A report by the Nigeria Centre for Disease Control (NCDC) has disclosed that in the 22nd week of the ongoing Cerebrospinal Meningitis (CSM) outbreak in Nigeria, so far, a total of 14,005 suspected cases have been identified from 23 States and the Federal Capital Territory.
In its Weekly Epidemiological Report, the agency noted that four additional Local Government Areas (LGAs) were affected, bringing the total of affected LGAs to 226. It said out of 901 samples sent for laboratory testing, 423 (46.9 percent) were confirmed positive for Neisseria meningitides, while 73 percent (309) of the tested samples showed the causative organism to be Neisseria meningitidis serogroup C. NCDC said the number of deaths recorded so far is 1,114 giving a case fatality rate (CFR) of 8 percent. The agency explained that the increase in the number of suspected cases may be linked to an increased knowledge of the case definition for CSM. However, this does not translate to better outcome for the cases, as seen with the number of deaths recorded so far. Case management of CSM, like other disease conditions, follows a sequence of case detection, laboratory confirmation, treatment using the preferred drug of choice and supportive care, the report said.
At the onset of the outbreak, a large number of identified cases did not have samples taken for laboratory testing and were managed empirically. This may have been a contributory factor to the high number of deaths recorded, it added. However, the Rapid Response Teams deployed to the most affected States supported sample collection and therefore an increase in laboratory confirmed cases. Proper management of cases following approved protocols and guidelines is critical to the effective case management of any disease condition. States have the responsibility of ensuring that approved guidelines and protocols for case management are available in all health facilities/treatment centres, the report noted. Furthermore, given that CSM is a seasonal event of public health concern, preparedness for the outbreak should entail community sensitization on the disease to promote early presentation and use of health facilities for immediate and proper institution of treatment/management, the NCDC said.
It pointed out that in the course of the outbreak, the centre, alongside the National Primary Health Care Development Agency (NPHCDA) and other partner agencies, have provided on-site support for case management in the worst affected states. A total of 10 teams (5 in each State) have been deployed to Zamfara and Sokoto States to improve sample collection rates, proper institution of treatment and other supportive care of confirmed cases. This action has improved the outcomes of cases (decreased Case Fatality Rate from above 8.0% to less than 8%) with attendant transfer of knowledge on case management protocols to health workers in both states.
Also, Lumbar puncture rate increased from less than 50% to 71% in Zamfara State while it increased from less than 10% to 33% in Sokoto State. States are enjoined to continue to improve on best practices identified and ensure that high standards of case management are employed at all times, it said in the report.