A Retrospective Study of the Seroprevalence of Dengue Virus and Chikungunya Virus Exposures in Nigeria, 2010-2018.

Arboviruses are important public health threats in many regions of the world. Nigeria has experienced outbreaks of arboviruses over the past decades, leading to concerns of widespread endemicity, which are frequently misdiagnosed. This study aimed to determine the seroprevalence of dengue virus (DENV) (a flavivirus) and chikungunya virus (CHIKV) (an alphavirus) infections in three major population centers of Nigeria. A convenience sample of 701 sera was collected from both healthy and febrile participants between August 2010 and March 2018. Sera were tested for prior exposure to CHIKV virus and DENV using indirect IgG ELISA. Results showed that 54.1% (379/701) of participants were seropositive for anti-DENV antibodies, 41.3% (290/701) were seropositive for anti-CHIKV antibodies, and 20.1% (141/701) had previous exposure to both. The seropositivity for prior CHIKV exposure and prior exposure to DENV and CHIKV was significantly associated with age (CHIKV: OR = 2.7 (95% CI: 1.7-4.3); DENV and CHIKV: OR = 2.2 (95% CI: 1.2-4.0) for adults compared to participants under 18 years old). Overall, the high seropositivity across all age groups suggests that arboviral infections are prevalent in Nigeria and indicates that surveillance and further epidemiological studies are required to determine the true burden of these infections and the spectrum of diseases associated with these exposures.

Dog rabies control in West and Central Africa: A review.

Rabies is a neglected but preventable zoonotic disease that predominantly affects the most vulnerable populations living in remote rural areas of resource-limited countries. To date, every country on the African mainland is considered endemic for dog-mediated rabies with an estimated 21'500 human rabies deaths occurring each year. In 2018, the United Against Rabies collaboration launched the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. The epidemiology of rabies from most Western and Central African countries remains poorly defined, making it difficult to assess the overall rabies situation and progress towards the 2030 goal. In this review, we attempt to provide an overview of the current rabies situation in 22 West and Central African countries based on published scientific literature and information obtained from rabies focal points. To this end, information was collected on i) established surveillance, ii) diagnostic capacity, iii) post-exposure prophylaxis (PEP) availability and coverage, iv) dog population estimates, v) dog vaccination campaigns, vi) animal and human health communication (One Health), vii) molecular studies, viii) Knowledge, Attitude and Practices (KAP), ix) cost estimates and x) national control strategies. Although rabies is a notifiable disease in the majority of the studied countries, national surveillance systems do not adequately capture the disease. A general lack of rabies diagnostic capacity has an additional negative impact on rabies surveillance and attempts to estimate rabies burden. Recurrent shortages of human rabies vaccine are reported by all of the countries, with vaccine availability usually limited to major urban centers but no country has yet adopted the new WHO-recommended 1-week intradermal vaccination regimen. Most countries carry out subsidized mass dog vaccination campaigns on World Rabies Day. Such activities are indispensable to keep rabies in the public consciousness but are not of the scale and intensity that is required to eliminate rabies from the dog population. Countries will need to scale up the intensity of their campaigns, if they are to progress towards the 2030 goal. But more than half of the countries do not yet have reliable figures on their dog populations. Only two countries reached stage 2 on the Stepwise Approach towards Rabies Elimination ladder - indicating that their national governments have truly prioritized rabies elimination and are thus providing the necessary support and political buy-in required to achieve success. In summary, the sub-region of West and Central Africa seems to be divided into countries which have accepted the challenge to eliminate rabies with governments committed to pushing forward rabies elimination, while other countries have achieved some progress, but elimination efforts remain stuck due to lacking government commitment and financial constraints. The possibility to meet the 2030 goal without international solidarity is low, because more than two-thirds of the countries rank in the low human development group (HDI ≤ 152). Leading countries should act as role models, sharing their experiences and capacities so that no country is left behind. Unified and with international support it is possible to reach the common goal of zero human rabies deaths by 2030.

Bat and Lyssavirus Exposure among Humans in Area that Celebrates Bat Festival, Nigeria, 2010 and 2013.

