Management of Viral Haemorrhagic Fever Outbreaks in Primary Healthcare Settings: Lessons from Ondo State

The management of viral haemorrhagic fever (VHF) outbreaks at primary healthcare centre (PHC) level requires rapid triage, infection prevention protocols, and coordinated specimen referral, yet frontline health workers in endemic communities often lack the operational training to execute these functions effectively. This study evaluates the adequacy of VHF outbreak management at primary healthcare centres in Ondo State, South West Nigeria, with emphasis on Lassa fever as the most frequently encountered VHF in the state. Using a mixed-methods approach, the study will conduct structured assessments at 25 PHCs across five endemic local government areas, evaluating availability of personal protective equipment, presence of written triage protocols, staff training records, and case referral documentation from 2021 to 2024. Key informant interviews will be conducted with PHC officers-in-charge and local government disease surveillance and notification officers. The assessment framework will be adapted from the WHO VHF Care Manual and Nigeria Centre for Disease Control Lassa fever response guidelines. Evidence from Ondo State suggests that most VHF cases are initially mismanaged at PHC level due to lack of awareness and protective equipment. Findings will generate a PHC-level VHF readiness score for Ondo State and provide actionable recommendations for the state's PHC development board to improve frontline outbreak management. Keywords: viral haemorrhagic fever, Lassa fever, primary healthcare, outbreak management, Ondo State