Factors associated with late presentation for Lassa fever treatment among symptomatic cases in Ondo State, Nigeria

Ipadeola, Abiodun F. and Olasehinde, G. I and Akinnola, Olayemi O. and Kolawole, Olatunji Mathew and Ejikeme, Adaora Rosemary and Ipadeol, Oladipupo Banji (2023) Factors associated with late presentation for Lassa fever treatment among symptomatic cases in Ondo State, Nigeria. PAMJ: One Health, 10 (6). ISSN 2707-2800

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Abstract

Introduction: this study assesses the sociodemographic factors associated with late presentation among suspected Lassa fever (LF) cases in Ondo State, Nigeria. Late presentation was determined as presentation to treatment center after sixth day of onset of symptom. Methods: a cross-sectional study conducted among suspected LF cases who presented at Federal Medical Center, Owo Ondo State, Nigeria. Patient level data from December 2019 to May 2020 was extracted from medical records including socio-demographic variables, test outcomes and treatment outcomes. Descriptive statistics was conducted to measure the distribution of the disease and Chi-Square analyses to determine statistical association while multiple logistic regression analysis was used to identify significant determinants. Results: of the 992 suspected cases extracted, 332 (33.47%) tested positive for LF with mean age 34.60 (SD-20.0). Owo local government area (LGA) (52.0%) recorded the highest number of positive cases compared to other LGAs. A total of 421 (42.5%) suspected LF cases presented at the treatment center later than the sixth day of onset of symptoms. Location, locality, and outcome of test presentation were significantly associated with late presentation, while cases that presented at the treatment center after the sixth day of onset of symptoms had higher odds of mortality (P<0.001). Conclusion: residence in rural areas and months of suspicion of LF were associated with late presentation to treatment center in Ondo State. Provision of treatment in rural communities and all year awareness about LF will prevent late presentation, community-based disease transmission and improve quality of care and chances of survival of cases. Introduction Nigeria is one of the West African countries well known for Lassa fever (LF), a zoonotic acute febrile viral illness [1]. It can be transmitted by “multimammate rat”, an indigenous animal in sub-Saharan Africa including Nigeria. This rat specie carries Arenavirus known as the Lassa virus (LASV) which causes hemorrhagic fever in infected persons. Individuals who are infected with this virus present symptoms such as “fever, muscle aches, sore throat, cough, nausea, vomiting, chest and abdominal pain alongside bleeding from the orifices” [2]. However, the virus is mostly asymptomatic in 80% of infected cases [2,3]. Therefore, an accurate diagnosis will require test assays that can detect all existing strains of the virus [4]. Lassa virus is contracted from ingestion of foods/water contaminated with urea and excreta of infected multimammate rat, inhalation of virus particles, or from eating infected rat [2]. Transmission from one person to another person through contacts with blood and sweat of someone who already has the virus has been reported, and transmission is usually common in households or healthcare facilities [5]. Because symptoms of this disease are not specific, there are higher tendencies of transportation of the virus across non-endemic regions, thereby putting unaffected regions at risk of an outbreak and widespread transmission [6]. While symptoms of LF resemble that of malaria and typhoid fever, laboratory diagnosis is performed through “Enzyme Linked Immunosorbent Serologic Assays (ELISA)” [2]. Currently, LF has no approved or known vaccine, but Ribavirin is widely used for treatment (Muse et al. 2020). Since its discovery over 51 years ago, LF is increasing in transmission with limitations in grounded understanding of the disease and the need for further research to fully address unanswered public health concerns. One area of potential work is in developing LF vaccines, which would be key in curtailing the disease [7]. However, this remains a research gap till date as no studies have presented any preventative remedy to this endemic disease. To this end, infected persons are advised to present early to treatment facilities, so they can receive prompt treatment for better chances of survival [8]. Unfortunately, health seeking behavior remains questionable, especially in Nigerian rural communities where numerous

Item Type:	Article
Uncontrolled Keywords:	Lassa fever, late presentation, onset of symptoms, mortality, Ondo State, Nigeria
Subjects:	Q Science > QH Natural history Q Science > QR Microbiology
Divisions:	Faculty of Medicine, Health and Life Sciences > School of Biological Sciences
Depositing User:	ORIGBOEYEGHA
Date Deposited:	10 Jul 2024 09:49
Last Modified:	10 Jul 2024 09:49
URI:	http://eprints.covenantuniversity.edu.ng/id/eprint/18179

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