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Tag: meningitis

  • FG assures on containment of meningitis

    FG assures on containment of meningitis

    •WHO, UK supply 1.2m vaccines   

    Minister of Health Prof Isaac Adewole has assured that the rising cases of meningitis in some northern states will soon be contained.
    Adewole also declared that over 1.2 million doses of vaccines have been secured by the government.
    Already the country has recorded 328 deaths as a result of meningitis since November 2016.
    The minister stated requests will be made to the international organisation for additional vaccines in the next few days.
    In a statement yesterday by the ministry in Abuja, Adewole said: “Through our initiatives, we have secured 500,000 doses of the meningococcal vaccines from WHO which will be used in Zamfara and Katsina states while additional 800,000 units from the British government.
    “By next Tuesday, there will be a meeting with the International Review Group of The World Health Organisation (WHO) where request for additional vaccines shall be approved as part of practical and medically certified efforts to stem this ugly incidence.”
    He went on: “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.”
    Adewole hinted the recent upsurge in the disease was not unconnected with the discovery of a different stereotype without commercial vaccines.
    He explained: “Unfortunately, Nigeria had always been bedevilled with the stereotype A in years past but this new strain of the bacterial disease, Meningitis Stereotype C which the vaccine is not commercially available in required quantities and can only be shipped to the country by WHO only if laboratory investigation confirms the existence of the strain type C.
    “Our ongoing spirited effort is geared to upscale through nationwide immunisation campaign while navigating the menace using a combination vaccine by conducting active case finding, strengthening surveillance, case detection, verification and communication management, performing lumbar puncture of suspect cases in a well coordinated atmosphere under NCDC.
    “Our partners are already re-training physicians on the effective collection of cerebrospinal fluid for diagnosis.
    “We are equally advocating for prompt diagnosis and have issued directive to all Federal medical facilities and PHCs to treat all cases of meningitis free of charge.”
    He charged residents of Katsina, Kano, Kebbi, Sokoto, Niger, Zamfara and Jigawa states to seek early attention “when discomforted with symptoms of Cerebro Spinal Meningitis (CSM) and avoid clogging together in unventilated and over-crowded rooms.”

  • Nigeria and the scourge of meningitis

    At least 282 people aged between 5and 14 have lost their lives in Nigeria due to the outbreak of meningitis, mostly in the North Western States of Sokoto, Zamfara, Kebbi, Katsina, Niger and the Federal capital, Abuja. With close to 2,000 suspected cases across the country, the current outbreak is purported to be the worst in the history of the country since 2009 when at least 156 people died.

    Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord known as the meninges. This inflammation is usually caused by bacterial or viral infection of the fluid surrounding the brain and spinal cord. Meningitis can also result from injury, cancer, or certain drugs. Bacterial meningitis is spread from person to person. The bacteria are spread by exchanging respiratory and throat secretions (saliva or spit) during close or lengthy contact, in form of kissing or coughing, especially if living in the same household.

    On the other hand, if you have close contact with a person who has viral meningitis, you may become infected with the virus that made the person sick, but you are probably not likely to develop meningitis from the illness. This is because only a small number of people who get infected with the viruses that cause meningitis will actually develop meningitis.

    Other rare forms of meningitis are as results of fungi, parasites or amoebic infections. Fungal meningitis is rare and usually caused by fungus spreading through blood to the spinal cord. Although anyone can get fungal meningitis, people with weakened immune systems, like those with an HIV infection or cancer, are at increased risk. Also, various parasites can cause meningitis or can affect the brain or nervous system in other ways. Primary amebic meningoencephalitis (PAM) is a very rare form of parasitic meningitis that causes a brain infection that is usually fatal. PAM is caused by the microscopic ameba (a single-celled living organism) Naegleria fowleri when water containing the ameba enters the body through the nose.

    The first symptoms of meningitis are usually fever, vomiting, headache and generally feeling unwell, but as time goes on, the victim presents with symptoms peculiar to the disease. These are limb pain, pale skin, and cold hands and feet which often appear earlier than the rash that can be all over the body. Other specific symptoms include, neck stiffness, dislike of bright lights, confusion and seizures.

    To diagnose meningitis blood culture is necessary, that is blood sample from the patient is tested for bacterial meningitis. Computerized tomography (CT) or magnetic resonance (MR) scans of the head can also be done. This may show swelling or inflammation. X-rays or CT scans of the chest or sinuses may also show infection in other areas that may be associated with meningitis.

