Evaluating the 2018 Cerebrospinal Meningitis Response in Nigeria
This week’s editorial focuses on After Action Reviews (AAR), as one of the four components of International Health Regulation Monitoring and Evaluation Framework (IHR MEF), and Nigeria’s adaptation of this.
Following the 2017/ 2018 Meningitis outbreak, the Nigeria Centre for Disease Control (NCDC) in collaboration with the World Health Organisation (WHO) organised an AAR meeting in Abuja from the 13th to 15th August, 2018. This was to review the preparedness and outbreak response, identify best practices and challenges and drawing lessons for improved response to CSM.
The AAR also provided an opportunity for collective learning by bringing together the relevant individuals to critically and systematically analyse actions taken to respond with focusses on the assessment of what worked, what did not work, why and how to improve.
The workshop had representatives from the Federal Ministry of Agriculture and Rural Development, State Ministries of Health (Director Public health, State Epidemiologists, State DSNOs, State clinicians, State Immunization officers & State laboratory scientists), NPHCDA, Nigeria Prison Service, Nigeria Immigration service, Nigeria Custom service, National Planning Commission, Nigeria Meteorological Agency (NiMET), Nigeria Nuclear Regulatory Agency, NOA, NYSC, US-CDC, IFAIN, MSF, AFENET, UMB, SORMAS and other stakeholders.
In 2017, NCDC conducted an AAR to evaluate the 2016/2017 response to Meningitis outbreak in Nigeria. This was based on the six pillars of response (Coordination, Surveillance & Epidemiology, Laboratory diagnosis, Case management, risk communication & social mobilization and vaccines and logistics). The lessons learnt from that process was used to develop the 2017/2018 preparedness plan and strengthened response activities this year.
In working with this wide range of stakeholders, we are ensuring that Nigeria has the capacity to effectively utilise the limited human and materials resources to ensure health security. The output from this activity will guide the development of activities/plans towards the reduction of the impact of outbreaks and public health emergencies in case of any meningitis outbreak in Nigeria.
States are therefore encouraged to conduct After Action Review meetings at that level, to enable them review their preparedness and response activities, identify best practices and challenges that will position them to improve the response to CSM.
Summary of reports
In the reporting week ending on August 5, 2018:
- There were 164 new cases of Acute Flaccid Paralysis (AFP) reported. None was confirmed as Polio. The last reported case of Polio in Nigeria was in August 2016. Active case search for AFP is being intensified as Nigeria has reinvigorated its efforts at eradicating Polio.
- 595 suspected cases of Cholera were reported from 38 LGAs in 11 States (Abia – 4, Adamawa – 4, Borno – 9, Ebonyi – 9, Ekiti – 1, FCT – 20, Kaduna – 24, Kano – 119, Katsina – 122, Yobe – 3 and Zamfara - 280). Of these, 23 were laboratory confirmed and 12 deaths were recorded.
- 18 suspected cases of Lassa fever were reported from seven LGAs in six States (Edo – 9, Enugu – 1, Gombe – 1, Kogi – 1 & Ondo - 4). Nine were laboratory confirmed and two deaths were recorded.
- There were five suspected cases of Cerebrospinal Meningitis (CSM) reported from four LGAs in two States (Katsina – 3 & Yobe – 2). Of these, none was laboratory confirmed and no death was recorded.
- There were 275 suspected cases of Measles reported from 30 States. None was laboratory confirmed and no deaths was recorded.
In the reporting week, all States sent in their report except Cross River and Taraba States. Timeliness of reporting remains 88% in both previous and current weeks (week 30 & 31) while completeness also remains 99% at same period. It is very important for all States to ensure timely and complete reporting at all times, especially during an outbreak.