Conference abstract

Outbreak of cerebrospinal meningitis in Kebbi State, Nigeria, April 2017

Pan African Medical Journal - Conference Proceedings. 2018:8(47).05 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.47.629

Contact the corresponding author
Keywords: Cerebrospinal meningitis, outbreak, Kebbi State
Opening ceremony

Outbreak of cerebrospinal meningitis in Kebbi State, Nigeria, April 2017

Jeremiah Daikwo1,&, Abdulmajid Suleiman2, David Olarinloye1, Timothy Ukonu1, Abisola Oladimeji1, Patrick Nguku1

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Nigeria Centre for Disease Control, Abuja, Nigeria

&Corresponding author
Jeremiah Daikwo, Nigeria Field Epidemiology and Laboratory Training Programme, Asokoro, Abuja, Nigeria

Abstract

Introduction: community-acquired bacterial meningitis continues to exact a heavy toll, even in developed countries, despite the implementation of childhood vaccination programs and effective antimicrobial agents. Nigeria experienced an outbreak of cerebrospinal meningitis (CSM), majorly affecting five states (Zamfara, Sokoto, Kebbi, Niger, and Katsina). We investigated the outbreak in Kebbi State to determine the magnitude, characterize the outbreak in person, place and time, and strengthen case management.

Methods: we conducted active case search in affected Local Government Areas (LGAs) and reviewed hospital records. We defined a case as any person with sudden onset of fever (> 38.5C rectal or 38.0C axillary) and one of the following meningeal signs: neck stiffness, altered consciousness or other meningeal signs including bulging fontanel in toddlers residing in Kebbi State between January and April 2017. Using line listing forms we collected socio demographic data and clinical information. Cerebrospinal fluid (CSF) samples were collected from 43 patients to test for the etiological agents using Pastorex rapid diagnostic kit.

Results: a total of 84 cases were identified in 16 (76.2%) of the 21 existing LGAs from January to April 2017. Females affected were 43 (51.2%). The median age of cases was 10 years (range 1 - 60 years). The overall attack rate (AR) was 1.9/100,000, with the highest (8.5/100,000) and least (0.4/100,000) AR recorded in Maiyama and Zuru LGAs respectively. Out of 38 samples tested 21 (55.3%) were positive for Neisseria meningitides C. Fifteen deaths were recorded during the outbreak (CFR 17.9%). The epidemic curve demonstrated a propagated epidemic pattern. The four secondary health facilities visited in four LGAs had shortage of intravenous ceftriaxone, with no vaccines supplied to the State.

Conclusion: Kebbi State had a confirmed outbreak of CSM caused by Neisseria meningitides C. Maiyama LGA was most affected. Visit was paid to the State Ministry of Health to advocate for an effective drug distribution to facilities in order to maintain prompt case management. Urgent procurement of vaccines by emergency operation center for immediate reactive vaccination was recommended.