    However, for a definitive diagnosis of meningitis, a spinal tap to collect cerebrospinal fluid (CSF) is needed. In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein. CSF analysis also help in identifying which bacterium caused the meningitis. But if viral meningitis is suspected, a DNA-based test, known as a polymerase chain reaction (PCR) amplification or a test to check for antibodies against certain viruses to determine the specific cause and determine proper treatment is needed.

    Also, if an individual is ill and develops rashes or spots, the tumbler test can be used. In this case, a clear glass tumbler is placed firmly against the rash. If the rashes can be seen clearly through the glass, then urgent medical help should be sought.

    In treating meningitis, it is important to know the specific cause of meningitis because the treatment differs depending on the cause and the age of the individual involved. Most people with viral meningitis usually start getting better within 3 days of feeling sick, and they recover within 2 weeks. With mild cases of viral meningitis, only home treatment may be needed including drinking extra fluids and taking medicine for pain and fever.

    On the other hand, in treating bacterial or severe viral meningitis, treatment in a hospital may be required. In this case, medicines such as antibiotics, corticosteroids, and medicines to reduce fever are prescribed. And despite the availability of effective anti-microbial therapy, bacterial meningitis results in substantial morbidity and mortality, particularly in children. Although, most healthy adults who have recovered from meningitis don’t need follow-up care, but babies and children always need follow up care after recovery; therefore, they need to be checked for long term complications such as hearing loss, memory or concentration problems and learning difficulties which can be temporary or permanent among others.

    Although Nigeria has witnessed outbreaks of meningitis in the past, but the current one is caused by new strain of Cerebro Spinal Meningitis, purportedly imported from Niger Republic. Therefore, new vaccines are required in its prevention. Hence, preventive measures should as a matter of urgency be put in place to combat the spread.

    Meanwhile, the Federal Ministry of Health has deployed epidemiologists to the affected States to minimize the impact of the disease among the people but the States that are free from the illness should take precautions. Since meningitis is spread by contact with the infected individual, overcrowding should be avoided. It is important that windows are left open to avoid stuffiness.

    And because children are more susceptible to meningitis, suspected cases of unusual fever should be reported at a health facility. Immunizing children against the disease which remains the main method of preventing the disease should be prioritized by all parents. It is of utmost importance that these five groups of people considered at risk should get a meningitis vaccine: college freshmen who live in dorms and haven’t been vaccinated, adolescents who are 11 to 12 years old, new high school students who haven’t been vaccinated, people traveling to countries or areas where meningococcal disease is common, children who are ages 2 or older and who have a compromised immune system.

     

    • Bakare is of the Ministry of Information & Strategy, Alausa, Ikeja, Lagos

  • Kenya unveils meningitis vaccine amid threat of outbreak

    Kenya on Friday unveiled meningitis vaccine as the debilitating bacterial disease threatens to break out in the country’s northern counties amid biting drought.

    The new meningitis vaccine called “Nimenrix” was developed by Pfizer, an American pharmaceutical giant and will bolster efforts to eradicate the highly infectious disease that is rampant in Kenya and 26 other Sub-Saharan Countries.

    Deshnee Achary, the head of Pfizer Vaccines in the Anglophone region said Kenya became the first country in the region to benefit from a meningitis vaccine that was developed after rigorous scientific research.

    “Vaccination is a critical intervention in healthcare like clean water.

    “The meningitis vaccine will therefore offer long-term immunity against the disease to high risk populations,” Achary said.

    Kenya has recorded sporadic Meningitis outbreaks fuelled by droughts and displacement of populations in the northern frontier districts.

    Achary noted that Kenya’s vulnerability to a meningitis outbreak remained higher in the light of escalating drought and influx of refugees from endemic and strife torn neighboring countries.

    “Any meningitis outbreak in Africa coincides with drought hence the need for Kenyan authorities to take proactive measures like mass vaccination, hygiene education and intensive surveillance at border crossings,” said Achary.

    She added that a partnership with the ministry of health will facilitate distribution of the Meningitis vaccine to the high risk counties.

    The Nimenrix Meningitis vaccine that was approved by global regulatory agencies five years ago has proved to be an effective tool of containing the bacterial disease which impairs physical and neurological functions of patients.

