NIMR seeks upgrade of diagnostics to combat viral haemorrhagic fevers

The Nigerian Institute of Medical Research has underscored the necessity for enhanced diagnostic tools and vaccines to swiftly and effectively identify and manage viral hemorrhagic fevers, which are prevalent in the nation.

The research institute has also warned that both emerging and re-emerging infectious diseases, particularly viral hemorrhagic fevers, are becoming increasingly frequent. This highlights the importance of screening patients who present with fevers prior to the administration of any medication or treatment.

Prof. Rosemary Audu, the Deputy Director General of NIMR, conveyed this information during a media discussion where she presented her research findings on the rise of emerging and re-emerging infectious diseases.

Audu, who serves as a Director of Research and is a professor of Medical Virology at Lead City University in Ibadan, Oyo State, emphasized that not all fevers are indicative of malaria. She pointed out that improving surveillance systems is essential for the effective control and management of viral hemorrhagic fevers.

According to the Nigeria Centre for Disease Control and Prevention, viral hemorrhagic fevers encompass a range of illnesses caused by various virus families, including arenaviruses, filoviruses, bunyaviruses, and flaviviruses.

These fevers are transmitted from infected animals to humans and can also spread from person to person.

The NCDC identifies several viral hemorrhagic fevers of concern in Nigeria, including Lassa fever, Ebola, dengue fever, and yellow fever.

While yellow fever and dengue fever are transmitted by mosquitoes, Lassa fever is endemic in certain regions of West Africa and is responsible for approximately 5,000 deaths each year.

Further elaborating, Audu noted that during the Lassa fever outbreak in 2018, the endemic nature of the infection was confirmed in Ondo State, where 80 percent of suspected cases were ultimately confirmed as negative, raising significant concerns regarding the accuracy of patient diagnoses.

The researcher investigating the viral reservoirs of viral hemorrhagic fevers (VHFs) observed that from 2018 to 2020, the Crimean-Congo hemorrhagic fever virus was identified in febrile patients and herdsmen in Kwara State. Additionally, in 2021 and 2022, the Yellow Fever Virus was detected in febrile patients and mosquito pools, while the Zika Virus was confirmed in febrile patients in Delta State.

In discussing the implications of these research findings, Audu remarked, “The identification of dengue, Zika, yellow fever, and Lassa fever viruses in this community indicates that infections are currently occurring.”

Audu, who is actively involved in global initiatives to combat the Mpox virus, cautioned healthcare professionals to maintain a high level of suspicion for VHFs when patients present with fever.

She stated, “When individuals arrive at hospitals with fever, it is crucial for our health workers to remain vigilant. If malaria tests return negative, consider the possibility of viral hemorrhagic fever. It could be any of those viruses.”

She further noted, “The presence of a significant number of Aedes aegypti mosquitoes suggests that they may facilitate the transmission of these viruses. We must develop more effective control measures for them.”

The expert called for heightened public awareness regarding VHFs, advising Nigerians to refrain from self-medicating with over-the-counter fever treatments.

“Self-medication will not be beneficial. Beyond malaria, there are numerous other potential infections. Antimalarial medications will not address viral pathogens,” emphasized the deputy director-general of NIMR.

She highlighted the necessity to improve diagnostic capabilities for identifying viral hemorrhagic fevers in patients presenting with fever. Despite the non-specific nature of symptoms, which can resemble those of various diseases, testing is essential.

“We require reliable diagnostic tools. While we have some available for research purposes, there are limited laboratories in Nigeria equipped with PCR technology.”

There remains a need for enhancements in the development of serologic kits that laboratories can utilize, as emphasized by Audu. Additionally, he highlighted the necessity of improving surveillance for both emerging and re-emerging infectious diseases, particularly at entry points.

In his remarks, Prof. John Obafunwa, the Director General of NIMR, underscored the critical role of diagnosis, asserting its necessity prior to any treatment.

He elaborated that timely diagnosis is essential for ensuring precise treatment, given that many viral hemorrhagic fevers (VHFs) initially exhibit symptoms akin to those of malaria.

Obafunwa expressed concern over the exorbitant costs associated with purchasing reagents and the institution's reliance on foreign assistance, advocating for increased domestic funding.

He also criticized the high electricity expenses and reiterated his appeal for the institute to benefit from the 50 percent reduction in electricity tariffs allocated to tertiary institutions.

Furthermore, he mentioned that the institute is addressing the growing incidence of drug-resistant tuberculosis and is optimistic about collaborating with organizations focused on TB.

"NIMR is committed to thoroughly examining the TB situation. With the technology available at NIMR, it is imperative that we establish sufficient collaborations to conduct the necessary tests," the Director General stated.