Conference Abstract | Volume 8, Abstract ELIC2025278 (Oral 054) | Published: 12 Aug 2025
Lilian Omoyemen Akerele1, Sylvester Oziegbe Alikah1, Andrew Oseghale Eigbedion1, Kikelomo Victoria Doherty1, Sheila Mary Ojor Ileli1, Endurance Omokaro2,3, Omoyenmen Sonia Ifada1, Ephraim Ogbaini-Emovon3,4, Cyril Oshomal Erameh3,5, Willam Omoh Akerele1,6, George Obozokhale Akpede1,2,&
1Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria, 2Department of Paediatrics, Ambrose Alli University, Ekpoma, Edo State, Nigeria, 3Department of Chemical Pathology, Irrua Specialist Teaching Hospital, irrua, Nigeria, 4Institute for Viral and Emergent Pathogens Control and Research, Irrua Specialist Teaching Hospital, Irrua, Nigeria, 5Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria, 6Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria
&Corresponding author: George Obozokhale Akpede, Ambrose Alli University, Ekpoma, Edo State, Nigeria. Email: georgeakpede@yahoo.co.uk
Received: 31 May 2025, Accepted: 09 Jul 2025, Published: 12 Aug 2025
Domain: Infectious Disease Epidemiology
Keywords: Missed diagnosis, Neonatal Lassa virus disease, Neonatal mortality, Neonatal morbidity, Diagnostic lumbar puncture
©Lilian Omoyemen Akerele et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Lilian Omoyemen Akerele et al., A place for lumbar punctures in the standard of care of neonates with suspected sepsis in Lassa virus disease endemic areas: The ISTH experience. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc5):00054. https://doi.org/10.37432/JIEPH-CONFPRO5-00054
The diagnosis of neonatal Lassa virus disease (NNLVD) is usually made from RT-PCR testing of cord blood or baby’s serum but this could lead to missed diagnosis where CSF examination is not part of the standard of care. Besides, the place of diagnostic LPs in neonatal care is topical. There is also a dearth of data on the presentation of NNLVD, an important cause of newborn morbidity and mortality in endemic countries. We sought to determine the need for diagnostic LPs in the clinical care of acutely ill newborn babies in endemic areas as a means of reducing the risk of missed diagnosis.
We reviewed the diagnosis and outcome of 27 babies hospitalized with LVD between January 2021 and December 2024 at the neonatal units of ISTH. The diagnosis of LVD was confirmed using LASV-RT-PCR test. We assessed the relationship between the risk of missed diagnosis and clinical presentation and virus load on presentation using odds ratios (95% confidence intervals, OR (95% CIs). We also compared groups using c2 or Fisher exact tests and ANOVA, with p<0.05 taken as significant.
3/13 (23%) babies with serum/CSF LASV-RT-PCR test results had negative serum/positive CSF. The risk of missed diagnosis was not significantly associated with demographic (p >0.05) and clinical features on presentation (p >0.05) and viral load (p >0.05) but was accentuated among babies with bacteremia (3/6 bacteraemic vs 0/5 non-bacteremic babies; p = 0.242).
The risk of missed diagnosis is high in the absence of CSF examination in acutely ill babies but is unrelated to clinical presentation and viral load. We recommend that LP should be part of the standard of care of ill babies in Lassa-endemic areas to reduce the risk of missed diagnosis with its potentially serious consequences.
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