    Dr Ombeva Malande, Director of East African Centre for Vaccines and Immunisation said the Nimenrix vaccine has over 90 per cent efficacy and will embolden other clinical interventions to manage the disease.

    “Vaccinating people suppresses the meningitis bacteria to ensure it does not develop to fatal stages. Available data indicates Nimemrix vaccine has met the threshold of safety and efficacy,” said Malande.

    Kenya belongs to the Meningitis Belt that comprises 27 Sub-Saharan African countries.

    The World Health Organisation contends that 1.2 million new cases of Meningitis leading to 135,000 deaths are reported annually across the globe.

  • Meningitis: NCDC confirms 282 deaths in five states

    The Nigeria Centre for Disease Control (NCDC) has confirmed the outbreak of Cerebro Spinal Meningitis (CSM) in five states with 282 deaths.

    Dr Chikwe Ihekweazu, the Chief Executive Officer of the centre, made this known to the News Agency of Nigeria (NAN) on Thursday in Abuja.

    Ihekweazu said that 1,966 suspected cases have been recorded while 109 have been confirmed since the outbreak of the disease in February in the country.

    He said that the centre had deployed a response team to the affected states to vaccinate the residents and control further spread of CSM.

    According to him, Zamfara has the highest number of confirmed cases of 44, followed by Katsina with 32, Sokoto 19, Kebbi 10 and Niger 4 confirmed cases.

    He also said that there is an inter-agency response supporting the states to contain the outbreak through the primary mode of vaccination.

    However, Ihekweazu explained that a new strand of meningitis called “stereotype C” has emerged in place of the previous known type “stereotype A”, which has disappeared.

    He regretted that there was not yet commercially available vaccine for this new stereotype “C” meningitis.

    “There is a vaccine available but it is not commercially available for the stereotype involved in this specific outbreak and we have to make application to the World Health Organisation for the vaccines.

    “Thankfully the vaccines have arrived and we have started vaccination campaign in Zamfara. We are in the process of starting in Sokoto and Kebbi states.

    “We continue to advocate for scientists and for the global community to really try and push to develop a vaccine for meningitis `C’, on the other hand all we can do is prevention,” he said.

    Ihekweazu said that prevention and early detection was key to combating the disease, if detected early, it could be treated with antibiotics.

    He said that the centre was working with the states by supporting and ensuring they have the supplies to combat the disease.

    “Meningitis is a tough disease especially during this period and it is associated with over-crowding, understanding the living conditions in the country, people must keep their building ventilated,” he said.

    He urged Nigerians to avoid sleeping in overcrowded condition and if a lot of people must sleep together in the same room, the windows and doors must be open to allow enough ventilation.

    The chief executive officer assured that the centre would work with state governments in the North West and North Central, where most cases were recorded, to ensure better preparation and avert similar outbreak next year.

     

  • Zamfara people cry out for government help against meningitis

    Nigerians in Gusau, Zamfara state have cried out to the government to help in preventing meningitis, which they said has been killing many people in the state.

    The appeal was made by a cross section of residents interviewed by the News Agency of Nigeria (NAN).

    Earlier this March, the Commissioner of Health in the state, Alhaji Suleiman Gummi said over 80 people had died as a result of the disease while another 500 were undergoing treatment at various health facilities across the 14 Local Government Areas of the state.

    The people interviewed were of the view that the situation has worsened, although they could not cite figures.

    According to  the Nigeria Centre for Disease Control said, about 269 people have been killed in recent weeks by meningitis.

    As of Monday, 1,828 suspected cases of meningitis were reported with 269 deaths in 15 of the country’s 36 states, the Nigeria Centre for Disease Control (NCDC) said on Twitter late on Tuesday.

    Mallam Bello Aliyu,  a civil servant said that the rate at which meningitis has been killing both young and adult in Zamfara state was worrisome.

    Aliyu said that his neighbor, a 35-year-old man recently died of meningitis and some of his family members had been infected as well.

    Hajiya Salamatu Isa, a school teacher also complained about how her four year-old daughter died of meningitis, which she said was due to lack of vaccine.

    She said that the disease became rampant in February and that she tried her best to immunize all the members of her family, but due to non-availability of the vaccine, she could not. The inadequacy of vaccines, she said killed several people, including her daughter.

