Abstract
Early case detection and isolation of patients infected with highly infectious diseases through active case search (ACS) are important for early commencement of treatment and control of the disease within a population. This study aimed to assess the ACS of COVID-19 in healthcare facilities during the third wave of the pandemic in Ekiti State, Nigeria. This cross-sectional study was conducted in all healthcare facilities in Ekiti State. All cadres of local government primary healthcare workers were trained to carry out the ACS using semi-structured interviewer-administered questionnaire uploaded on android phone software open data kit (ODK). ACS was conducted between June and September (epidemiological week 23 to 36), 2021 and the collected data were analyzed using IBM SPSS version 23.0. P-value < 0.05 was taken as significant. The number of ACS visits for COVID-19 increases with epidemiological week progression, but the highest was in week 32 (9.9%). Cases of suspected COVID-19 in the healthcare facilities in the last one week were reported in more than half (58%) of the visits and 57.8% of those reported, documented between 1 - 4 cases. Also, out of those that were reported, 42% of them missed (not line listed) at least one suspected case of COVID-19. The private health facilities missed more cases of COVID-19 (54.3%) than other categories of health facilities (p < 0.001). The health educators and local government immunization officers (LIO) than other cadre of healthcare workers found most missed cases (57.1% and 51.4% respectively) in their visits (p < 0.001). The health educator as well as the LIO detected the highest proportion of missed suspected cases which shows that disease surveillance officers alone may not be adequate for ACS, there is a need to involve other local government team member.
Highlights
Corona virus disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
About one-quarter of the entire case search were done by the disease surveillance officers (DSNOs and ADSNO), this is followed by the medical officer of health (MOH)/primary healthcare coordinators (PHCC) with 340 (12.9%) active case search (ACS) and laboratory scientist with 328 (12.4%) ACS
The steady increase earlier seen might be due to the increase in awareness on ACS of COVID-19 as the week progresses while the late reduction seen may be due to reduced COVID-19 cases as well as fatigue by the healthcare workers
Summary
Corona virus disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The variant has been linked to a surge in cases in nations where it is the dominant strain in circulation and it has been implicated in the third wave of COVID-19 disease [4]. ACS is an important approach for capturing all the cases, as many may not have access to healthcare facilities and may seek care elsewhere during outbreaks of disease especially in pandemic season of COVID-19 [5] [6]. Case detection and isolation of patients infected with highly infectious diseases are important for early commencement of supportive treatment and control of further transmission of the disease within a population [1] [7] [8]
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