The Forms, Challenges and Strength of the Monkeypox Surveillance System in Nigeria

Monkeypox is now a disease of global public health concern, making it cut across boundaries into different countries, continents and spread worldwide. However, it originated in the Democratic Republic of Congo as a human pathogen in 1970, with the first case reported in Nigeria in 1971. The World Health Organization recently declared Nigeria the country with the highest burden of monkeypox-confirmed cases and deaths in Africa for the current outbreak. This study aimed to identify forms, challenges, strengths, and ways to further strengthen the surveillance system of monkeypox in Nigeria. We conducted a rapid narrative review of articles published in English on monkeypox between January 2018 and October 2022. Google Scholar and PubMed were searched with the following terms: "Monkeypox", "Surveillance system", "Strengthening", "Challenges" "Nigeria" and relevant publications were reviewed. The forms of surveillance systems in Nigeria include Indicator-based and Event-based surveillance, contact tracing, laboratory-based surveillance, sero-surveillance, and mortality surveillance. Shortage of highly skilled staff in public health interventions, insufficient testing capacities, power instability, poor healthcare systems and stigmatization from communities with misinformation, and co-epidemic surveillance burden in Nigeria are some of the challenges contributing to weak surveillance in the country. The Nigerian governments must focus on investing in surveillance systems and bolster preparedness to stem the rapid spread of infectious diseases. Strengthening the surveillance system in the country as a response intervention for monkeypox is no longer a matter of option in Nigeria but of necessity to prevent the forecasted effect the incidence portends.