    Dr Oyaromade Abidemi, a consultant obstetrician, Head of Clinical Services, Ahmad Sani, Yerima Bakura specialist hospital, Gusau, said the disease was under control.

    Dr Abidemi said that the state government and Medicin San Frontieres MSF nongovernmental organization donated some drugs to the hospital, for the treatment of patients suffering from meningitis.

    He said that 80 percent of meningitis patients that were taken to the hospital at early stage had been treated and discharged, while those that were seriously affected before being taken to the hospital have 50 percent chances of survival.

    The Doctor however said that the hospital had not gotten any vaccine to give the public to prevent meningitis.

    Some medical personnel from Federal Medical Center Gusau, who pleaded anonymity told NAN that the disease had affected many children and adults to the extent that 80 percent of the patients in the ward were suffering from meningitis.

    NAN also gathered that both the state government and nongovernmental organization had been distributing antibiotics  to hospitals in the state, for the treatment of the affected people, but vaccines are scarce.

    At the two major hospitals in Gusau, Ahmad Sani Yerima Bakura specialist hospital and Federal Medical Center Gusau, there were hundreds of patients suffering from the disease, awaiting treatment.

    Earlier this March, the Commissioner of Health in the state, Alhaji Suleiman Gummi said over 80 people had died as a result of the disease while another 500 were undergoing treatment at various health facilities across the 14 Local Government Areas of the state

  • Meningitis kills 23 in Sokoto

    •Govt contemplates closing schools

    Twenty-three deaths have been recorded in Sokoto State following the outbreak of Meningitis, it was learnt yesterday.

    Government is considering closing some schools.

    Commissioner for Health Dr. Balarabe Kakale, confirmed the outbreak in Dane, Dange/Shuni Local Government, during sensitisation campaigns on the disease.

    Some of the areas covered in the campaign were Sahabi Dange Primary School and the PHC, Dange, Bodai, Shuni, Fajaldu and Wababe communities.

    Kakale said the deaths were recorded in the seven worst hit councils of Kebbe, Bodinga, Rabah, Wamakko, Gada, Dange/Shuni and Tureta.

    He said: “The government, since March 20, deployed about 15 medical teams, comprising over 150 personnel, to the 23 councils. They were equipped with ambulances, free drugs, and medicament.

    “The teams conducted house-to-house searches, definition and management, both at home and the hospitals. They have so far treated about 400 mixed cases of severe malaria and meningitis across the seven worst-hit councils.

    “Of the 400 cases, 56 were confirmed to be meningitis, of which additional fatalities were recorded. These 16 additional deaths excluded the seven earlier recorded in parts of Gada council.”

    Kakale added that the government was contemplating closing some schools if the problem persisted

    “This is to save more lives, though the cases are reducing, and the people now report suspected cases to health facilities.

    “We also intimate the people not to link meningitis to witchcraft or sorcery. Rather, suspected cases should be reported to hospitals as they are stocked with drugs and medicament for free treatment of the patients.”

    He urged parents to ensure their children are immunised against polio, and especially the six child-killer diseases – tuberculosis, whooping cough, measles, meningitis, tetanus and diphtheria.

  • North tackles meningitis

    In the Sahel belt, of which extreme northern states are a part, cerebro spinal meningitis or CSM, sometimes a fatal disease, occurs during the hot, dry season and terminates at the onset of the rains. The good thing is that the regional state governments are taking steps to stop it, writes News Agency of Nigeria

    Northern state governments and stakeholders are deploying more human and material resources to contain and prevent the spread of Cerebro Spinal Meningitis (CSM) and other haemorrhagic fevers in the region.

    The News Agency of Nigeria (NAN) reports that various state governments, community and religious leaders as well as Non-Governmental Organisations (NGOs) are scaling up their interventions to prevent further outbreak and spread of communicable diseases.

    Many lives have been lost to recent reported cases in Zamfara and Sokoto states.

    In a survey by NAN, the Kano State Primary Health Care Management Board said it has strengthened surveillance to prevent the outbreak of communicable and airborne diseases. The Executive Secretary of the board, Dr Nasiru Mahmud told NAN that the board would scale up its efforts during this hot season that would herald the rains. He explained that the weather and population rate of the state made it necessary for the agency to strategise against outbreak of diseases.

