Lassa fever case management capacity in ECOWAS Region: Progress, gaps, and policy recommendations

Abstract Introduction: Lassa fever remains a significant public health concern in the ECOWAS region. Prompt diagnosis and effective case management are critical for controlling outbreaks and reducing associated mortality and severe complications. This study assessed the case management capacity for Lassa fever across ECOWAS member states, focusing on early detection, diagnostics, treatment infrastructure, and infection prevention and control (IPC) measures. Methods: A cross-sectional, mixed-methods study was conducted using structured questionnaires, key informant interviews, and document reviews in 10 ECOWAS member states. The evaluation encompassed diagnostic capacities, treatment availability, IPC measures, and workforce readiness. Thematic and comparative analyses were employed to synthesize the findings. Results: Considerable differences were observed across participating Member States. Nigeria, Guinea, and Liberia demonstrated relative strengths in diagnostics and treatment infrastructure. In contrast, countries such as Gambia, Ghana, and Côte d’Ivoire exhibited serious shortcomings, revealing significant deficiencies in healthcare worker training and access to antiviral therapies. The implementation of standardised case management protocols was inconsistent. Additionally, data sharing challenges and inadequate coordination across borders were highlighted as significant issues. Conclusion: While progress has been made, substantial gaps remain in Lassa fever case management across ECOWAS. Strategic investments in health systems strengthening, legal frameworks development for data sharing, and capacity building are critical to improving regional preparedness and reducing the risk of future outbreaks.