Outbreak of cerebrospinal meningitis in Kebbi State, Nigeria

Abstract

Background: Cerebrospinal meningitis (CSM), is a major public health problem still affecting tropical countries particularly in sub-Saharan Africa. Group A and occasionally group C account for large scale epidemics in many countries in the African meningitis belt. The study aimed to describe the pattern of cerebrospinal meningitis outbreak in Kebbi state in 2015.

Method: Information on cases and deaths was collected throughout the duration of the meningitis outbreak in all affected local government areas of Kebbi state. During this outbreak, we defined a suspected case as any person with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal signs and any toddler with sudden onset of fever (>38.5 C rectal or 38.0 C axillary) and one of the following signs: neck stiffness, or flaccid neck, bulging fontanel, convulsion or other meningeal signs. All the data was entered into SPSS statistical software and analyzed.

Results: A total of 1,992 suspected cases of CSM were seen within the 18 weeks that the outbreak lasted. 1127 (57.0%) were males and 865 (43.0%) were females with a case fatality rate of 4.0%. The highest proportion of cases was found among those above 15 years of age (31.0%), 1252 (62.9%) of cases were immunized against neisseria meningitides type A. Two-thirds (16) of the LGAs in the state were affected and Aliero LGA had about half (n=1106; 55.5%) of cases seen. Most (77.3%) of samples analysed were positive for Nm type C.

Conclusion: Kebbi state experienced an outbreak of cerebro-spinal Meningitis in 2015 which was massive. Effective surveillance system and mass vaccination with polyvalent vaccines containing serogroup C will prevent future occurrence.

Keywords: Meningitis belt, MenAfriVac, Neisseria meningitidis type C, Sub-Saharan Africa