    The state, he said, has improved on its awareness campaign in all the local government areas through various stakeholders’ meeting to address public health.

    “The state Ministry of Health has already ordered all health educators and all stakeholders to embark on massive campaign to let people know that the season has come.”

    Mahmud further explained that Kano has a minimal risk of meningitis as about 10 million children were immunised against the disease in 2016.

    The secretary noted that the immunisation has a life span of 10 years for whoever received it.

    He commended the Kano Emirate Council through its committee on health, where traditional rulers and religious leaders in all local governments have been tasked with advocating on health-related issues. He also commended development partners in the state who, he said, were involved in all stages of the health sector in the state.

    Furthermore, the scribe stressed that the board had procured large consignment of drugs and other consumables for rapid response.

    The Kaduna State Primary Health Care Development Agency said that it trained 1,500 community health workers and members on the prevention of child killer-diseases. Mr Hamza Ikara, the agency’s Deputy Director, told NAN that the training was to reduce outbreak of illnesses in the state.

    “We train them on different child illnesses such as malaria and pneumonia to reduce outbreak during the hot season.’’

    He said no case have been recorded for now because adequate preventive measures have been taken by the government. Ikara added that traditional rulers with their scribes have also been trained in order to carry out sensitisation in rural areas. He said that the state government has embarked on the clearing of drainages across the state to control malaria in addition to the distribution of treated mosquito nets to residents.

    He advised residents to sleep in ventilated rooms and avoid overcrowding, adding that people should adopt the habit of sleeping with their mosquitoes net.

    In Gombe State, the Head of Medicine, Specialist Hospital Gombe, Dr Raymond Dankwoli, has appealed to the general public to always ensure adequate ventilation in their rooms to avert possible occurrence of diseases.

    Dankwoli told NAN in Gombe that: “As we are all aware, the hot and rainy season has set in in some parts of the country. This may likely come with some outbreak of diseases like meningitis and conjunctivitis, among others.

    “This is because poor ventilation is a risk factor, therefore taking preventive measure is important.’’

    According to him, the hospital has recorded five cases of unconfirmed CSM.

    From Bauchi, the Executive Chairman of the state Health Care Development Agency, Mr Adamu Gamawa, said proactive measures would be taken to prevent measles and other child killer diseases through community vaccination.

    In Dutse, the Jigawa State Primary Healthcare Development Agency (JSPHCDA) said it has taken precautionary measures to check the outbreak of communicable and airborne diseases across the state. The Executive Secretary of the agency, Dr Kabir Ali, also told NAN in Dutse that the state government had introduced free maternal and healthcare service where pregnant women and children under the age of five were given free drugs in order to safeguard their health.

    Ali said that the agency was also taking preventing measures through routine immunisation in all the 530 public health facilities across the state.

    Also, the Borno state government said it has set aside 200,000 doses of vaccine for meningitis as a proactive measure against any outbreak as the hot season sets in.

    A report from Katsina said that the state government has confirmed an outbreak of meningitis in Batsari Local Government Area. The Permanent Secretary in the state Ministry of Health, Dr Kabir Mustapha, told NAN in Katsina that the disease was reported in some communities in the affected local government area.

    “But I cannot tell you further details because the State Primary Healthcare Development Agency is yet to forward full details on the disease outbreak to my office,’’ he said.

  • How to prevent pneumonia, meningitis, by experts

    Experts have urged Nigerians to practise good hygiene to avoid contracting pneumococcal and meningococcal diseases.

    The specialists, who consist of the best from West African, spoke  at this year’s West African Vaccine Summit in Lagos.

    It had as theme Ready for life.

    The professionals agreed that though there were vaccines by Pfizer to treat the diseases, if one rested, drank plenty of water and juices to keep the body hydrated, increased the intake of Vitamin A and C, washed hands to prevent germs spread, and covered the mouth while sneezing or coughing, the chances of knocking off the diseases were high.

    According to a Professor of Medicine at the Obafemi Awolowo University (OAU), Ile- Ife, Gregory  Erhabor, the West African region  has a plethora of meningitis and pneumonia.

