Practices and Challenges in Lassa Fever Contact Tracing in Edo State

Contact tracing is a cornerstone of Lassa fever outbreak response, enabling early identification of exposed individuals and prompt application of infection prevention measures. In Edo State, South South Nigeria, which is endemic for Lassa fever, contact tracing teams face persistent operational challenges that limit response effectiveness. This study examines the practices, operational challenges, and outcomes of Lassa fever contact tracing activities in Edo State between 2021 and 2024. A mixed-methods design will review outbreak response documentation from the Edo State Ministry of Health, including line lists, contact tracing registers, and outbreak response reports. Semi-structured interviews will be conducted with 40 contact tracers, supervisors, and local government disease surveillance officers to elicit operational perspectives. Key performance indicators assessed will include mean time from case notification to contact listing, proportion of contacts followed up to 21-day completion, loss to follow-up rates, and symptomatic contact conversion rates. Global outbreak response literature indicates contact tracing completion rates in Lassa fever response are frequently below 70 percent in field conditions. Findings will identify specific operational and motivational barriers in Edo State's contact tracing system and recommend process improvements for the State Epidemiology Division, including standardised protocols, incentive structures, and digital contact management tools. Keywords: Lassa fever, contact tracing, outbreak response, Edo State, field epidemiology