Alarming meningitis death toll

It is very sad that the northern part of Nigeria, which falls within the Sub-Saharan African meningitis belt, has continued to witness an aggressive outbreak of the deadly Cerebro-Spinal Meningitis (CSM), claiming lives in large numbers. This is a disgrace to Nigeria because the deaths were preventable and the country has enough experience of the scourge to have prepared much better for the current outbreak. In 1996, several thousands of lives were lost. Also, in 2009, Bauchi State confirmed the death of not less than 51 people; Gombe State, 22; Kano State, 32; and in Zamfara State, at least 18 people died. In 2016, about 33 people died as a result of CSM.

This year, Nigeria is witnessing another outbreak and history is about to repeat itself on a higher scale if the figures of the ‘harvest’ of death as a result of the disease are anything to go by. The Nigeria Centre for Disease Control (NCDC) has confirmed the outbreak in five states with at least 282 deaths already, while about 1,966 suspected cases have been recorded. Out of 109 fully confirmed cases, Zamfara has the highest number of 44, followed by Katsina with 32, Sokoto 19, Kebbi 10 and Niger 4.

Meanwhile, for the first time this year, the Federal Capital Territory (FCT) Administration has also recorded the death of four residents as a result of meningitis. These horrible developments are coming on the heels of the report that malnutrition may kill 1.4 million children in Nigeria and three other nations.

Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the meninges that affects the brain membrane. It can cause severe brain damage and is fatal in 50 per cent of cases if untreated. Some of the symptoms are fever, headache, catarrh, stiff neck and in advanced cases sardonic laughter. The recurrence and magnitude of loss of lives from CSM show poor surveillance and control of the disease. This is unfortunate because it is a known fact that CSM is prevalent in the north of Nigeria due to the scorching heat. Also, poor ventilation, desert encroachment leading to dry and dusty wind, climate change, and poor hygiene are worsening the situation. Children aged 5-14 years are more susceptible to the disease because their immune systems are not well developed. Despite these known facts, there have been several outbreaks still. So, the question is: what is this nation ever prepared for? Nigerians are left to the vagaries of life while the leaders do nothing. Not even enough work on preventive health!

This is worrisome because media reports have it that the World Health Organisation, (WHO) and partners including National Primary Health Care Development Agency (NPHCDA), UNICEF, Nigeria Field Epidemiology and Laboratory Training Programme, eHealth Africa, Médecins Sans Frontières, Rotary International, and NCDC are providing support for the current outbreak.

It is a shame that Nigeria responds more to disease outbreak instead of prevention. A visit to some immunisation centres even reveal that vaccines for Haemophilus influenza type B (Hib); Rotavirus (diarrhoea and vomiting); Measles, Mumps and Rubella (MMR); Chicken Pox; Typhoid Fever; and Meningitis are not available for free. The only vaccines that are free are Hepatitis B; Oral Polio Vaccine (OPV); BCG; Diphtheria, Tetanus and Pertussis (DPT); Measles; and Vitamin A supplement.

Although, the magnitude differs, CSM epidemic is somewhat a yearly ritual. As such Nigeria should be on red alert. So, the National Programme on Immunisation (NPI) should make meningitis vaccine as part of the free routine immunisations. In addition, government at all levels and religious leaders should embark on massive enlightenment programmes to educate the citizens on the prevention of CSM through the use of vaccines and sleeping in cross-ventilated as well as hygienic rooms. Citizens should be enlightened on the nature of the disease and symptoms; the need to quickly visit nearby medical centres for early treatment when they notice the symptoms. Health-related NGOs should also embark on massive sensitisation on the prevention and treatment of CSM instead of fleecing funders. Students at various levels of education should be made to undergo health screening and immunised as appropriate. Individuals and parents should also take personal responsibility for their health and those of their children by ensuring that all members of their families are immunised against CSM.

In addition, the federal and state governments should set up an inter-agency epidemic rapid response team with membership from the affected states, health officers, experts and members of the media to curtail the outbreak. Also, this team should not be an ad-hoc body to be disbanded after the epidemic but should be a permanent one with the capacity to respond as appropriate. It should not be starved of funds and other resources to enhance its effectiveness and efficiency in order to save the nation the tragedy of preventable deaths. Trees should be planted around homes. Tree planting should indeed, be seen as a form of primary health care. As a result, Northern state governments should step up their tree planting campaigns towards ensuring a more liveable environment and preventing the ravages of diseases.