    Erhabor said: “In 2008, an estimated 177,000 under five children died from pneumonia in Nigeria alone. The African Meningitis Belt—extending from Senegal in the West to Ethiopia in the East—has the highest annual incidence of Invasive Meningococcal Disease (IMD) worldwide, with superimposed frequent epidemics occurring every eight to 12 years. The diseases are a contagious and life-threatening infection. And is the leading cause of bacterial meningitis and septicaemia in many parts of the world like Western Europe and North USA among children aged two months to 12 years, following introduction of universal immunisation against H.influenzae type b and S.pneumoniae.

    ‘’It occurs most frequently in infants, young children, and teenagers. And can be difficult to diagnose. It can progress very quickly and be fatal within a few hours, with up to 20 percent of patients dying despite rapid treatment.  Hence it is good to maintain a clean environment because N. meningitidis is spread by airborne droplet infection or direct contact with respiratory secretions or saliva, e.g., through coughing, kissing or sharing a glass or eating /drinking utensil.  And children’s immunity should not be compromised.”

    Dr Adejumoke Ayede of the Department of Paediatrics, College of Medicine at the University of Ibadan, said the number one risk factor is age due to lack of serum bactericidal antibodies.

    Others are defects in host defence. He explained that patients with deficiency of  components, weak immune system, such as long-term therapy with corticosteroids in patients with nephrotic syndrome, Systemic lupus erythematosus (SLE), a chronic inflammatory disease that has protean, hepatic failure or respiratory tract infections, such as the flu, may suffer from the disease.

    Ayede, a  Consultant Paediatrican/Senior Lecturer, said there were environmental factors, such as crowded living areas – dormitories, barracks, day care; climatic conditions,such as low humidity, smoking, and contact with patients.

    ‘’And the two most common manifestations of IMD are:  Meningitis affecting about 50 percent of patients or Septicaemia, affecting between five percent and 20 percent of patients. Less common manifestations of IMD are pneumonia, occurring in up to 15 percent of patients, respiratory tract infections, otitis media, and focal infections (e.g., conjunctivitis, urethritis, arthritis, or pericarditis).

    “But with the dry season, this region has recently benefited from the Meningitis Vaccine Project, a major alliance of international health bodies that have developed and are deploying an affordable and effective vaccine against serogroup A meningococcus, is the main cause of the disease in this area. The vaccine is meningococcal conjugate vaccine,” Ayede said.

    Director Corporate Affairs Nigeria and East African Region, Pfizer, Mrs Margret Olele, said the firm was passionate about research and development (R and D), and was working to bring the benefits of vaccines into previously unexplored areas where successes could be recorded, help usher in a new era of vaccine innovation, prevent and treat diseases.

    “Pfizer’s world-class vaccines are produced by more than 500 global scientists with deep expertise in investigating and advancing unique vaccine candidates to deliver the next wave of breakthroughs to meet needs and help save lives. It has made investments in developing world-class vaccine manufacturing expertise, sites, and capabilities,’’ she said.

    She said the drug giant was working in areas, such as hospital-acquired infections.

    ‘’At the same time, we’re  building on our leadership in pneumococcal and meningococcal disease prevention. Our unique Investigational Vaccine-Based Immunotherapy Regimen (VBIR) brings the science of vaccine research out.

    ‘’Pfizer is also developing an experimental PCSK9 vaccine, designed to induce the body to produce its own antibodies. It is seeking to develop a cytomegalovirus (CMV) vaccine to prevent diseases that can have a devastating and lifelong impact on young children. And they are accessible and affordable,” Mrs Olele added.

  • Preventing meningitis, measles outbreak

    Preventing meningitis, measles outbreak

    Apart from Lassa fever, other diseases that can be endemic during this time of the year are meningitis and measles, OYEYEMI GBENGA-MUSTAPHA reports

    Meningitis and measles are still threatening Africa despite efforts by multilateral orgnisations to contain  the diseases.

    For instance, meningitis is still common in some parts of the country because of the acute shortage of meningitis C vaccine for treating the disease.

    Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. It can cause severe brain damage and is fatal in 50 per cent of untreated cases. Some bacteria can cause meningitis.

    International Federation of Red Cross and Red Crescent Societies (IFRC), Médecins Sans Frontières (MSF), United Nations Children’s Fund (UNICEF) and World Health Organisation (WHO) have warned against the threat posed by the diseases.

    These organisations, which constitute the International Coordinating Group for Vaccine Provision for Epidemic Meningitis Control (ICG), called on vaccine manufacturers to step up meningitis C-vaccine production by five million doses before the start of this year’s meningitis season later in the month.

