Trend of Lassa fever cases and factors associated with mortality in Liberia, 2016 - 2021: a secondary data analysis.

Introduction: Lassa fever (LF) is endemic in Liberia and is immediately reportable. Suspected cases are confirmed at the National Public Health Reference Laboratory. However, there is limited information on the trend and factors associated with mortality. We described the epidemiological characteristics of LF cases and determined factors associated with mortality in Liberia from 2016 to 2021. Methods: we reviewed 867 case-based LF surveillance data from 2016 to 2021 obtained from the National Public Health Institute of Liberia (NPHIL). The cases that met the suspected LF case definition were tested with RT-PCR. Using Epi Info 7.2.5.0. We conducted univariate, bivariate, and multivariate and analysis. We calculated frequencies, proportions. Positivity rate, case fatality rate, and factors associated with LF mortality using chi-square statistics and logistics regression at 5% level of significance. Results: eighty-five percent (737/867) of the suspected cases were tested and 26.0% (192/737) were confirmed LF positive. The median age of confirmed LF cases was 21(IQR: 12-34) years. Age 10-19 years accounted for 24.5% (47/192) and females 54.2% (104/192). Bong 33.9% (65/192), Grand Bassa 31.8% (61/192), and Nimba counties, 21.9% (42/192) accounted for most of the cases. The median duration from symptom onset to hospital admission was 6 (IQR: 3-9) days. A majority, 66% (126/192) of the cases were reported during the dry season (October-March) and annual incidence was highest at 12 cases per 1,000,000 population in 2019 and 2020. The overall case fatality rate was 44.8%. Non-endemic counties, Margibi, 77.8% and Montserrado, 66.7% accounted for the highest case fatality rate (CFR), while 2018, 66.7% and 2021, 60.0% recorded the highest CFR during the period. Age ≥30 years (aOR=2.1,95% CI: 1.08-4.11, p=0.027) and residing in Grand Bassa County (aOR=0.3, 95% CI: 0.13-0.73, p=0.007) were associated with LF mortality. Conclusion: Lassa fever was endemic in three of the fifteen counties of Liberia, case fatality rate remained generally high and widely varied. The high fatality of LF has been reported to the NPHIL and is currently being further investigated. There is a need to continuously train healthcare workers, especially in non-endemic counties to improve the LF treatment outcome.

Knowledge, attitude, and practice towards hepatitis B virus among healthcare workers: a cross-sectional, hospital-based study in Montserrado County, Liberia.

Prevention is critical in safeguarding against the spread of hepatitis B virus (HBV) infection. The knowledge, attitudes, and practices of healthcare workers (HCWs) regarding the disease play an important role in its prevention or spread, yet in this regard, data in Liberia remains scarce. Hence, determining the Knowledge, Attitude, and Practices (KAP) level of HCWs toward HBV infection becomes necessary. A descriptive cross-sectional hospital-based study was conducted among 251 HCWs at two major health facilities in Monrovia. KAP regarding HBV was assessed using a standardized structured questionnaire. Results were analyzed using descriptive statistics for demographic characteristics, percentages for categorical variables, and mean ± standard deviation for continuous variables. Kruskal Wallis test, p < 0.05, was used to derive statistical inferences. Complete data from 248 respondents showed a mean age of 36.3 ± 8.9 years with most respondents were within 30-39 age range (45.82%). While poor knowledge was observed in responses to all categories of questions, correct response rates to questions range from 41.93 - 99.19% for transmission of HBV, to 98.79 - 100% for preventive measures of HBV. About 77.8% and 90.32% of study respondents strongly agreed that hepatitis B is a major public health threat and that following infection control guidelines will protect them from being infected with HBV at work respectively. More than half of the participants (60.08%) had a history of needle-stick injury (NSI), and washing the injury site with water and soap, sterilizing the wound, and checking whether the patient has a blood-borne disease was done by 48.79%, 53.62% and 27.01% of the respondents respectively. Findings from this study show that there is an inadequate level of KAP regarding HBV infection among the HCWs. It therefore is expedient to conduct regular awareness campaigns for HCWs on preventive measures against HBV infection in hospitals, in addition to workshops and in-service trainings on infection prevention and control (IPC) best practices.