Using questionnaires and serologic testing, we evaluated bat and lyssavirus exposure among persons in an area of Nigeria that celebrates a bat festival. Bats from festival caves underwent serologic testing for phylogroup II lyssaviruses (Lagos bat virus, Shimoni bat virus, Mokola virus). The enrolled households consisted of 2,112 persons, among whom 213 (10%) were reported to have ever had bat contact (having touched a bat, having been bitten by a bat, or having been scratched by a bat) and 52 (2%) to have ever been bitten by a bat. Of 203 participants with bat contact, 3 (1%) had received rabies vaccination. No participant had neutralizing antibodies to phylogroup II lyssaviruses, but >50% of bats had neutralizing antibodies to these lyssaviruses. Even though we found no evidence of phylogroup II lyssavirus exposure among humans, persons interacting with bats in the area could benefit from practicing bat-related health precautions.

Syndromic survey and molecular analysis of influenza viruses at the human-swine interface in two West African cosmopolitan cities suggest the possibility of bidirectional interspecies transmission.

Influenza viruses are frequently transmitted between pigs and their handlers, and among pig handlers. However, reports on socio-environmental variables as potential risk factors associated with transmission of influenza in West African swine production facilities are very scarce. Syndromic survey for influenza was therefore conducted in Ibadan, Nigeria, and Kumasi, Ghana, in order to identify and elucidate selected socio-environmental variables that may contribute to the occurrence and distribution of influenza-like illness (ILI) among swine industry workers. In addition, molecular analyses were conducted to elucidate the nature of influenza viruses circulating at the human-swine interface in these cities and better understand the dynamics of their transmission. Influenza viruses were detected by type-specific and subtype-specific RT-PCR. Sequencing and phylogenetic analyses were carried out. Socio-environmental variables were tested by both univariable and multivariable regression methods for significance at p < 0.05. Three risk factors for ILI were identified in each city. These included "frequency of visit of pig handler to pig pen or lairage" (Ibadan: risk ratio [RR] = 1.54, 95% confidence interval [CI] = 1.36-1.79, p = 0.02; Kumasi: RR = 1.28, 95% CI = 1.11-1.71, p = 0.01) and "pig handler's awareness about biosecurity measures" (Ibadan: RR = 7.09, 95% CI = 2.36-21.32, p < 0.001; Kumasi: RR = 4.84, 95% CI = 1.98-11.80, p < 0.001). Influenza A(H1N1)pdm09 viruses, with M genes closely related to those which circulated among pigs in the two cities during the same period, were detected among Nigerian and Ghanaian pig industry workers. These findings suggest the possibility of bidirectional transmission of influenza at the human-swine interface in these cities and underscore the need for more extensive molecular studies. Risk factors identified may assist in the control of human-to-human and human-to-swine transmission of influenza in the West African swine industry.

Comparative non-metric and morphometric analyses of rats at residential halls of the University of Benin campus, Nigeria.

BACKGROUND: In mammals and across rat species, the variation in conformation is markedly observed in the head and the variation in the shape of the head is mostly determined by the shape of the skull. Hence comparative topographic analysis and morphometry is a veritable tool in precise categorization of peri-domestic rats and species identification. METHODS: Killed rodents around residential dwellings of students on campus were collected and measurements taken of external morphology. Thirty-one external head and corporal parameters; and 40 cranial measurements respectively were obtained. Topographic features and specific anatomical landmarks measured were matched using congruent anatomical landmarks and compared to referenced standard measurements. RESULTS: External morphometry suggests that all retrieved samples were more closely related to the species Rattus rattus. However, craniodental analysis of captured rats reveals variations from the mean of typical R. rattus. In comparison with Mastomys natalensis, the mean averages of the rat species were perceptibly different for only two of the parameters viz palatine fissure length (PL) (p=0.039) and distance between interparietal bone (DP) (p=0.06). In contrast, the mean of whole length of skull (WL), length of diastema (PI), length of nasal bone (NL), length of frontal bone (LF) and occipital width (OH) were significantly different from that of R. rattus with p values of 0.047, 0.036, 0.048, 0.032 and 0.034 respectively. CONCLUSION: This study focuses on peridomestic rat's identification within the University campus based on morphometry, providing unique landmarks for differentiation between Mastomys, Mus, Rattus and other rat species with emphasis on the need for more comprehensive investigation, categorization and morphometric profiling of rat population in Nigeria. Metric data generated for rat profiling in Nigeria is pivotal for a more comprehensive strategy for prevention of Lassa fever.