    According to Coordinator for Control of Epidemic Diseases Unit at WHO Dr William Perea, “Meningitis tends to hit Africa in cycles. Cases of meningitis C have been rising since 2013, first in Nigeria in 2013 and 2014, and then in Niger  last year. We have to be ready for a much larger number of cases during the 2016 meningitis season.”

    Health Specialist, Programme Division, UNICEF Dr Imran Mirza, said: “We have had preliminary discussions with vaccine manufacturers and impressed upon them the need to produce a stockpile of five million doses of vaccine to be ready for flare-ups of the disease next year in Africa, but so far, they haven’t yet revised their production plans to meet demand.”

    While substantial progress has been made in recent years in protecting Africa from other main sub-types of meningitis with, for example, the introduction of the MenAfrVac vaccine against meningitis A in 2010, much work needs to be done to protect the African meningitis belt from meningitis C outbreaks.

    “We have been working to reinforce detection and response systems, and are working to secure other sources of meningitis C vaccine in Cuba and Brazil, but the manufacturers have not yet submitted an application for WHO prequalification,” said Mr Alejandro Costa of ICG Secretariat.

    ‘’Until they do, we can only turn to those manufacturers who are already prequalified and have provided vaccine in the past. We need to get them to produce and provide vaccine, in the right quantity and at an affordable price.”

    International Medical Coordinator, MSF, Dr Myriam Henkens, said: “In just the first six months of 2015, there have been 12,000 cases of meningitis C in Niger and Nigeria, and 800 deaths. At the same time, there has been a critical shortage of vaccine.

    “The campaigns consequently were limited to the critically affected age groups and areas, and even so, had to be delayed until vaccine supply became available and we believe next year will be worse. We need vaccine manufacturers to plan production of multivalent vaccine now to allow sufficient lead time and capacity to meet this demand.”

    The ICG stresses that vaccination remains key to preventing meningitis. “Since the introduction of the meningitis A conjugate vaccine (MenAfriVac) in 2010 in 15 countries in Sub-Saharan Africa, the meningitis disease burden has been dramatically reduced. No epidemics of meningitis A have been reported in areas where the population has been vaccinated. We need now to do the same for meningitis C,” said Senior Officer, Emergency Health, IFRC, Ms Amanda McClelland.

    There is no vaccine manufacturing firm in the country. Though there are two in Abuja, the one in Yaba, Lagos is moribund.

    In 1974, WHO established the Expanded Programme on Immunisation to ensure that children have access to vaccines. Since then, global coverage with the four core vaccines – Bacille Calmette-Guérin vaccine (BCG) – for protection against tuberculosis, diphtheria-tetanus-pertussis vaccine (DTP), polio vaccine, and measles vaccine

    – have increased from less than five per cent to over 85 percent;  more vaccines have been added to the recommended schedule. Coverage with the first dose of measles vaccine (MCV1) is impressive.

    According to WHO, measles is caused by a virus in the paramyxovirus family and it is got through contact and air. The virus infects the mucous membranes, from where it spreads in the body.

    Though measles does not occur in animals, more than 95 percent of deaths caused by the disease occur in countries with low per capita incomes and weak health infrastructure.

    Health Minister Prof Isaac Adewole has reaffirmed that the country has weak health infrastructure.

    Measles is one of the leading causes of death among young children, though a safe and cost-effective vaccine is available. It costs  $1 to immunise a child against measles. In 2010, the World Health Assembly established three milestones for the eradication of the disease by 2015, increase routine coverage with the first dose of measles-containing vaccine (MCV1) by e”90 per cent nationally and e”80 percent in every district or equivalent administrative unit for children aged one year; reduce and maintain annual measles incidence to five cases per million; and reduce estimated measles mortality by 95 per cent from the 2000 estimate.

    Sadly, the country still battles measles. Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children, as is the case up North.

    The WHO said based on measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunisation (SAGE) concluded that last year’s global milestones and measles elimination goals would not be achieved on time.

    “Measles is highly infectious and strong, sustained efforts are needed to maintain the current level of control. To achieve paradigm shift in measles, endemic countries will require changes in policies and practices that currently prevent vaccination of children 12 months of age or older,” it stated.

