Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria
Abstract Lassa fever (LF) remains endemic in Nigeria with the country reporting the highest incidence and mortality globally. Recent national data suggests increasing incidence and expanding geographic spread. Predictors of LF case positivity in Nigeria have been sparsely studied. We thus sought to...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-04-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-33187-y |
| _version_ | 1797840981211480064 |
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| author | Chinwe Lucia Ochu Lorretta Ntoimo Ikenna Onoh Friday Okonofua Martin Meremikwu Sandra Mba Akanimo Iniobong Obinna Nwafor Mahmood Dalhat Cornelius Ohonsi Chinedu Arinze Ekpereonne Esu Ehimario Uche Igumbor Chioma Dan-Nwafor Elsie Ilori Ifedayo Adetifa |
| author_facet | Chinwe Lucia Ochu Lorretta Ntoimo Ikenna Onoh Friday Okonofua Martin Meremikwu Sandra Mba Akanimo Iniobong Obinna Nwafor Mahmood Dalhat Cornelius Ohonsi Chinedu Arinze Ekpereonne Esu Ehimario Uche Igumbor Chioma Dan-Nwafor Elsie Ilori Ifedayo Adetifa |
| author_sort | Chinwe Lucia Ochu |
| collection | DOAJ |
| description | Abstract Lassa fever (LF) remains endemic in Nigeria with the country reporting the highest incidence and mortality globally. Recent national data suggests increasing incidence and expanding geographic spread. Predictors of LF case positivity in Nigeria have been sparsely studied. We thus sought to determine the sociodemographic and clinical determinants of LF positivity amongst suspected cases presenting to health facilities from 2018 to 2021. A secondary analysis of the national LF surveillance data between January 2018 and December 2021. Socio-demographic and clinical data of 20,027 suspected LF cases were analysed using frequencies and Chi-square statistics with significant p-value set at p < 0.05. The outcome variable was LF case status (positive or negative). Predictors of LF case positivity were assessed using multiple logistic regression models with 95% confidence intervals (CI). Case positivity rate (CPR) for the four years was 15.8% with higher odds of positivity among age group 40–49 years (aOR = 1.40; 95% CI 1.21–1.62), males (aOR = 1.11; 95% CI 1.03–1.20), those with formal education (aOR = 1.33; 95% CI 1.13–1.56), artisans (aOR = 1.70; 95% CI 1.28–2.27), religious leaders (aOR = 1.62; 95% CI 1.04–2.52), farmers (aOR = 1.48; 95% CI 1.21–1.81), and symptomatic individuals (aOR = 2.36; 95% CI 2.09–2.68). Being a health worker (aOR = 0.69; 95% CI 0.53–0.91), a teacher (aOR = 0.69; 95% CI 0.53–0.89) and cases reporting in the 3rd quarter (aOR = 0.79; 95% CI 0.69–0.92) had lower odds. In a sex-disaggregated analysis, female farmers had higher odds of positivity (aOR = 2.43; 95% CI 1.76–3.38; p < 0.001) than male farmers (aOR = 1.52; 95% CI 1.19–1.96; p < 0.01). Fever (aOR = 2.39; 95% CI 2.00–2.84) and gastrointestinal (GI) symptoms (aOR = 2.15; 95% CI 1.94–2.37) had the highest odds among symptoms. Combination of fever and GI symptoms (aOR = 2.15; 95% CI 1.50–3.10), fever and neurological symptoms (aOR = 6.37; 95% CI 1.49–27.16), fever and musculo-skeletal symptoms (aOR = 2.95; 95% CI 1.37–6.33), fever and cardiopulmonary symptoms (aOR = 1.81; 95% CI 1.24–2.64), and cardiopulmonary and general symptoms (aOR = 1.50; 95% CI 1.19–1.89) were also predictive. Cumulative LF CPR appears high with clearly identified predictors. Targeted interventions with heightened index of suspicion for sociodemographic categories predictive of LF in suspected cases are recommended. Ethnographic and further epidemiological studies could aid better understanding of these associations. |
| first_indexed | 2024-04-09T16:23:31Z |
| format | Article |
| id | doaj.art-05e2c8f0350147d4a898208ec8a7cea8 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T16:23:31Z |
| publishDate | 2023-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-05e2c8f0350147d4a898208ec8a7cea82023-04-23T11:17:12ZengNature PortfolioScientific Reports2045-23222023-04-0113111210.1038/s41598-023-33187-yPredictors of Lassa fever diagnosis in suspected cases reporting to health facilities in NigeriaChinwe Lucia Ochu0Lorretta Ntoimo1Ikenna Onoh2Friday Okonofua3Martin Meremikwu4Sandra Mba5Akanimo Iniobong6Obinna Nwafor7Mahmood Dalhat8Cornelius Ohonsi9Chinedu Arinze10Ekpereonne Esu11Ehimario Uche Igumbor12Chioma Dan-Nwafor13Elsie Ilori14Ifedayo Adetifa15Department of Prevention Programmes and Knowledge Management, Nigeria Centre for Disease ControlDepartment of Demography and Social Statistics, Faculty of Social Sciences, Federal University Oye-EkitiDepartment of Health