Response to the meningococcal meningitis epidemic (MME)at Aminu Kano Teaching Hospital, Kano (2008-2009)

Abstract

In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from 5 January 2009 to 15 May 2009, AKTH managed 222 cases of suspected meningitis with 14 deaths (case fatality rate [CFR] of 6.3%). Twenty three per cent (23%) were microbiologically proven as meningococcal meningitis while 9% were confirmed to be pneumococcal meningitis. Male to female ratio was 1:1 with most patients (81%) aged below 14 years. The epidemic peaked in weeks 10 and 13 with 38 admissions in the respective weeks. Meningococcemia with purpura fulminans, post meningitic immune complex cutaneous vasculitis and polyarthritis were observed. Control measures instituted included provision of free ceftriaxone, chemoprophylaxis to contacts, vaccines to staff/families, and creation of dedicated isolation wards. Clinical management guidelines were developed and hospital staffs were also enlightened. Lessons learnt included the difficulty of discriminating between nosocomial transmission and community clusters; relative increase in pneumococcal meningitis during the epidemic; unreliability of penicillin/chloramphenicol; the utility of internet for communication; and the inadequacy of vaccines to meet staff & public demand.

Satisfaction among patients attending oncology clinic in a tertiary hospital in South West, Nigeria

“…This finding is better than findings from a study done in a tertiary hospital in South east Nigeria (23). Similarly, another study carried out in a teaching hospital in Northern Nigeria had 83% of their respondents satisfied with the health services rendered (24). The high level of satisfaction in this study could be due to the high opinion on physical environment and staff attitudes expressed.…”

Emergence and control of epidemic meningococcal meningitis in sub-Saharan Africa

“…However, it is not certain whether these changes are also due to enhanced disease surveillance. The most recent largescale meningitis epidemic in the African meningitis belt occurred in 2009, with a total of 88,199 suspected cases and case fatality rate of about 6.1% [8,9]. More than 85% of the cases occurred in Northern Nigeria and Niger and are characterized by the predominance of Neisseria meningitidis (Nm) serogroup A.…”

A case report of bilateral uveitis with meningococcal septicaemia resulting to blindness and adjustment disorder

“…Northern Nigeria and Niger accounted for about 85% of cases. 1,2 This was followed by mass vaccination with menafric. [3][4][5] Children with Nesseria meningitides meningitis could develop complications such as purpura fulminans, polyarthritis and cutaneous vasculitis.…”

“…[3][4][5] Children with Nesseria meningitides meningitis could develop complications such as purpura fulminans, polyarthritis and cutaneous vasculitis. 2 Complication such as bilateral uveitis and endophthalmitis are rare. 6 Even though this intraocular inflammation is rare it may be caused by spread of the micro-organisms from the primary site of infection haematogenously penetrating the blood ocular barrier to the eye (secondary site).…”