    Meanwhile, Lagos State Health Commissioner, Dr Jide Idris said his ministry will soon begin immunisation against measles, adding that it will watch out for cases of meningitis.

  • ‘How we kicked polio, meningitis out’

    ‘How we kicked polio, meningitis out’

    The Executive Director, Katsina State Primary Health Care, Dr. Muawiya Aliu, speaks with Adetutu Audu on  how the state has been tackling polio and meningitis endemic in the state.

    Primary health care is a crucial aspect of medical care. To what extent would you say the Katsina government is giving attention to it?

    I have been here since the agency was created in 2005. The agency is saddled with the responsibility of providing primary health care for the people even as it collaborates with the local governments to provide effective primary health services in the state. It has five departments for proper running of its activities, namely administration, finance and supply, primary health care, ophthalmology and disease control, projects and pharmaceutical services. We are responsible for improvement of maternal and child health, preventive care services, immunisation, health education and mobilisation of the people towards better health behaviour. We collaborate with donor agencies in the state even as we coordinate the comprehensive health centres one in all the 34 local government areas across the state. Here in the state headquarters, we have four health facilities. Katsina has four major gates; around each of these gates, there is a facility which acts as the first level of referral in the health care chain before the General Hospital. We also have mobile ambulances, one in each of the 34 local governments. The essence is to penetrate the remotest parts of the state to give health facilities to the people who ordinarily would not have the opportunity of coming to town to receive healthcare services. What the local government area in this wise does as the ambulance is given to them is to identify which locality does not have health facility yet, make a list of the villages, and on daily basis, the ambulance visits a particular village and renders services. On quarterly basis, the ambulances are given drugs that would last them for that duration.

    How do you prevent the drugs in your health facilities from being commercialised by the personnel?

    When we give them the drugs, we don’t end it there. We have people that monitor them. We have the traditional leaders that monitor what they are doing. Beyond that, we have records for the ambulance itself. Where it is going to, you must indicate by giving date, time and even mileage. We have also directed that traditional leaders must sign a certain document each time the ambulance visits their locality. That is a way of endorsement to the fact that this ambulance was in my domain today. On a monthly basis, we have what we call integrated supportive supervision team that goes out to look at the activities of the ambulance in each of the local governments. Apart from looking at the health facilities, they also check the mobile ambulances. It is these records they look into in order to give proper evaluation of the activities for the month. Katsina is one of the states that started implementing COMESS/CONES, the new improved salary structure for health personnel in the country. All our health workers are adequately taken care of. So, I don’t think they would want to commercialise drugs meant for the poor people. At the same time, these health personnel are indigenes of these localities; whoever they are treating are their own people, so I don’t think they will have the conscience to do that.

    Polio is one of the conditions ravaging young children. How are you combating this?

    I can tell you that polio is an issue to Nigeria as a whole; it is not only Katsina State. All countries have already eradicated polio except Nigeria and two other countries. Coming to Nigeria, in the northern part of the country, there are states that are endemic of the disease, but in Katsina State, we have overcome polio. This is the twelfth month since we recorded the last case of polio in the state. The issue of eradication of polio is not that of the agency alone, it is something that all other sectors are putting in their own contributions in order to get rid of the disease in the state permanently and forever. So, we are collaborating with the traditional rulers, the Ulamas, among others, to get rid of the disease.

    How are the Almajiris being provided for medically?

    I said earlier that we have the mobile ambulance that goes from village to village to look after the people. The governor looked at the under-served sector which he identified as the Almajiris. Whether we like it or not, we have Almajiris that are also part of the communities. They are also in some urban centres seeking for Islamic knowledge, so they are part of us all. That is why the governor thinks there must be a clinic of sort for the Almajiris. So we started one as a pilot project in three local government areas where Almajiris are mostly populated. Three mobile ambulances are provided for them and manned by two health care personnel. Each morning, they go from one Almajjiri school to another. Of course, it is similar to the conventional ambulance service we have in all the local government areas. Under this agency, we have been able to vaccinate over 4.1 m people against cerebral meningitis which is one of the diseases that is rampant in the north. We have vaccinated everybody within the age of one year to nine years. Before now, we used to have outbreak of meningitis on an annual basis once the weather is hot and this is usually around March to May. Since the vaccination, we no longer have the outbreak. We have distributed over 2. 7m treated mosquito nets across the state against malaria.