Acute Febrile Illness (AFI) Surveillance Project, Liberia

The African Field Epidemiology Network (AFENET), Liberia through funding from the United States Centers for Disease Control and Prevention implemented the acute febrile illness surveillance project in health facilities across Liberia. This is under a five-year cooperative agreement between AFENET and the US CDC under “Building Acute Febrile Illness Surveillance Capacity through Laboratory Systems Strengthening and Workforce Development (FETP) activities”. The project has the National Public Health Institute of Liberia as its main principal investigator, the Ministry of Health, University of Virginia, and Riders for Health as partners. The AFI project which started in December 2018 in the Redemption Hospital, New Kru town and Star of the Sea Health Center, WestPoint, Montserrado.
AFI-Surveillance-Project
The project under implementation has its main objectives as below.

Primary Objective
To determine the etiologies of AFI among children and adolescents (2-17 years) and adults (18+ years) attending selected health facilities in Liberia to inform public health programs at these facilities including capacity development to identify, monitor, and assess pathogens of potential public health importance, programmatic improvement for patient care and treatment, and resource allocations.

Secondary Objectives

  1. To describe the infectious disease etiology of AFI and epidemiological characteristics of AFI cases at selected health facilities in Liberia, using basic demographics such as patient ages, sex, geographic area, and other characteristics
  2. To provide a platform for the detection of emerging infections and/or disease outbreaks of public health importance at selected sites
  3. To improve epidemiologic and laboratory capacity in Liberia

The AFI surveillance Liberia, investigates for over 28 pathogens (Bacteria, Viruses, and protozoa) associated with febrile illnesses using the TaqMan Array Card (TAC) quantitative polymerase chain reaction (qPCR).

Surveillance activities under the AFI project are currently at Redemption Hospital and Star of the Sea Health Centre where over 3000 patient enrollments detecting over 9 different pathogens dominated by Plasmodium/Plasmodium falciparum. Surveillance activities under the AFI surveillance, Liberia has augmented Liberia’s diagnostic capacities immensely through the emergency use of TAC where pathogen diagnostic capacities are limited or for pathogen of unknown etiology causing outbreaks in Liberia.

The AFI surveillance, Liberia in response support to the SARS-CoV-2 pandemic in Liberia also sought to use existing AFI surveillance systems for epidemiological and virologic surveillance for COVID-19. The integration of COVID-19 in existing AFI surveillance project support emergency and high-priority investigations through leveraging existing systems and available staff, material, supplies, reagents, and testing processes of samples its two surveillance sites (Redemption Hospital and Star of the Sea Health Centre). The objective of integration of COVID-19 activities into the AFI surveillance project, Liberia received administrative approval from the Incident Management System, Ministry of Health, and the National Public Health Institute of Liberia.

Collaborating Partners

AFENET Liberia
Center for Disease Control
Ministry of Health of Liberia
National Public Health Institute of Liberia
Vital Strategies
Community Based Initiative in Liberia
Bill and Melinda Gates Foundation
Resolve to save Lives