Pattern of the meningococcal meningitis outbreak in Northern Nigeria, 2009

•Kastina (11153, 20.4%), Jigawa (8643, 15.8%), Bauchi (8463, 15.5%), Kano (6811, 12.4%), and Gombe (6110, 11.2%) were the states with the highest prevalence of meningitis.•Higher proportions of death among cases of cerebrospinal meningitis were found in the states of Nasarawa (11.0%), Adamawa (8.0%), and Borno (7.6%).•The local government areas (LGAs) with the highest proportions of deaths among cases seen were Shongom LGA of Gombe State (12.5%), Illela LGA of Sokoto State (9.8%), and Ikara LGA of Kaduna State (9.1%).

SummaryObjectivesDespite the availability of vaccines, children are the people most often affected by epidemic meningococcal meningitis. The pattern of the epidemic meningococcal meningitis outbreak in Northern Nigeria in 2009 and the Neisseria meningitidis strains responsible for this epidemic are described here.MethodsA retrospective cross-sectional study was conducted in 16 states, involving 48 local government areas (LGAs), 91 health facilities, and 96 communities. Data collection involved in-depth interviews with key informants from the federal to the community level, a review of records, and a solution-oriented national workshop with participants from all states of the Federation. Cerebrospinal fluid (CSF) samples were collected from some of the suspected cases at the start of the outbreak and were tested using the rapid Pastorex latex agglutination kit.ResultsKastina (11153, 20.4%), Jigawa (8643, 15.8%), Bauchi (8463, 15.5%), Kano (6811, 12.4%), and Gombe (6110, 11.2%) were the states with the highest prevalence of meningitis. The states of Nasarawa (11.0%), Adamawa (8.0%), and Borno (7.6%) recorded the highest percentage of deaths, while the Shongom (Gombe State 12.5%), Illela (Sokoto State 9.8%), and Ikara (Kaduna State 9.1%) LGAs recorded the most deaths amongst cases seen.ConclusionsThe testing of CSF samples during meningitis outbreaks is recommended in order to monitor the occurrence of the multiple meningitis serotypes during these outbreaks and to direct serotype-specific vaccination response activities.