The United States Centers for Disease Control and Prevention (U.S. CDC) has urged Nigeria to reinforce its Acute Febrile Illness (AFI) surveillance system by tackling long-standing challenges that continue to weaken its impact on public health.
According to the agency, the absence of a clear national policy framework, limited geographical coverage of testing centres, inadequate diagnostic capacity, delays in sample transportation, difficulties maintaining sample integrity, staff attrition, and slow turnaround times for laboratory results remain critical barriers to effective surveillance.
Speaking at a media roundtable in Abuja on Wednesday, Dr. Oladipupo Ipadeola, Senior Public Health Specialist for Epidemiology and Surveillance at U.S. CDC Nigeria, said addressing these gaps was essential for improving AFI surveillance, which plays a central role in safeguarding communities against disease outbreaks.
He explained that the wide range of diseases presenting as febrile illnesses makes diagnosis difficult, saying, “Acute febrile illnesses are among the most common reasons people seek healthcare, yet they are often misunderstood.
“Symptoms frequently overlap, making it difficult to identify the exact cause. ‘That is why we need robust surveillance systems,” he said.
Dr. Ipadeola noted that U.S. CDC’s support for AFI surveillance, delivered in partnership with the Nigeria Centre for Disease Control and Prevention (NCDC), the Institute of Human Virology Nigeria (IHVN), and other stakeholders has become indispensable given the complex and widespread nature of these illnesses.
He said AFI surveillance helps to determine disease prevalence, identify causes, monitor patterns of spread, and generate data that supports stronger outbreak response.
“The overall intent of this system is to improve early detection, strengthen capacity, and generate quality data that will help us respond faster and better to outbreaks,” he added.
Since its introduction, he noted, sentinel surveillance sites have been established across the six geopolitical zones of Nigeria, adding that more than 11,000 samples have been tested for priority diseases including malaria, yellow fever, dengue, Lassa fever and COVID-19.
Laboratory capacity has also improved through the provision of upgraded equipment, the introduction of multiplex PCR testing, and targeted staff training in selected facilities.
Dr. Ipadeola emphasized that AFI surveillance is a critical component of U.S. CDC’s global health security strategy, noting that In Nigeria, it is helping to detect co-infections, track disease patterns, and strengthen diagnostic systems.
According to him, while formal coordination of the programme was transferred to the NCDC in August 2024, the U.S. CDC still provides technical expertise, rapid diagnostic kits, and laboratory reagents to maintain operations at sentinel sites.
He acknowledged that Nigerian government initiatives, such as malaria control campaigns, vaccination programmes, public health education, and integrated disease surveillance have made important contributions.
However, operational hurdles remain. In some cases, delays in moving samples to the National Reference Laboratory compromise integrity, while staff attrition has disrupted consistency in certain sentinel sites.
“In terms of turnaround time, patients naturally want to receive results quickly. But it is important to clarify that AFI testing is for surveillance, not for direct treatment,” he said.
Dr. Ipadeola said the lessons learned from Nigeria’s AFI programme could serve both national and international interests, emphasizing, “With sustained support from U.S. CDC and partners, Nigeria’s surveillance capacity will not only strengthen outbreak response locally but also contribute to global health security”.
At the facility level, Dr. Ifeyinwa Ejinkeonye, Focal Person for AFI at Kubwa General Hospital in Abuja, said the centre had maintained strong performance in AFI data reporting since ownership was transferred and under its current management.
She explained, however, that staff losses and power supply challenges in recent months have forced the centre to rely on the National Reference Laboratory for real-time sample transfer, a role the hospital had previously managed effectively.
However, Professor Alash’le Abimiku, Executive Director of the International Centre of Excellence, noted that the institute has been supporting Nigeria’s efforts to expand surveillance and improve diagnostic accuracy for AFIs.
Earlier, Dr. Farah Husain, Programme Director at U.S. CDC Nigeria, in her opening remarks, underscored the need for a more resilient AFI system.
She explained that robust surveillance makes it possible to identify the causes, burden, and spread of febrile illnesses, which in turn enables more timely interventions during outbreaks.
Husain added that U.S. CDC and NCDC are working to institutionalize AFI surveillance in Nigeria’s national health architecture, focusing on sustainability, early detection, stronger laboratories, and better data.
NCDC’s Director of Surveillance, Dr. Fatima Saleh, highlighted the importance of advocacy and inclusivity in ensuring that AFI surveillance has long-term impact, noting that wider stakeholder engagement will be key to sustaining progress.