Time series analysis and mortality model of dog bite victims presented for treatment at a referral clinic for rabies exposure in Monrovia, Liberia, 2010-2013.

We developed time trend model, determined treatment outcome and estimated annual human deaths among dog bite victims (DBVs) from 2010 to 2013 in Monrovia, Liberia. Data obtained from clinic records included victim's age, gender and site of bite marks, site name of residence of rabies-exposed patients, promptness of care sought, initial treatment and post-exposure-prophylaxis (PEP) compliance. We computed DBV time-trend plot, seasonal index and year 2014 case forecast. Associated annual human death (AHD) was estimated using a standardized decision tree model. Of the 775 DBVs enlisted, care seeking time was within 24h of injury in 328 (42.32%) DBVs. Victim's residential location, site of bite mark, and time dependent variables were significantly associated with treatment outcome (p< 0.05). The equation X^t=28.278-0.365t models the trend of DBVs. The high (n=705, 90.97%) defaulted PEP and average 155 AHD from rabies implied urgent need for policy formulation on national programme for rabies prevention in Liberia.

Spatial pattern of foot-and-mouth disease virus serotypes in North Central Nigeria.

AIM: This study aimed to determine the foot-and-mouth disease virus (FMDV) serotypes circulating, the prevalence of FMDV serotypes, and the spatial distribution of FMDV among sedentary and pastoral cattle herds in the North-Central Nigeria. MATERIALS AND METHODS: A cross-sectional study was undertaken, during which a total of 155 sera that tested positive for foot-and-mouth disease (FMD) 3ABC non-structural protein antibodies were selected and screened for FMD structural protein serotypes, A, O, SAT 1, and SAT 2 using a solid-phase competitive enzyme-linked immunosorbent assay (ELISA). Epithelial tissue specimens were collected during outbreak investigations which were tested for FMD using an antigen capture ELISA for serotype A, O, SAT 1, and SAT 2. RESULTS: An overall serotype-specific prevalence of 79.35 (95% confidence interval [CI]: 72.4-85.18) was recorded for serotype O, 65.2% (95% CI: 57.41-72.3) for serotype A, 52.9% (95% CI: 45.03-60.67) for SAT 2, and 33.55% (95% CI: 26.45-41.26) for SAT 1. Evidence of exposure to multiple FMDV serotypes showed that 12.26% of the sera samples had antibodies against four serotypes circulating, 30.97% had antibodies against three serotypes circulating, 22.58% had antibodies against two serotypes, and 17% showed exposure to only one serotype. Clinical specimens (epithelial tissue) collected during outbreak investigations showed that serotype O has the highest proportion of 50% with serotype A - 25%; SAT 2 - 20.8%; and SAT 1 - 4.1%. CONCLUSION: The study detected diffuse and co-circulation of serotypes A, O, SAT 1, and SAT 2 within the study area, and hence the need for the appropriately matched multivalent vaccine is strongly advocated for FMD control in Nigeria.

Detection of pandemic strain of influenza virus (A/H1N1/pdm09) in pigs, West Africa: implications and considerations for prevention of future influenza pandemics at the source.