Emergency Preparedness and Response, Nigeria Centre for Disease ControlCentre of Excellence in Reproductive Health Innovation, University of BeninCochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching HospitalDepartment of Surveillance and Epidemiology, Nigeria Centre for Disease ControlDepartment of Health Emergency Preparedness and Response, Nigeria Centre for Disease ControlDepartment of Surveillance and Epidemiology, Nigeria Centre for Disease ControlDepartment of Prevention Programmes and Knowledge Management, Nigeria Centre for Disease ControlDepartment of Prevention Programmes and Knowledge Management, Nigeria Centre for Disease ControlDepartment of Surveillance and Epidemiology, Nigeria Centre for Disease ControlCochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching HospitalCentre for Infectious Disease Research, Nigerian Institute of Medical ResearchDepartment of Surveillance and Epidemiology, Nigeria Centre for Disease ControlDepartment of Surveillance and Epidemiology, Nigeria Centre for Disease ControlThe Office of the Director General, Nigeria Centre for Disease ControlAbstract Lassa fever (LF) remains endemic in Nigeria with the country reporting the highest incidence and mortality globally. Recent national data suggests increasing incidence and expanding geographic spread. Predictors of LF case positivity in Nigeria have been sparsely studied. We thus sought to determine the sociodemographic and clinical determinants of LF positivity amongst suspected cases presenting to health facilities from 2018 to 2021. A secondary analysis of the national LF surveillance data between January 2018 and December 2021. Socio-demographic and clinical data of 20,027 suspected LF cases were analysed using frequencies and Chi-square statistics with significant p-value set at p < 0.05. The outcome variable was LF case status (positive or negative). Predictors of LF case positivity were assessed using multiple logistic regression models with 95% confidence intervals (CI). Case positivity rate (CPR) for the four years was 15.8% with higher odds of positivity among age group 40–49 years (aOR = 1.40; 95% CI 1.21–1.62), males (aOR = 1.11; 95% CI 1.03–1.20), those with formal education (aOR = 1.33; 95% CI 1.13–1.56), artisans (aOR = 1.70; 95% CI 1.28–2.27), religious leaders (aOR = 1.62; 95% CI 1.04–2.52), farmers (aOR = 1.48; 95% CI 1.21–1.81), and symptomatic individuals (aOR = 2.36; 95% CI 2.09–2.68). Being a health worker (aOR = 0.69; 95% CI 0.53–0.91), a teacher (aOR = 0.69; 95% CI 0.53–0.89) and cases reporting in the 3rd quarter (aOR = 0.79; 95% CI 0.69–0.92) had lower odds. In a sex-disaggregated analysis, female farmers had higher odds of positivity (aOR = 2.43; 95% CI 1.76–3.38; p < 0.001) than male farmers (aOR = 1.52; 95% CI 1.19–1.96; p < 0.01). Fever (aOR = 2.39; 95% CI 2.00–2.84) and gastrointestinal (GI) symptoms (aOR = 2.15; 95% CI 1.94–2.37) had the highest odds among symptoms. Combination of fever and GI symptoms (aOR = 2.15; 95% CI 1.50–3.10), fever and neurological symptoms (aOR = 6.37; 95% CI 1.49–27.16), fever and musculo-skeletal symptoms (aOR = 2.95; 95% CI 1.37–6.33), fever and cardiopulmonary symptoms (aOR = 1.81; 95% CI 1.24–2.64), and cardiopulmonary and general symptoms (aOR = 1.50; 95% CI 1.19–1.89) were also predictive. Cumulative LF CPR appears high with clearly identified predictors. Targeted interventions with heightened index of suspicion for sociodemographic categories predictive of LF in suspected cases are recommended. Ethnographic and further epidemiological studies could aid better understanding of these associations.https://doi.org/10.1038/s41598-023-33187-y |
| spellingShingle | Chinwe Lucia Ochu Lorretta Ntoimo Ikenna Onoh Friday Okonofua Martin Meremikwu Sandra Mba Akanimo Iniobong Obinna Nwafor Mahmood Dalhat Cornelius Ohonsi Chinedu Arinze Ekpereonne Esu Ehimario Uche Igumbor Chioma Dan-Nwafor Elsie Ilori Ifedayo Adetifa Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria Scientific Reports |
| title | Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria |
| title_full | Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria |
| title_fullStr | Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria |
| title_full_unstemmed | Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria |
| title_short | Predictors of Lassa fever diagnosis in suspected cases reporting to health facilities in Nigeria |
| title_sort | predictors of lassa fever diagnosis in suspected cases reporting to health facilities in nigeria |
| url | https://doi.org/10.1038/s41598-023-33187-y |
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