Written by: Dr. Ojum Ekeoma Ogwo.
“Doc, you said meningitis has a vaccine. Why are Nigerians, still dying yearly from meningitis?” That was James Bitrus (not real names) from Abuja. Yes, I had discussed meningitis severally, and its possible prevention through vaccination, yet every year, hundreds of people die in Nigeria, of this killer – Cerebro Spinal Meningitis (CSM). Examples ;
1) In Abuja, meningitis killed 4 children in Durumi-Garki, as at Thursday, March 30, 2017.
2) The death toll as a result of meningitis epidemic in Sokoto State, has now risen to 41, Health Commissioner Dr Balarabe Kakale disclosed this to Journalists on Sunday, April 2, 2017. The deaths were recorded out of 600 clinically confirmed cases of meningitis in the eight worst-hit Local Government Areas. They are Rabah, Kebbe, Tureta, Gada, Dande/Shuni, Wamakko, Kware and Bodiga.
• Dr Kakale said: “the epidemic was caused by the type “C” strain of meningitis, and not the type “A” strain which the people of the State had hitherto developed immunity for. This new strain of meningitis is deadlier than the dreaded Ebola disease, as it kills within four to six hours of afflicting a patient."
3) 328 deaths recorded so far of the deadly meningitis, as at Friday March 31, 2017. In a press release by Mrs Boade Akinola – Director Media and PRO Federal Ministry of Health. It was said that Cerebro-Spinal-Meningitis(CSM), has spread across the Country, mostly affecting States in the part of Nigeria, which fell within the African Meningitis Belt (AMB).
4) As at Friday March 31, 2017 about 90 Local Government Areas, in 16 States have been affected. These include Zamfara, Kano, Kastina, Sokoto, Kebbi, Niger, Nasarawa, Jigawa, FCT, Gombe, Taraba, Yobe, Osun, Cross River, Lagos and Plateau.
5) The epidemic of meningitis was not unique to only Nigeria, but had also spread to neighbouring West African Countries like Niger, Chad, Cameroun, Togo and Burkina Faso.
6) According to statistics from the Federal Ministry of Health, 2,524 people have been affected across the 16 States, 131 samples confirmed in the laboratory, with majority being meningitis “type C”, and as stated earlier, 328 deaths recorded as at Friday March 31, 2017.
7) Federal Ministry of Health, also issued health advice for prevention of spread of meningitis which included a) Avoidance of overcrowding. b) Sleeping in well ventilated places. c) Avoidance of close and prolonged contact with cases of meningitis. d) Proper disposal of respiratory and throat secretions. e) Strict observation of hand hygiene. f) Reduction in hand shaking, kissing, sharing utensils or medical interventions such as mouth resuscitation.
8) Federal Ministry of Health continued by stating that self-medication should be avoided, and appropriate vaccination for meningococcal stereotype should be taken at Health Centers. Individuals should acquaint themselves with the basic knowledge of meningitis, in order to prevent transmission.
9) Mrs Akinola lastly added that, people should seek early treatment, as all Federal secondary and tertiary public health facilities have been directed to provide free treatment to all meningitis patients. She also gave a comforting word to Nigerians, that the over-all actual rate of infection of meningitis, has begun to decline in some States, indicating that the end of the epidemic is in sight.
• Yes I went into all these details, in explaining the Federal Ministry of Health press release, to allay the fears of all my patients, who have been panicking and bombarding me with questions, of meningitis this and that. All Nigerians should note that treatment of meningitis is free. Now let me briefly summarize additional information on meningitis so as to fortify our knowledge.
How do we define meningitis?
• Meningitis is defined as inflammation of the meninges, which surround the brain and spinal cord. It is common in Northern Savanna of Africa. The disease is known as “sankara” by the Hausas, which means stiff-neck. According to Prof Perry, it is greatly feared and is thought to be caused by evil spirit.
Epidemiology of Meningitis.
• Close contact of people promotes transmission. Infected individuals usually carry the organism in their nose and throat for sometime, varying from two weeks to 10 months.
• In a few people who have immunity and antibody to the invading strain, there are no symptoms and the organism enters the blood. Here it multiplies and causes septicaemia. In about one in every 100 people, it lodges in the meninges to multiply further and causes meningitis.
• The number of cases of meningitis starts to increase as the temperature and humidity rise and reaches a peak in March and April, when it is very hot and humid. The incidence drops sharply when the rains begin. The usual explanation obtained from studies conducted in Northern Nigeria is that during the cold-dry-season, people crowd together in small huts for shelter. Transmission is high and the number of carriers increases greatly.
• The incidence of meningitis is highest in the 5 to 15 years of age-group, and more frequent in males. It is uncommon in the very young and rare in the old.
What is our take this week?
As the rains are beginning to come to signal the end of the yearly meningitis season, be guided by the precautions enumerated above. May God help us.