Governors North-west states recently met with religious leaders, the health minister, development partners and other health stakeholders in Kaduna to address the outbreak of meningitis in Nigeria.
ABDULRAHEEM AODU, who was there, reports that concerted eff orts are being maTh e outbreak of Cerebrospinal Meningitis (CSM) in Zamfara state last November has spread to 26 Nigerian states killing 489 victims out of the 4,637 people suspected of having the disease. Th is alarming rise in, and spread of less known Type C meningitis led the Sultan of Sokoto, Alhaji Muhammad Sa’ad Abubakar III to convene an emergency meeting of Northern state governors, Northern Traditional Leaders Council (NTLC), development partners, health minister and other health stakeholders.
Emergency meeting timely – Sultan Th e Sultan, in his opening address, said the meeting is timely and commendable noting that the monarchs will support other health stakeholder to tackle the disease and stifl e the spread.
“Th e meeting is timely and commendable, the traditional leaders in coordination with other stakeholders would do everything possible to assist in ensuring appropriate medical assistance promptly to avoid further outbreak of meningitis.
“Th e eff orts so far taken by the Federal Government and some state governments is highly commendable but these eff orts should be carried to conclusive end until this disease is eliminated or controlled,” the Sultan, who was represented by the Emir of Zazzau, Alhaji Shehu Idris, said.
Over 1,000 meningitis cases recorded in Sokoto -Tambuwal Sokoto state Governor, Alhaji Aminu Waziri Tambuwal described meningitis as a dangerous epidemic, “in Sokoto state, we recorded over 1,000 cases in about seven local governments.
Th e state government had to mobilise with traditional leaders in the state and other stakeholders, particularly our development partners. “We had a collaboration with the federal ministry of health, we received over 20,000 vaccines from the federal ministry of health and we are expecting about 800,000 more vaccines, our target is to have 2 million vaccines to cover our people in most of the areas.
We have mobilised a team led by the health commissioner. We have had challenges of drugs and health personnel as well,” he said. Meningitis outbreak in Nigeria sad – el-Rufai Governor Nasir el-Rufai of Kaduna state said it was a great sadness for governors to see the number of deaths recorded in their states due to meningitis.
He lamented that, the North West zone has been battling meningitis epidemic because it is Type C strain that health professionals were not conversant with. He tasked the traditional leaders to take the battle with the same zeal with which they took polio eradication and come up with strategies to combat this epidemic.
“Th e action so far taken by the federal government has slowed down the spread. Here in Kaduna state, we have 17 suspected cases across 11 local governments with one type C case and one death. Alongside the measures instituted by neighbouring states, we have intensifi ed surveillance and engaged in mass media enlightenment, while mobilising appropriate medicines and medical supplies in our hospitals across the state.
With the proactive steps we have taken, we hope the epidemic will not occur in Kaduna state,” el-Rufai said. Nigeria needs $1bn to vaccinate 21m people in 5 states Th e Minister of Health, Prof. Isaac Adewole said that Nigeria needs $1 billion to eff ectively vaccinate 21 million people across the fi ve endemic states of Zamfara, Sokoto, Katsina, Kebbi and Niger states, currently ravaged by meningitis. Since the current outbreak last November in Zamfara state, meningitis has so far spread to 26 states with 4,637 suspected cases leading to 489 deaths, while 207 bacterial meningitis have rshaled against the scourge. been laboratory confi rmed and 171 other forms confi rmed meningitis cases. “Meningitis vaccination is very expensive. To eff ectively stop meningitis in Nigeria, we need to vaccinate 21 million people in the fi ve states which will cost about $1 billion. We need Immunity Trust Fund to cater for immunisation, we need to put more money in health to build robust health system that is resilient. Nigeria would need to put more money on vaccine. “Th e state governments also need to put in more money on health. We want the state governments to support us to revitalise the PHC for every political ward to have at least one PHC. We need to put community health extension workers there and to invest in routine immunisation. About 7 million births are recorded annually, if we vaccinate all of them we would protect them from meningitis and other diseases. “North west is our emergency zone. We need to declare public health emergency in North west.
Where we have robust health system, meningitis will not be a problem. Surveillance aspect and early warning system is very important to call us on time. We need to look at local production of vaccines to take charge of our destiny,” the Minister added. Causes and types Meningitis is the thin infl ammation of the thin lining that surrounds the brain and spinal cord, according to the Head of Epidemiology, Federal Ministry of Health, Dr Nasir Sani Gwarzo. He said meningitis can be caused by bacteria, fungi, virus and even lead poisoning.