BACKGROUND: Human and animal influenza are inextricably linked. In particular, the pig is uniquely important as a mixing vessel for genetic reassortment of influenza viruses, leading to emergence of novel strains which may cause human pandemics. Significant reduction in transmission of influenza viruses from humans, and other animals, to swine may therefore be crucial for preventing future influenza pandemics. This study investigated the presence of the 2009 pandemic influenza A/H1N1 virus, A(H1N1)pdm09, in Nigerian and Ghanaian pigs, and also determined levels of acceptance of preventive measures which could significantly reduce the transmission of this virus from humans to pigs. METHODS: Nasal swab specimens from 125 pigs in Ibadan, Nigeria, and Kumasi, Ghana, were tested for the presence of influenza A/California/04/2009 (H1N1) by quantitative antigen-detection ELISA. A semi-structured questionnaire was also administered to pig handlers in the two study areas and responses were analyzed to evaluate their compliance with seven measures for preventing human-to-swine transmission of influenza viruses. RESULTS: The virus was detected among pigs in the two cities, with prevalence of 8% in Ibadan and 10% in Kumasi. Levels of compliance of pig handlers with relevant preventive measures were also found to be mostly below 25 and 40% in Ibadan and Kumasi, respectively. CONCLUSION: Detection of influenza A(H1N1)pdm09 among pigs tested suggests the possibility of human-to-swine transmission, which may proceed even more rapidly, considering the very poor acceptance of basic preventive measures observed in this study. This is also the first report on detection of influenza A(H1N1)pdm09 in Ghanaian pigs. We recommend improvement on personal hygiene among pig handlers, enforcement of sick leave particularly during the first few days of influenza-like illnesses, and training of pig handlers on recognition of influenza-like signs in humans and pigs. These could be crucial for prevention of future influenza pandemics.

Development of a time-trend model for analyzing and predicting case-pattern of Lassa fever epidemics in Liberia, 2013-2017.

OBJECTIVE: The objective was to develop a case-pattern model for Lassa fever (LF) among humans and derive predictors of time-trend point distribution of LF cases in Liberia in view of the prevailing under-reporting and public health challenge posed by the disease in the country. MATERIALS AND METHODS: A retrospective 5 years data of LF distribution countrywide among humans were used to train a time-trend model of the disease in Liberia. A time-trend quadratic model was selected due to its goodness-of-fit (R2 = 0.89, and P < 0.05) and best performance compared to linear and exponential models. Parameter predictors were run on least square method to predict LF cases for a prospective 5 years period, covering 2013-2017. RESULTS: The two-stage predictive model of LF case-pattern between 2013 and 2017 was characterized by a prospective decline within the South-coast County of Grand Bassa over the forecast period and an upward case-trend within the Northern County of Nimba. Case specific exponential increase was predicted for the first 2 years (2013-2014) with a geometric increase over the next 3 years (2015-2017) in Nimba County. CONCLUSION: This paper describes a translational application of the space-time distribution pattern of LF epidemics, 2008-2012 reported in Liberia, on which a predictive model was developed. We proposed a computationally feasible two-stage space-time permutation approach to estimate the time-trend parameters and conduct predictive inference on LF in Liberia.

The rubber plantation environment and Lassa fever epidemics in Liberia, 2008-2012: a spatial regression.

As Lassa fever continues to be a public health challenge in West Africa, it is critical to produce good maps of its risk pattern for use in active surveillance and control intervention. We identified eight spatial features related to the rubber plantation environment and used them as explanatory variables for Lassa fever (LF) outbreaks on the Uniroyal Liberian Agricultural Company (LAC) rubber plantation environment in Grand Bassa County, Liberia. We computed classical and spatial lag regression models on all spatial features, including proximity of residential camp to rubber tree-edge, main road in the plantation, LAC hospital, rice farmland, household refuse dump, human population density, post-harvest storage density of rice and density of rodent deterrent on rice storage. We found significant (p=0.0024) spatial autocorrelation between LF cases and the spatial features we have considered. We concluded that the rubber plantation environment influenced Mastomys species' breeding and transmission of Lassa virus along spatial scale to humans. The risk factors identified in this study offered a baseline for more effective surveillance and control of LF in the post-civil conflict Liberia.

Prevalence of antibody against rabies among confined, free-roaming and stray dogs in a transit city of Nigeria.

