A report from the World Health Organisation (WHO) has shown that between October 2022 and April 2023, 1,686 suspected meningitis cases, including 532 confirmed cases, and 124 deaths, were reported in Nigeria. The country’s Case Fatality Ratio (CFR) was seven per cent, with males accounting for 57 per cent of suspected cases, and the highest number of cases reported being among children aged one to 15 years. 

The report revealed that 74 per cent of all suspected cases came from Jigawa State, which borders the Zinder region in Niger, where a meningitis outbreak had been reported since October 2022. Nigeria’s CFR for the outbreak was seven per cent and five per cent at the national and Jigawa levels respectively. The extended meningitis belt of sub-Saharan Africa, which includes the northern part of Nigeria, has the highest rates of the disease.

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The disease is most common during the dry season, with a peak between March and April. Meningococcal meningitis is transmitted from person to person through droplets of respiratory and throat secretions. Close, prolonged contact with an infected person, or living with a carrier, facilitates the spread of the disease.  WHO said that Nigeria had implemented interventions to combat meningitis, including introducing the meningococcal A (MenA) conjugate vaccine against NmA from 2011-2022. Through preventive campaigns, Nigeria had vaccinated over 100 million people aged one to 29 years, and the vaccine had been included in the country’s routine immunisation schedule since 2019.

WHO noted that insecurity, particularly in the northeast, affects vaccination coverage, especially in areas controlled by non-state armed groups. It said that at the national level, immunisation coverage remains suboptimal at 50 per cent as of 2021.

According to the Nigeria Centre for Disease Control (NCDC), the major challenges in controlling CSM included difficulty accessing some communities due to security concerns in Zamfara, inadequately trained personnel in states for case management, poor and inconsistent reporting from states, and poor health seeking behaviour due to difficult terrain, high cost of transportation to treatment centres and poor personal and community hygiene promotion.

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Response measures implemented during an outbreak, including improved case finding and management, as well as mass vaccination campaigns, contribute to control. The WHO, with support from NCDC, is implementing response measures at the national level, including vaccination, surveillance, active case finding, sample testing and case management.

WHO noted that licensed vaccines against meningococcal, pneumococcal and Haemophilus influenzae diseases have been available for many years. These bacteria have several strains, and vaccines are designed to protect against the most harmful strains. Over time, there have been major improvements in strain coverage and vaccine availability, but no universal vaccine against these infections exists.