition.

 

A new study, which unveiled this development, was published in the Molecular Autism journal. Autism, or ASD, refers to a range of conditions characterised by challenges with social skills, repetitive behaviours, speech and non-verbal communication, as well as by unique strengths and differences.

 

Diagnosing autism over the years, especially in developing countries including Nigeria, has been a difficult task and this, in addition to poor awareness about the condition, poverty and stigma, had contributed to make many cases go undiagnosed until very late when affected children had become adults.

 

However, scientific evidence showed that early detection of autism and medical intervention, often resulted in good treatment outcomes, enabling many autistic children achieve independent living. Currently, there were no biological tests that can spot autism, which was often diagnosed through behavioural assessments by clinicians.

 

Often the personnel and equipment for conducting these tests were available in mainly health facilities located mostly in urban centres, leaving thousands of autistic kids from poor background in rural farto- reach communities, unable to access the therapy. In the new study, researchers tested children with and without autism and found higher levels of protein damage in those with the disorder.

 

They looked for chemical differences in the blood and urine of 38 autistic children and 31 children without the condition, all aged between five and 12. In those with autism they found higher levels of protein damage, particularly in the blood plasma, which they said were associated with illhealth.

 

Dr. Naila Rabbani from the University of Warwick, who led the study, said the tests could ultimately be used by doctors to diagnose autism earlier in childhood by detecting these markers. Rabbani added that she hoped the tests could also eventually reveal some of the factors that cause autism and improve its diagnosis.

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