Increased funding, personal hygiene will check Meningitis, Experts say

As the new strain of Cerebrospinal Meningitis (CSM), Neisseria Meningitides type C continues to spread in epidemic proportion for the first time in Nigeria, some concerned practitioners in medicine have listed proactive and practical ways the federal and state governments could adopt to arrest the situation.

Statistics from Nigeria Centre for Disease Control (NCDC) states that as at April 3, 2017, a total of 2,997 suspected cases of CSM have been reported in 16 states in the country, with 336 deaths and 146 laboratory confirmed cases.

The current meningitis in Nigeria broke out in Zamfara State in November 2016 and has now spread to Katsina, Sokoto, Kebbi, Niger, Nassarawa, Jigawa, FCT, Gombe, Taraba, Yobe, Kano, Osun, Cross River, Lagos and Plateau states.

According to the Minister of Health, Prof. Isaac Adewole: “This is not the first time or the worst epidemic we are facing in Nigeria, but this round of the epidemic has come with a difference, as all previous epidemics were caused by Neisseria Meningitides type ‘A’, but this year, we are recording Neisseria Meningitides type C in epidemic proportion for the first time.”

The states mostly affected are said to be in the upper parts of the country, which fall within the African Meningitis Belt.

Although other countries, such as, Niger, Chad, Cameroun, Togo, and Burkina Faso, are said to be facing similar outbreaks at the moment, that of Nigeria according to Chief Executive Officer of NCDC, Dr. Chikwe Ihekweazu, has assumed a worrisome dimension, considering the number of deaths and the size of the outbreak amid vaccine shortage.

Listing ways of curtailing the spread during an interview with The Daily Times, a former Director General, Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, Prof. Innocent Ujah, said the immediate measure is for the Federal and state governments to urgently release sufficient fund for robust vaccine procurement and then carry out massive vaccination of the vulnerable groups, including children.

His words: “This will require political commitment of both the Federal and State governments through allocation of huge fund for the treatment and prevention and capacity development of service providers, as an urgent priority”
“Massive, extensive and aggressive public health awareness through all the effective channels of communication such as radio, television, print media and the National Orientation Agency (NOA) should up-scale public awareness campaign on preventive measures.

“Let governments and Civil Society Organisations deploy the strategy used during the Ebola outbreak of 2014. The strategy used in the containment of Ebola which received world acclamation should be deployed to reduce the avoidable deaths in Nigeria.”

Speaking on the long term measures, Ujah advised that the Emergency Preparedness and Response (EPR) Units of the Ministries of health and Environment be fortified both at the Federal and state levels.

He further said the epidemics of Meningitis has epidemiological circles, “And we know that from December to May of each year, there will be outbreak of varying proportions – and this calls for preparation to prevent the epidemic by mounting extensive and aggressive public health awareness and campaigns and also vaccination of the vulnerable groups which should commence about the month of October of each year.

This will prevent the epidemics and therefore, avoidable deaths. Allocation of huge funds to this component of public health be given priority.”

Ujah who is a Professor of Obstetrics & Gynaecology, Department Of Obstetrics & Gynaecology, University of Jos/Jos University Teaching Hospital, Plateau State, also enjoined the private sector to support the government in the fight against meningitis as they have always done in Polio eradication.

On what the public can do to protect themselves against the bacteria, Ujah said: “The Nigerian public must take health education and campaigns seriously. The public should observe strict personal hygiene like hand washing practices with antiseptic soaps and observe environmental hygiene as well as effective ventilation (keeping windows and doors open) and avoid over-crowding in a room.”

He further advised that they should avoid self-medication, traditional healers and superstitions and report to the nearest health facility (Health Centres and Hospitals) as soon as they feel unwell.

“Children particularly cannot withstand meningitis, as they die very quickly. Their parents should immediately take them to the hospital when they notice that they are unwell.”

According to the World Health Organisation (WHO), Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. It is said to cause severe brain damage and is fatal in 50% of cases if untreated.

The most common symptoms, WHO says, are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.

Corroborating the views of the former NIMR boss, Director of Surveillance at NCDC, Mrs. Olubunmi Ojo, said immunisation is key to the prevention of meningitis.

She explained: “Between 2011-2014, the MenAfriVac vaccination campaign against the predominantly circulating Neisseria meningitidis serogroup A in Nigeria, led to a major reduction in cases recorded from that strain.

“We now see an outbreak caused predominantly by Neisseria meningitidis serogroup C (NmC). While reactive vaccination helps to curtail outbreaks, a vaccination campaign against NmC with a long-lasting conjugate vaccine is sorely needed in the region.”

On his part, Chairman, Nigerian Medical Association (NMA), Lagos State Branch, Dr. Olumuyiwa Odusote, urged members of the public to acquaint themselves with at least the basic knowledge/understanding of CSM and how it is transmitted and prevented.

He also appealed to them to strictly adhere to the advice of health workers on how to protect oneself as enumerated above and enjoined them also to seek prompt medical attention as soon as CSM or CSM-Like symptom is suspected.

Odusote further enjoined Nigerians to protect themselves against CSM by avoiding overcrowding rooms, sleeping in well ventilated places, avoid close and prolonged contact with a case/s, proper disposal of respiratory and throat secretions and strictly observe hand hygiene and avoid sneezing into elbow joint/sleeves.