Cerebrospinal meningitis in Kebbi State, Nigeria: 2015 - 2016

Introduction : cerebrospinal meningitis (CSM) is an epidemic-prone vaccine preventable disease associated with high mortality and morbidity, especially in developing countries like Nigeria. It is regarded as a priority disease in the Integrated Disease Surveillance and Response (IDSR) system in Nigeria. We analyzed surveillance data to describe the epidemiology of CSM in Kebbi State, 2015 - 2016. Methods : we reviewed surveillance data abstracted from Kebbi State IDSR data-base for the years 2015 - 2016. A suspected case of CSM was defined as: any person with sudden onset of fever (>38.5oc rectal or 38oc axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal signs. A confirmed case was defined as a suspected case confirmed by isolation of Neisseria meningitidis from Cerebro-spinal fluid (CSF) or blood. We computed frequencies and proportions. Results : a total of 2088 suspected cases of CSM were reported during the period under review with a cumulative attack rate of 48.6/100,000 and 2.3/100,000 in 2015 and 2016 respectively. Mean age was 12.9 ± 9.5 years. Males constituted 1183 (56.7%) of the reported cases. Persons aged 10-15 years accounted for the highest number of cases 720 (34.5%). All patients were treated with Intra-muscular or Intra-venous Ceftriaxone according to the national treatment guidelines. Only 140 (6.7%) patients, had their CSF samples taken of which 76 (54.3%) were positive for Neisseria meningitides serotype C. Ninety three of the total patients died during the reporting period (case fatality rate 4.5%). Amongst those that died, only 2 (2.2%) were laboratory confirmed. One thousand two hundred and fifty four (60.1%) of the cases had a single dose of Meningococcal polysaccharide vaccine, 803 (38.5%) were unvaccinated. Conclusion : the laboratory component of the surveillance system and the vaccination coverage were poor. We recommended further improvement in laboratory surveillance and vaccination activities in the State.