Pattern of the meningococcal meningitis outbreak in Northern Nigeria, 2009

Bassey, Bassey Enya; Vaz, Rui G.; Gasasira, Alex; Braka, Fiona; Weldegriebriel, Goitom; Komakech, Williams; Toritseju, Maleghemi Sylvester; Fatiregun, Akinola Ayoola; Okocha-Ejeko, Angela

doi:10.1016/j.ijid.2015.12.016

Cited by 17 publications

(21 citation statements)

References 11 publications

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“…Furthermore, none of the samples underwent culture studies in 2015 as against 2014, how much more polymerase chain reaction test. Similar challenges were pointed out in a recent publication authored by Bassey et al (2016) where small numbers of CSF samples were taken and of course, even smaller numbers were processed in state laboratories in Northern Nigeria.…”

Section: Strengthening Laboratory Capacitysupporting

confidence: 58%

Lessons Learnt from Cerebrospinal Meningitis Outbreak Surveillance Data-A Case for Public Health Action

Omoleke¹,

Alabi²,

Usman³

et al. 2016

GJHS

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Background: Outbreak of cerebrospinal meningitis (CSM) remains a major public health concern in Nigeria, particularly in northern Nigeria. The paper evaluates the effect of mass vaccination against cerebrospinal meningitis outbreak in 2013 on the incidence rate in 2014 and 2015, and to document lessons learnt from field experiences of the meningitis epidemic surveillance in Kebbi State, North-west, Nigeria. Methods:The authors analysed cerebrospinal meningitis surveillance data generated from the routine integrated disease surveillance and response (IDSR) programme executed by the Ministry of Health with support from the World Health Organisation (WHO). Cerebrospinal fluid (CSF) samples via lumbar puncture procedures from a small proportion of all suspected cases that met the standard case definitions were collected, and then tested using the rapid agglutination test kits (Pastorex) at the state public health laboratory. The WHO supported the trained Local Government Areas Disease Surveillance and Notification Officers to ensure data quality.Results: A total of 544 and 1,992 cases were analysed in 2014 and 2015 respectively. In 2014, 14% CSF samples were taken and 55.1% tested positive to Neisseria meningitidis type C. Of all the cases in 2014, 14% were reported dead. Further, in 2015, 4% CSF samples were tested and 83% were positive to Neisseria meningitidis type C. Of the total 1,992 cases in 2015, 4% were reported dead. Gender and CSF sample testing significantly predicts survival in 2014 (p<0.05). Conclusion:Desired political will and comprehensive epidemic prevention and control strategies are needed for effective control of seasonal outbreaks of CSM and other epidemic-prone diseases. Need for infrastructural and capacity development of hospital and state public health laboratories for adequate surveillance, testing of samples collected and effective case management cannot be over-emphasized.

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Section: Strengthening Laboratory Capacitysupporting

confidence: 58%

Lessons Learnt from Cerebrospinal Meningitis Outbreak Surveillance Data-A Case for Public Health Action

Omoleke¹,

Alabi²,

Usman³

et al. 2016

GJHS

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“…Meningitis epidemics occur globally and pose major public health challenges despite the availability of safe and cost-effective vaccine. 5,6 The global mortality rate for meningitis continues to be high, ranging between 2% to 30% notwithstanding the progress made in treating the condition. 7 The incidence of bacterial meningitis is higher in developing countries and children bear the highest consequence.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately, over 300,000 million people within the belt are at risk of bacterial meningitis morbidity and mortality. 2,6,8 In Ghana, the Upper East, Upper West and Northern Regions fall within the "African meningitis belt" with high annual meningitis incidence, frequent outbreaks and death. 2,9 The main strategy for meningitis prevention and control in Ghana includes surveillance and reactive vaccination of affected areas.…”

Section: Introductionmentioning

confidence: 99%

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Geospatial clustering of meningitis: an early warning system (hotspot) for potential meningitis outbreak in upper east region of Ghana

Akyereko

Ameme

Nyarko

et al. 2020

gmj

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Objective: We mapped and generated hot spots for potential meningitis outbreak from existing data in Upper East region, Ghana.Design: This was a cross-sectional study conducted in 2017Data Source: Meningitis data in the Upper East Region from January 2007, to December 2016.Main outcome measure: We used spatial tools in Quantum Geographic Information System (QGIS) and Geoda to draw choropleth map of meningitis incidence, case fatality and hotspot for potential meningitis outbreak Results: A total of 2312 meningitis cases (suspected and confirmed) were recorded from 2016-2017 with median incidence of 15.0cases/100,000 population (min 6.3, max 47.8). Median age of cases was 15 years (IQR: 6-31 years). Most (44.2%) of those affected were 10 years and below. Females (51.2%) constituted the highest proportion. Median incidence from 2007-2011 was 20cases/100,000 population (Min 11.3, Max 39.9) whilst from 2012-2016 was 11.1cases/100,000 populations (Min 6.3, Max 47.8). A total of 28 significant hotspot sub-districts clusters (p=0.024) were identified with 7 High-high risk areas as potential meningitis outbreak spots.Conclusion: The occurrence of meningitis is not random, spatial cluster with high –high-risk exist in some sub-districts. Overall meningitis incidence and fatality rate have declined in the region with district variations. Districts with high meningitis incidence and fatality rates should be targeted for intervention.Keywords: meningitis outbreak, geospatial clustering, Upper East Region, meningitis incidence, GhanaFunding: Author EA was supported by the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN°57212014/mcrt).

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“…Another factor that potentially delayed notification of the outbreaks to the NCDC by the states was their perception of the ability to contain the outbreaks without external assistance. While this may seem true and possible on the surface, more often than not, the states do not have the adequate technical and material resources to respond to meningococcal outbreaks on their own [ 16 ]. Giving credence to this statement are other findings in this study which implied that inadequate skilled personnel to carry out lumbar punctures, inadequate medical consumables and inadequate laboratory capacity might also have impacted on delayed detection of the outbreak in the three states.…”

Section: Discussionmentioning

confidence: 99%

Time delays in the response to the Neisseria meningitidis serogroup C outbreak in Nigeria – 2017

et al. 2018

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BackgroundNigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria.MethodsUsing data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak.ResultsThere were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states.ConclusionThere were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.

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Pattern of the meningococcal meningitis outbreak in Northern Nigeria, 2009

Abstract: The testing of CSF samples during meningitis outbreaks is recommended in order to monitor the occurrence of the multiple meningitis serotypes during these outbreaks and to direct serotype-specific vaccination response activities.

Cited by 17 publications

References 11 publications

Lessons Learnt from Cerebrospinal Meningitis Outbreak Surveillance Data-A Case for Public Health Action

Lessons Learnt from Cerebrospinal Meningitis Outbreak Surveillance Data-A Case for Public Health Action

Geospatial clustering of meningitis: an early warning system (hotspot) for potential meningitis outbreak in upper east region of Ghana

Time delays in the response to the Neisseria meningitidis serogroup C outbreak in Nigeria – 2017

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