Conference abstract

Outbreak investigation of Neisseria meningitides serogroup C Meningitis in Kano State, March - May 2017

Pan African Medical Journal - Conference Proceedings. 2018:8(49).05 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.49.691

Contact the corresponding author
Keywords: Outbreak, cerebrospinal meningitis, attack rate, Kano State
Opening ceremony

Outbreak investigation of Neisseria meningitides serogroup C Meningitis in Kano State, March - May 2017

Mukhtar Muhammad Abdulaziz1,&, Olufunmilayo Badmus2, Tyakaray Visa1, Nura Karaye3, Mahmood Dalhat4, Abba Shehu3, Imam Bello3, Tijjani Husseini3, Stephen Akar1, Goodwill Effah1, Abisola Oladimeji4, Patrick Nguku4

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Epidemiology Unit, Federal Ministry of Health, Nigeria, 3Epidemiology Unit, Kano State Ministry of Health, Nigeria, 4African Field Epidemiology Network (AFENET), Nigeria

&Corresponding author
Mukhtar Muhammad Abdulaziz, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

Abstract

Introduction: Nigeria experienced a multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides serogroup C (Nmc) in March 2017. Kano State, one of the affected 22 states reported its first two confirmed CSM cases on March 22nd 2017. NFELTP residents were deployed to the state to determine the magnitude of the outbreak and characterize it in time, place, and person, and to carry out response activities to control the outbreak.

Methods: using the case definition of 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, we reviewed and validated the line list developed between 1st March to 20th May, 2017. We conducted active case search in health facilities and communities especially along border Local Government Areas (LGAs). We determined frequencies, proportions and attack rates, at wards and LGA levels to track alert and epidemic thresholds and we created a spot map to show distribution of cases.

Results: a total of 295 suspected cases (Attack Rate = 2.26/100,000) were line-listed with 22 confirmed, and 17 (77.3%) belonging to serogroup C. Twenty-four (24) deaths were recorded (CFR: 8%). Median age was 11 years (range 1 month - 65 years), with the age group 5 - 14 years constituting the majority, 88 (34.9%). Males constituted 60% of cases. The outbreak was propagated with peaks at weeks 11 and 15 of year 2017. It affected 34 of the 44 LGAs in Kano State, with clustering within the densely populated metropolitan LGAs and LGAs sharing border with Katsina State. Fagge LGA had the highest attack rate, while Dambatta the least; 14.4/100,000 population and 0.3/100,000 population respectively.

Conclusion: Kano State had a confirmed cerebrospinal meningitis outbreak, affecting mostly the densely populated LGAs. These areas were targeted for intense community sensitization on preventive measures, prepositioning of ceftriaxone at health facilities and strengthening of case management. The shortage in national supply of CSM vaccines however made control effort challenging and less effective. We recommended sustenance of enhanced surveillance activities in unaffected LGAs bordering affected ones.