Trend, pattern, and outcome of meningitis cases in Northwest, Nigeria: A 10 Year review of case-based surveillance data

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Objective: This study aimed to describe the epidemiological pattern of Cerebrospinal meningititis (CSM) cases, and related mortality in Jigawa State, Northwest Nigeria, over a 10-year period. Methods: We conducted a retrospective descriptive cross-sectional study of 1943 line-listed CSM cases spanning 2015–2024, in line with the Integrated Disease Surveillance and Response (IDSR) guidelines. Data were analyzed using SPSS version 22 at a 5 % level of significance. Results: Patient ages ranged from 1 to 70 years, with a median of 12 years (IQR 6–17). Adolescents aged 10–19 years constituted the largest proportion of cases (39.7 %). The highest burden of CSM occurred in 2023 (71.6 % of cases). Overall, case fatality was 8 %. Unlike previous years, when outbreaks peaked in the early weeks, the 2023 outbreak extended from epidemiological week 50 through week 1 of 2024. The overall attack rate at the state level was 25.8 per 100,000 population. Mortality was significantly higher among cases not admitted for care; admitted patients were 50 % less likely to die (aOR = 0.5; 95 % CI: 0.4–0.8). Laboratory results from the National Reference Laboratory (NRL) showed 59.4 % positivity, with serogroup C (Neisseria meningitidis type C) accounting for 57.1 % of confirmed cases. All positive cultures correlated with PCR positivity (100 %, p < 0.001), and nearly all (99.7 %, p < 0.001) confirmed N. meningitidis type C. Other detected pathogens included N. meningitidis X, Streptococcus pneumoniae, and non-groupable Neisseria. Conclusions: Recurrent CSM outbreaks in Jigawa State are linked with considerable illness and death, primarily affecting individuals aged 1–29 years, most of whom lacked prior vaccination against any meningococcal serotype. The predominant strains are not covered by the current national immunization program. There is an urgent need for government and partners to introduce the Multivalent Meningococcal Conjugate Vaccine (MMCV), in line with WHO recommendations.

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