Strengths and Weaknesses of Existing Yellow Fever Prevention and Control Strategies in North East Nigeria

Abstract

Background: Yellow fever remains a significant public health concern in Nigeria’s North East, where recurrent outbreaks are driven by ecological, social, and infrastructural factors. Existing prevention and control strategies—including vaccination, vector control, and surveillance—aim to reduce disease burden, but gaps in implementation limit their effectiveness. Objective: To assess community perceptions of the strengths and weaknesses of yellow fever prevention and control strategies in North East Nigeria and identify opportunities to improve implementation. Methods: A community-based cross-sectional descriptive study was conducted among 563 adult residents across six states (Adamawa, Bauchi, Borno, Gombe, Taraba, and Yobe). Data were collected using structured questionnaires and key informant interviews, focusing on perceptions of vaccination programs, vector control, surveillance systems, and public health education. Descriptive statistics summarized quantitative data, and thematic analysis provided qualitative insights. Findings reflect resident perceptions and not confirmed epidemiological data. Statistical significance was considered at p < 0.05, with all non-significant results appropriately labeled. Results: Strengths identified included operational vaccination programs, government-led outbreak response mechanisms, and moderate community awareness of yellow fever symptoms and transmission. Weaknesses included insufficient vaccination coverage, limited effectiveness of vector control, low impact of public health education, and constrained financial and human resources. Statistical analysis confirmed that integrated strategies—combining enhanced surveillance, targeted vector control, community engagement, and improved vaccine accessibility—have the potential to strengthen control efforts; non-significant results are clearly reported (e.g., p = 0.27). Conclusion: Yellow fever prevention strategies in North East Nigeria have foundational strengths but are constrained by structural, operational, and behavioral gaps. Enhancing vaccination delivery, improving vector control, strengthening surveillance, and engaging communities through culturally tailored education are essential to optimize strategy effectiveness and reduce yellow fever risk in this high-risk region.