NCDC Weekly Epidemiological Report: Issue: Volume 11 No. 47: 16th – 22nd November 2020

Situation Report
Originally published
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Optimising sample collection for cerebrospinal meningitis management in Nigeria

Cerebrospinal Meningitis (CSM) is one of the priority epidemic-prone diseases that is reported all year round in Nigeria. Despite its endemicity, CSM has predilection for dry season with peak between January and May. It is characterised by acute severe infection of the central nervous system (CNS) causing inflammation of the meninges with morbidity and mortality. Highest burden occurs in the part of sub-Saharan Africa known as the “Meningitis Belt. In Nigeria, the belt covers all the 19 northern states and the Federal Capital Territory (FCT).

In the last few years, low sample collection rates have been reported resulting in low confirmation rates. In 2019, only 30 (3.9%) of the suspected cases of meningitis were confirmed. The report of the recent After Action Review also corroborates low CSF collection rates as well as poor sample handling. It is against this backdrop that the Nigeria Centre for Disease Control (NCDC) has continued to intensify efforts to optimise sample collection and ensure effective management of confirmed cases.

As part of the preparedness activities for 2020/2021 peak season, the Nigeria Centre for Disease Control (NCDC) has sent alert letters to states to put necessary public health measures in place. We are supporting them in the areas of training and retraining of their public and clinical workforce to ensure they are well equipped with prerequisite knowledge and skill set for timely detection and effective management of cases.

In line with the above, the Nigeria Centre for Disease Control from 24th – 26th November, 2020 conducted a training on case management, sample and data management for Clinicians as well as Disease Surveillance and Notification Officers in Kebbi State. Other key states had previously being trained in these areas. The objectives of the training were to:

  1. Train clinicians on case definition and clinical management of meningitis cases

  2. Develop clinicians’ competence and skills in performing the lumbar puncture procedure and CSF sample handling

  3. Improve health workers knowledge on packaging and transportation of CSF samples

  4. Improve the working relationship between clinicians and their respective LGA DSNOs

  5. Raise awareness of the BLoTIMA study proposed to take place in the state: This is an ongoing study to enhance bacterial diagnosis of CSM in five Northern States.

With 21 LGA DSNOs, 26 clinicians and four rapid team members trained, key outputs from the meeting were increased skills in CSF collection and management among the trainees. The NCDC will continue to support the sub-national level to improve CSF collection and data gathering for timely decision making. We are working towards reducing significantly, the morbidity and mortality associated with CSM in Nigeria.

Summary of Incidents

  1. Information for this disease was retrieved from the Technical Working Group and Situation Reports

  2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only

  3. Information for this disease was retrieved from IDSR 002 data

  4. CFR for this disease is reported for total cases i.e. suspected + confirmed

  5. Information for sentinel influenza was retrieved from the laboratory