18 November 2018

Nigerians Advised to Be Alert As Meningitis Season Begins

Photo: Vanguard
Meningitis.

Nigerians have been cautioned to stop living in crowded rooms, seek medical advice when down with fever and be more alert to the outbreak of the cerebrospinal meningitis (CSM) in their environment.

This advice was given by the Nigeria Centre for Disease Control (NCDC). It comes with the announcement of the beginning of the CSM season in Nigeria which usually starts from November to June with a peak in April.

Nigeria is one of the countries in Africa which is on the meningitis belt and as such the outbreak of meningitis has become a yearly occurrence in at least 26 states including the Federal Capital Territory (FCT).

These states include Zamfara, Katsina, Sokoto, Kebbi, Niger,Adamawa, Yobe, Gombe Nasarawa, Borno, Cross River, Jigawa, Taraba, Kaduna, Kano, Lagos, Plateau, Osun, FCT.

CSM is a disease characterised by the swelling of the membrane of the throat and the spinal cord. In Nigeria, different classes of bacterial meningitis exist, including A B, C, W, X and Y.

Between December 2016 and June 23, 2017, Nigeria recorded severe cases of the disease with a total of 1,166 people dead.

Unfortunately, children between five and 14 were most affected accounting for 6,791 cases out of a total 14, 513 cases recorded in 24 states.

Zamfara was the most affected state in terms of casualties, followed by Sokoto and Katsina. Together, they accounted for about 89 per cent of the cases.

The outbreak, which reached an epidemic alert threshold, was declared over six months after the first case.

Fortunately, in 2018, the casualties from the diseases were not as high as that of the previous year.

To forestall a repeat of 2016/2017 epidemic outbreak, the Nigeria Centre for Disease Control in its weekly epidemiological report announced the commencement of the meningitis season for this year.

In the report, NCDC called on the 36 states and the Federal Capital Territory especially the 26 states more prone to the disease to strengthen preparation and improve surveillance.

The agency in its advisory note to Nigerians said though 26 states are prone to the disease because they fall on the meningitis belt; other states need to be prepared because the disease spreads with human contact. This can be transmitted to other parts of the country through human migration.

"It is important to note that Nigeria experienced a large outbreak of meningitis during 2016/2017 season and with State's support, we achieved over 70 per cent reduction in cases and deaths during the 2017/2018 season and it is possible to prevent more cases/ deaths this season (2018/2019) if we pare early.

"Therefore, this is a wakeup call to all states to be better prepared to respond in event of an outbreak. As such, states are requested to intensify their support for the meningitis season by strengthen active surveillance and notification for meningitis in communities and health facilities using standard case definition."

The agency also advised that for all suspected cases, the states should ensure immediate collection of Cerebrospinal fluid (CSF) sample and send to the State Public Health Laboratory.

It also advised that states set up an incident management system for Cerebrospinal meningitis (CSM) in anticipation of cases.

"States are to procure and preposition Ceftriaxone, intravenous fluids and other medical supplies for immediate case management. The should also train appropriate healthcare workers in all their health facilities to collect CSF samples from all suspected cases of CSM before commencement of treatment, and send same to the appropriate laboratory for diagnosis.

Also, the Nigeria Primary HealthCare Development Agency said it is already working with NCDC to increase awareness on the symptoms and signs of meningitis and how people can be protected against the disease.

Speaking in an interview with PREMIUM TIMES, the executive secretary, NPHCDA, Faisal Shuaib, said the agency has started advising people on how they can protect themselves by avoiding overcrowding.

He said people should endeavour to visit the nearest primary healthcare centre around them when they come down with symptoms suggestive of meningitis.

Speaking on other efforts taken by the agency to curtail the spread of the disease, Mr Shuaib said the agency had a meeting with the health workers in the states and also just concluded a meeting with the executive secretaries of the 36 state primary healthcares.

"We talked about how they should step up campaigns and also increase enlightenment on meningitis in their states. Also, the agency is preparing to stockpile meningitis vaccines and we will start vaccinating those Local Government Areas that did not get vaccines in the last campaigns.

"We have identified those who did not also get vaccines in the last season we are going to be vaccinating them to protect them against meningitis," he added.

One of the reasons for the high number of deaths recorded during the 2016/2017 meningitis season was because there was no vaccine for the" strain C" CSM" in the country when the disease broke.

It took the intervention of the World health Organisation and other international partners working in the health sector in Nigeria to get some vaccine.

Vaccination for the disease would have been the best preventive measure against the disease. Unfortunately, there is a shortage of vaccine for meningitis especially for strain C globally.

Olaolu Aderinola, head of the technical working group of the cerebrospinal meningitis at the NCDC, said CSM is a very deadly disease and if not treated it can kill up to 50 per cent of patients who have it.

Mr Aderinola said the bane of the disease is that though it can be treated if detected early, about 10 to 20 per cent of those who survive it will have disabilities such as brain damage, hearing loss and other disabilities among others.

He said people need to report cases of fever early as the disease is air borne and it passes from one person to another through the air and though close contact with people who have meningitis.

He mentioned some of the symptoms of the disease as fever, headache, and neck stiffness.

"Other people may have sensitivity of the legs but this may not be too common among children. They will also not like to see the sunlight or any bright area and when its gets more severe, they will have altered consciousness. That is, they will not be very coherent in their speech and how the relate with others, he said

Mr Aderinola added that parents need to always observe their children in this season.

"Infants also have similar symptoms as adults and as such there is a need to always observe them and take them to the nearest health centre when they start running temperature.

"Due to their ages, they might not exhibit some of the symptoms highlighted but key thing to watch out in infants, especially those below one year, is the fontal part of the head called the fontanelle."

He added that because infants cannot talk, they might be crying in high pitch and excessively than is expected and also refuse to feed.

"The thing about meningitis is that it is very fast and once the symptoms starts, the patient needs to get to the health facility as soon as possible for treatment," he added.

Nigeria

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