Determinants of Presumptive Diagnosis of Yellow Fever in Nigeria, July 2017- December 2018

Kelly Osezele Elimian 1,2*; and Abubakar Jafiya 2

1Department of Microbiology, University of Benin, Benin City, Nigeria 2Nigeria Centre for Disease Control, Abuja, Nigeria

Corresponding Author: kelly.elimian@uniben.edu

Recieved Date: 10th March, 2023; Accepted Date: 1st May, 2023; Published Date: June, 2023

Citation: Kelly Osezele Elimian 1,2*; and Abubakar Jafiya 2

ABSTRACT

Background: Yellow fever (YF) epidemics have become more frequent in Nigeria since its re-emergence in 2017. Therefore, this study aimed at identifying the context-specific factors associated with the presumptive diagnosis of YF, with a view to strengthening the country’s capacity for surveillance and outbreak response. Materials and Methods: A cross-sectional analysis of YF surveillance data spanning from July 2017 to December 2018. A presumptive diagnosis of YF was defined as YF virus-specific Immunoglobulin M (IgM) in a suspected case without a history of recent YF vaccination. Multivariable logistic regression analyses were performed to identify factors independently associated with a presumptive diagnosis of YF. Findings were presented using adjusted odds ratios (aOR) and 95% Confidence Intervals (CIs). Results: There were 2,057 suspected YF cases during the study period, of which 157 were presumptive positive, including 36 fatalities. Age groups 15-24 (aOR 3.46, 95% CI: 1.49-8.04), 25-34 (aOR 3.10, 95% CI: 1.27-7.53), and 35-44 (aOR 2.96, 95% CI: 1.06-8.25) years, south-south (aOR 4.03, 95% CI: 1.76-9.25), north-west (aOR 3.54, 95% CI: 1.56-8.02) and north-east (aOR 4.25, 95% CI: 1.40-12.84) residency, and presentation with general systemic symptoms (aOR 147.63, 95% CI: 71.21-306.06) significantly increased the odds of presumptive YF diagnosis. In contrast, delay in turnaround time by ?8 days (aOR 0.28, 95% CI: 0.17-0.46) and presentation with gastrointestinal symptoms (aOR 0.05, 95% CI: 0.01- 0.23) significantly decreased the odds of presumptive YF diagnosis. Conclusion: This study has identified context-specific factors associated with the presumptive diagnosis of YF in Nigeria, with the potential to strengthen in-country diagnostic capacity, clinical case management and surveillance system, and epidemic preparedness and response.