Meningitis season 2007-2008: moderate levels of meningitis activity
9 July 2008
The WHO Multi-Disease Surveillance Centre in Ouagadougou (MDSC - Burkina Faso), monitored the epidemiological situation of bacterial meningitis in the African meningitis belt countries throughout the epidemic season. Data were collected for Benin, Burkina Faso, Chad, the Democratic Republic of the Congo, the Central African Republic, Côte d'Ivoire, Ethiopia, Guinea, Mali, Niger, Nigeria, Togo and Uganda. Data for Sudan and Uganda were compiled by WHO-HQ-EPR. Altogether these countries reported a total of 27 985 cases, including 2578 deaths (case-fatality ratio - 9.2%) from 1 January to 25 May 2008 (see table 1). This caseload is 45%, lower than the one reported during the same period in 2007.
Table 1. Suspected meningitis cases, deaths, and number of districts having crossed the alert and epidemic thresholds, reported to WHO by affected African countries during the 2008 epidemic season (epidemiological weeks 1 to 21, 1 January - 25 May 2008*)
Country Cases**
Deaths Case-fatality
ratio (%) Number of alert
districts Number of
epidemic districts
276 9420 693 3958 7
27 985 9.2 100
Benin
38 13.8
1 0
Burkina Faso
920 9.8
22 20
Chad
80 11.5
4 1
Democratic Republic of
the Congo
450
11.4
14
10
Central African Republic
275
78
28.4 2
0
Côte d'Ivoire 883
150 17.0
0 2
Ethiopia 510
17 3.3
0 1
Guinea 263
58
22.1
0
1
Mali 1334
69 5.2
3 3
Niger 3057
161 5.3
7 5
Nigeria 6239
457 7.3
29 49
Northern Sudan 292
12 1.4
0 1
Southern Sudan 96
15 17.9
0 0
Togo 289
51 17.6
1 0
Uganda
400 22
5.5 3
TOTAL
2578
86
*Except: Chad up to 18 May, Guinea up to 30 March, North Sudan up to 9 March, South Sudan up to 4 May and Togo up to 27 April ** Number of cases includes deaths
Among countries reporting cases, Burkina Faso, the Democratic Republic of the Congo, Mali, Niger and Nigeria were the most affected, with Burkina Faso reporting 34% of the total reported cases and Nigeria 22%. Additionally, Nigeria reported the highest number of epidemic districts (49 out of a total of 100 epidemic districts).
Neisseria meningitidis A (Nm A) was identified as the causative agent in all confirmed epidemics. NmW135 was responsible for sporadic cases in Benin, Côte d'Ivoire, Chad and Togo while NmX was detected in a few cases in Niger.
The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control released 2 053 000 doses of bivalent vaccine to complement the efforts of the ministries of health in carrying out vaccination campaigns in Burkina Faso, Central African Republic, Mali, Niger, and Nigeria. The European Commission Humanitarian Aid Department (ECHO), Médecins sans Frontières, UNICEF, the World Bank and WHO provided technical and/or financial support to enable these vaccination campaigns.