“Th ere are 13 diff erent known types of meningitis; A, B, C, X, Y and W138 are notorious. A, B and C are prone to epidemic proportions, almost 80% is caused by A.” Mode of transmission, symptoms “Th e reservoir is person to person. It can be spread through kissing, coughing, sharing utensils, sneezing and prolonged closeness among others. All humans are vulnerable but children are more vulnerable, risks are higher with people with immuno defi ciency. Symptoms include severe headache, high fever, stiff neck, nausea, vomiting, numbness or loss of feelings, light sensitivity, rashes.” Effects and treatment “About 10% cases die, up to 50% cases die in bad situation. 10% to 20% cases who don’t die, live with severe damages leading to epilepsy, arthritis, thrombosis, deafness, blindness, abscess or brain damage (cerebral palsy). “Treatment within two days, the victim can survive, the key thing is early diagnosis, the public should quickly go to hospital. Epidemic is foreseeable and preventable.
Outbreak occurs in little clusters because of the climate. It occurs in seasonal variation frequently in the Africa belt. Supporting factors are overcrowding, large population displacement, large gathering of people like pilgrims, sport arenas and traditional markets.”
National Coordinator of Nigeria Center for Disease Control, Dr. Chikwe Ihekweazu, in his remarks said the outbreak of meningitis started in Zamfara state in November 2016 but they were only notifi ed on February 7, 2017 and they deployed along with other stakeholders to the area a week later.
“Th ere are 4,637 suspected cases and 489 deaths so far.” Vaccines available for outbreak – NPHCDA Th e Executive Director/ CEO, National Primary Healthcare Development Agency (NPHCDA), Dr Faisal Shuaib while giving update on vaccines availability and plans for future CSM outbreak, said Nigeria is well prepared for the current outbreak.
“Th e high risk states are Sokoto, Bauchi, Borno, Yobe, Jigawa, Zamfara, Kano, Katsina and Kebbi states. Vaccine forecast for 634, 394 doses of meningitis Types A plus C was made for meningitis outbreak in 2017. “We met with the nine high risk states on meningitis and measles outbreak and as part of preparation, meningitis A, C, W and Y vaccines were deployed to states.
We received 500, 000 doses of meningitis poly saccharide, we sent 20,000 doses to Sokoto state, 50,000 doses to Katsina state, 5,000 doses to FCT, 500,000 doses to Zamfara state and 125,000 doses to Kano state among others.
We are expecting 823, 000 doses (conjugate Type C) donation from British government. “Mass vaccination had already commenced in 14 LGAs in Zamfara state. Th rough UNICEF, 1.1 million doses of meningitis Type A vaccines from Kinshasa, Democratic Republic of Congo is being explored by the country.
Type A cases noticed in Yobe state. We have enough vaccines for the epidemic we are witnessing but we cannot say for future outbreaks,” he said. Meningitis’ spread to Northeast will be catastrophic – Unicef Th e United Nations Children Fund (UNICEF) has warned that the current meningitis outbreak should not be allowed to spread to war ravaged states like Borno and Yobe, as such spread to IDPs camps, where displaced persons are camped together in crowded environment will be devastating and the outcome could be catastrophic.
UNICEF Country Representative, Mohammed Fall said, children in the Northeast were already facing burden of malnutrition and other consequences of devastating conflicts in crowded environment and letting meningitis penetrate the region would increase the burden to alarming rate.
Meningitis outbreak in Zamfara avoidable – WHO Th e World Health Organization (WHO) has blamed the outbreak of meningitis in Zamfara state last November on lack of robust surveillance and delay in notifying the Center for Disease Control, saying the Zamfara outbreak was avoidable and could have been curtailed with better coordination. WHO Country Representative, Wondimagegnehu Alemu said, Nigeria henceforth needs to spend more and invest on outbreak investigation and detection, particularly in rolling out robust surveillance system. He said, 500 cases of meningitis discovered sometimes last November in Zamfara would have been been avoided if there was a robust surveillance system.
Representative of the Department for International Development (DFID), Salma Kolo blamed the outbreak of the scourge on weak health system in Northern Nigeria, calling on the leaders of the region to improve on their eff orts to fi x the health system
