Utilizing local solutions through active community engagement to strengthen Lassa fever prevention and control in Ondo state, Nigeria, July 2024

Introduction: Lassa fever (LF) is endemic in Ondo state, Nigeria with yearly outbreaks reported. A novel approach called Local Innovations Scaled through Enterprise Networks (LISTEN) was piloted in 2 high-burden Local Government Areas (LGAs) in Ondo State to optimize control efforts. LISTEN is a co-creation iterative strategy utilizing a human-centered design to identify data-driven challenges and solutions through continuous data review and leveraging Communities of Practice (CoP) for implementation and sustainability. Methods: Data was collected through a semi-structured questionnaire for community needs assessment, key informant interviews, and focus group discussions with 71 respondents, including politicians, community leaders, and healthcare workers in Akure-South and Owo LGAs. Manual thematic analysis identified challenges in LF prevention, focusing on healthcare access, environmental conditions, and social behaviors. Data was securely archived on a shared drive, accessible only to the project team. Results: Insights include poor healthcare access attributed to long distances to testing centers and high transportation costs, misconceptions and traditional beliefs hindering early medical intervention, and unhygienic food storage practices. Others were the presence of unkempt bushes, open refuse dumps in the community, and poor hygiene in markets and residential areas, which are responsible for rat infestations and vehicles for disease spread. Social stigma against LF survivors was a major factor that complicates disease management. Conclusion: The study demonstrated that community engagement and collaborative public health efforts are critical to controlling LF outbreaks. Immediate actions include improved waste management, raising awareness to reduce stigma, and promoting good food hygiene to prevent future outbreaks in Ondo State. These insights provide a roadmap for leveraging local LF control resources and expand efforts to other endemic regions.