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Togo: Meningitis epidemic - Emergency Plan of Action (EPoA) DREF operation n° MDRTG006 Final Report

Situation Report
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A. Situation analysis

Description of the disaster

Since December 2015, Ghana was affected by a new strain of meningitis outbreak - Pneumococcal Meningitis caused by streptococcus pneumoniae, which is both contagious and fatal. As of 10 February 2016, there were 85 fatalities reported and 465 people hospitalized in Ghana. The meningitis outbreak spread from Ghana to Togo, starting in the Kara region, the district of Dankpen, before moving on to the Western border district of Bassar. As of 15 February 2016, the district of Dankpen reported a total of 219 cases and 12 deaths (case fatality rate (CFR): 5.5%) and the district of Bassar reported a total 63 cases including 9 deaths (CFR: 14.3%). Following investigations in the district of Dankpen, it was identified that the causal agent was Neisseria Meningitides W135.

This strain of meningitis is rare and has common signs and symptoms similar to that of Cerebro-Spinal Meningitis (CSM). It should be noted that the epidemic was expanding to other areas, not only in the districts of Kara region but also to neighboring areas – since 5 February 2016 2 cases were reported in the Central region. There was also a cross-border risk of spreading of cases to other countries in West Africa, in Ghana, potentially Cote d’Ivoire and beyond, at the time of the operation.

The hot and humid climate of Togo is a key factor to the proliferation of vectors for diseases and partly responsible for the National epidemiological profile dominated by infectious and parasitic diseases. The months of March - April with their scorching heat mark the transition between the dry season and the rainy season. This period corresponds to the time when Togo can experience the onset of meningitis outbreaks (December to June) and also with lean periods where the malnutrition rate is very high.

In order to respond to the outbreak, on 25 February 2016, the International Federation of Red Cross and Red Crescent Societies (IFRC) released 178,079 Swiss francs from the Disaster Relief Emergency Fund (DREF) to support Togolese Red Cross Society (TRCS). The DREF operation was implemented to support 1,747,200 people (291,200 households) in the Savannes, Kara and Central regions, with substantial health care and hygiene promotion activities; over a period of 3 months initially and was extended for 1 more month to end in June 2016. Initially, the Ministry of Health and Social Protection, according to the epidemiological situation, planned to conduct 1 vaccination campaign in response to this epidemic. The rapid spread of cases in 3 regions motivated the health department to conduct 2 more vaccination campaigns. This led to the extension and intensification of the activities for 1 month (June) without additional cost.

The major donors and partners of the TRCS in this meningitis operation include the IFRC and Catholic Relief Services (CRS). The Togolese Red Cross Society would like to extend many thanks to all partners for their generous contributions. The DREF operations donors include: The Red Cross Societies and governments of Australia, Austria, Belgium, Canada, Denmark, Ireland, Italy, Japan, Luxembourg, Monaco, the Netherlands, Norway, Spain, Sweden and the USA, as well as DG ECHO, the UK Department for International Development (DFID), the Medtronic, Zurich and Coca Cola Foundations, and other corporate and private donors. The Togolese Red Cross Society would like to extend many thanks to all partners for their generous contributions.