The high death toll, which rose to over 300 in 15 of the 36 states in the country as at March 30, as a result of the recent Cerebrospinal Meningitis (CSM) epidemic, is as alarming as it is worrisome. Sokoto state appears to be among the worst hit, having recorded over 41 deaths few weeks after the outbreak of the disease, which, according to the Nigeria Centre for Disease Control (NCDC), has infected 1,966 people.
Sokoto State Health Commissioner, Balarabe Kakale, confirmed the meningitis-related deaths last week in Dange town, headquarters of Dange/Shuni Local Government of the state. Kakale gave an update on the state of high alert declared on the health sector by the Ministry on March 20.
He stated that the deaths were recorded in the seven worst hit local government areas of Kebbe, Bodinga, Rabah, Wamakko, Gada, Dange/Shuni and Tureta. “The state government had since March 20, deployed no fewer than 15 medical teams, comprising more than 150 medical personnel.
“They were deployed across the 23 local governments of the state, fully equipped with ambulances and provided with drugs, as well as medicament. The emergency response teams are conducting house to house cases search, definition and management, both at home and the hospitals.
“They have so far treated no fewer than 400 mixed cases of severe malaria and meningitis across the seven top-hit local governments. Out of the 400 cases, 56 were confirmed in the laboratories to be cases of meningitis, out of which additional fatalities were recorded.”
Kakale further noted that thousands of other cases were treated at the primary health centres in the state. The commissioner disclosed that the state government was contemplating closing some public and private schools if the problem persisted. “We are hereby again intimating the people of the state that the cases of meningitis should not be linked to witchcraft or sorcery”.
Meningitis is an infection of the thin lining that surrounds the brain and spinal cord called the meninges. Viral and bacterial infections are the most common cause but bacterial meningitis is much more serious due to its rapid onset and it poses a significant risk of death.
Neisseria meningitidis can be carried in the throat and sometimes, for reasons not fully understood, can overwhelm the body’s defenses allowing infection to spread through the bloodstream to the brain. It is believed that 10% to 20% of the population carries neisseria meningitidis in their throat at any given time but the carriage rate may be higher in epidemic situations.
The most common symptoms of meningitis are stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. Bacterial meningitis can also result in mental retardation, deafness, epilepsy, or necrosis leading to limb amputation.
Meningococcal disease is potentially fatal and should always be viewed as a medical emergency. Even when the disease is diagnosed early and adequate treatment is started, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms. It is important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.
Appropriate antibiotic treatment must be started as soon as possible. A range of antibiotics can treat the infection, including penicillin, ampicillin, chloramphenicol and ceftriaxone. Under epidemic conditions in areas with limited health infrastructure and resources, ceftriaxone is the drug of choice.
It is instructive that Nigeria has suffered meningitis cases intermittently, recording the worst outbreak in 2009 when more than 2,000 people died from the disease.
Although the current high death toll could have been prevented, we, nevertheless, commend the federal government’s quick response in tackling the menace and spread of the meningitis epidemic. The federal government said it has secured not less than 500, 000 meningococcal vaccines while additional 800,000 units were expected from the British government on April 4, 2017.
Disclosures by the Minister of Health, Prof Isaac Adewole, that the federal government has started working with all the affected states in specific areas of collaboration on massive awareness and sensitization, laboratory investigation and analysis, proper documentation and disease surveillance techniques are quite reassuring.
“We are in constant discussion with World Health Organization (WHO), UNICEF, E-health Africa and other international health agencies for supplies of vaccines and injections”, he said.
We, however, advise that to further facilitate meningitis control efforts, Nigeria should seize the opportunity provided by the upcoming African Vaccination Week (AVW) that is commemorated from April 24-30 to strengthen immunization services and systems through advocacy, social mobilization, education and communication tools and activities.