The prevalence of anti-glycoprotein antibodies against rabies virus is studied in the sera of confined, free-roaming and stray dogs in Ilorin, the capital city of Kwara State, Nigeria. A quantitative indirect enzyme-linked immuno-sorbent assay (i-ELISA) was used to detect rabies virus anti-glycoprotein antibodies in sera from 116 confined, 61 free-roaming, and 13 stray dogs. The sera were collected between June and December 2008 from apparently healthy dogs. Of these 190 dogs, 81 (42.6%), consisting of 57 confined (49.1%), 23 free-roaming (37.7%) and 1 stray (7.7%), had antibody titres that exceeded the positive threshold of 0.5 equivalent units (eu)/ml against rabies, while 109 (57.4%) presented titres that were below the threshold. Prevalence of rabies anti-glycoprotein antibody was higher in the confined dogs compared to free-roaming and stray dogs. Our results indicated low anti-rabies sero-prevalence (42.6%) in the dog population of Ilorin, a transit city that lies between northern and southern Nigeria. This is the first community-based prevalence report on the anti-rabies serological profile of dogs in Nigeria. The need for primary and booster mass vaccination of dogs and the impact of these findings on rabies control in Nigeria are discussed.

Antibody levels against rabies among occupationally exposed individuals in a Nigerian University.

The authors investigated the levels of anti-glycoprotein antibodies against rabies virus in the sera of occupationally exposed humans at the University of Ibadan, Nigeria. A quantitative indirect enzyme-linked immunosorbent assay (ELISA) was used to detect rabies virus anti-glycoprotein antibodies in sera from 20 zoological garden workers, 20 veterinarians and 30 clinical veterinary students at the University of Ibadan. The sera were obtained between September 2008 and February 2009. Of these 70 healthy individuals, 29 (41.4%) consisting of 15 zoological garden workers (75.0%), 13 veterinarians (65.0%) and 1 veterinary student (3.3%) were immune to rabies virus (antibody titre > or =0.5 equivalent units per ml), while 41 (58.6%) were not immune. The prevalence of rabies anti-glycoprotein antibody was higher within the older segment of the study population than among the younger veterinary students. Almost all those who had spent at least 10 years on the job had higher levels of rabies vaccination compliance and were immune. Our results indicated that there is low anti-rabies immunity among occupationally exposed individuals at the University of Ibadan. There is a need for a complete course of primary and booster vaccinations of professionals exposed to the rabies virus. The impact of these results on rabies control in Nigeria is discussed.

Isolation of influenza A viruses from pigs in Ibadan, Nigeria.

The authors investigated influenza virus types in pigs in Ibadan, a city in Oyo State, south-western Nigeria. From April to June 2008, nasal swabs were collected from pigs at three locations in Ibadan. Influenza A viruses (four A [H1N1], two A [H3N2] and one A [H1N1]-A [H3N2] double reactant) were isolated from 7 of the 50 apparently healthy Landrace pigs tested. This study is the first documented isolation of swine influenza viruses in Nigeria and it reveals that different strains of influenza viruses co-circulate in pigs in Ibadan. These pigs serve as reservoirs of different subtypes of influenza viruses and potential 'mixing vessels' in which genetic reassortment and the generation of future human pandemic strains could occur. These findings support the need for adequate and periodic surveillance among swine populations and pig handlers in Nigeria to detect circulating strains of influenza viruses. This would serve as an effective early warning system.

Pattern of spread of African swine fever in south-western Nigeria, 1997-2005.

Geographic coordinates of selected pig farms with confirmed African swine fever (ASF) outbreaks in Ekiti, Lagos, Ogun, Ondo and Oyo States were used to create spatial models of pig farms and ASF outbreaks in south-western Nigeria between 1997 and 2005. The probability of ASF virus-free pigs remaining in a non-infected state when located at various distances from ASF virus infected pigs was estimated. Movement of infected stock was the most important means of spreading the virus. The estimated mean duration of clinical signs prior to death was 3.4 +/- 1.1 days (mean +/- standard deviation); the mean convalescent period was 16.3 +/- 2.3 days and the mean period of survival after full recovery was 1 084 +/- 145.1 days. The continuous presence of recovered pigs in the population enables virus spread through trade and breeding. There is an urgent need for the implementation of an ASF eradication programme in Nigeria.