A. Situation Analysis
Description of the Disaster
On 7 September 2021, the National Minister of Public Health declared a meningitis epidemic in the DRC. This declaration follows confirmation by the National Institute for Biomedical Research (INRB) and the Pasteur Institute in Paris of the presence of meningococcal meningitis type W in the samples collected from some patients in the Tshopo province. The epidemiological events that aroused suspicion date back to early July 2021 following an increase in deaths in a clinical context of fever, headache, stiff neck, suggestive of meningitis. However, preliminary investigations helped to establish that the health events observed date back to the beginning of June 2021 (S23) in two mining sites in the health area (AS) of Panga, health zone (ZS) of Banalia, located north of Kisangani, capital of Tshopo province.
According to the WHO epidemiological bulletin dated 13 September 2021, 301 suspected cases of meningitis, including 131 deaths, i.e., a case-fatality rate of 48.8%, have been recorded since the beginning of the epidemic. WHO further highlights the notification of 39 new suspected cases between 10 and 11 September 2021.
A few observations have emerged at this stage:
• The outbreak remains confined to the Banalia health zone as 13/20 health areas (65%) have reported suspected cases
• Panga Health Area remains the epicentre of the disease as 72% of suspected cases have been reported (216/301)
• The epidemic is progressing because a new health area (St Elisabeth Health Area) has been affected in the past week according to the WHO epidemiological bulletin of 13 September 2021
• Lethality appears to be slightly elevated (48.8%) indicating the need for rapid action at the community level.
As of 11 September 2021, 18 patients were hospitalized and treated for meningitis, including 7 in Panga, 6 in Bethsaida, 3 in Banalia General Hospital of Reference and 2 in Lukelo. According to an expert opinion from the Ministry of Health, all age groups are vulnerable to meningitis. However, the National Committee for the Fight against the disease in the DRC states in its latest report dated 8 September 2021 that the age group most affected by the current meningitis epidemic is 15 years and above. The population exposed to this meningitis epidemic resides in Banalia health zone in Tshopo province. The total population of Banalia health zone is 162,723 people, spread over 20 health areas. At present, 13 of the 20 health areas in this health zone are affected.
It is clear from the above elements, that the DRC is once more faced with the emergence of a meningitis epidemic, the latest dating back to November 2009 with 214 cases and 18 deaths (a case-fatality rate of 8%) in the town of Kisangani, still in the Province of Tshopo. For the moment, the epidemic is confined to the Banalia health zone, but is showing an evolving trend. This situation puts additional pressure on the DRC's health system already weakened by multiple health risks, the most current are the Ebola virus disease (EVD), cholera, measles and COVID-19. The situation requires the rapid involvement of RC DRC volunteers in Tshopo to slow down the progression of meningitis within communities and mitigate its impact.