Vaccination, Most Effective Method Of Preventing Meningitis, Say Experts
HEALTH experts have noted that vaccination is sacrosanct if the battle against epidemics of meningococcal meningitis is to be achieved. Others include avoidance of close contact with cases of meningitis; overcrowded place and limitation of travels to areas with cases of the diseases are other potential preventive strategies.
However, Nigeria Centre for Disease Control ( NCDC) and Preventions recently noted that the centre is responding to disease outbreaks of meningitis, which recorded 507 cases and 63 deaths in 19 states.
Director General ( DG), Nigeria Centre for Disease Control ( NCDC) and Preventions and former Commissioner for Health Lagos State, Dr. Jide Idris, said NCDC, with the support of partners, continues to work with affected states to improve surveillance given the underreporting of cases and execute strategic prevention and control activities all in a bid to strengthen preparedness, detection, and response to meningitis outbreaks.
He explained that the NCDC has activated the National CSM emergency operations centre given the rising cases of meningitis in the country. States have begun response activities through the World Bank Coprep funding
Furthermore, with the support of partners, a national CSM epidemic preparedness and response plan has been developed.
He said currently, there is a network of 29 public laboratories with the capacity to diagnose CSM across the country, training of clinicians on case management of meningitis and lumbar puncture to increase the rate of confirmation of cases
On how to further prevent meningitis outbreak, he said NCDC continue to work with Federal Ministry of Health and Social Welfare and the sister agency, the Nigeria Primary
Health Care Development Agency ( NPHCDA), as well as other partners to ensure nobody is left behind in the fight against meningitis.
Consultant physician and neurologist, Neurology Unit, Lagos University Teaching Hospital Lagos State ( LASUTH), Ikeja, Lagos, Dr. Agabi Osigwe, said meningitis could be caused by an array of infectious agents, which include bacteria, viruses, fungi and parasites. Of the many causes of meningitis, he said bacterial meningitis is the most serious because its onset is rapid and the infection is associated with a significant risk of death.
He disclosed that several different bacteria could cause meningitis and they vary by age group and region of the world. Beyond the perinatal period, three organisms, which include neisseria meningitidis, haemophilus influenzae, and streptococcus pneumoniae are responsible for most cases of bacterial meningitis.
Osigwe said epidemics of meningitis occur during the dry season between December to June, when dust winds, cold nights and upper respiratory tract infections combine to damage the protective coatings of the airways thus increasing the risk of infection and colonisation by
Neisseria meningitidis.
He noted the disease is transmitted from person to person through droplet from respiratory and throat secretions by infected persons or carriers. Transmission is also facilitated by close contacts with cases of the disease or carriers, overcrowded housing and travels to areas with known cases of the illness.
In terms of signs and symptoms, he stressed that the clinical hallmark of meningitis is fever, headache and neck stiffness/ pain.
Other features include, sensitivity to light termed photophobia, nausea, vomiting, poor appetite, altered level of consciousness presenting as confusion or disorientation, seizures, coma and death. In addition, meningococcal meningitis may manifest with skin rash. In terms of how is meningitis diagnosed, he noted meningitis could be diagnosed on the strength of the presenting clinical features, signs and symptoms, alone. Laboratory investigations are necessary to confirm the diagnosis. In cases where the index of suspicion is high for meningitis, medical treatment is instituted immediately and laboratory work up follows thereafter.
Osigwe said the gold standard investigation in meningitis is a lumbar puncture and cerebrospinal fluid analysis. This is an aseptic procedure where a sample of cerebrospinal fluid is collected via a needle placed at the lower back. “This sample is then analysed in the laboratory, the causative organism cultured grown, and antibiotics sensitivity/ susceptibility performed. In selected cases especially when complications are present, a brain imaging, brain computed tomography scan, computed tomography ( CT), scan maybe required,” he said.
He said a brain imaging is not required in most cases of meningitis. Other investigations like blood culture where the organism is grown from a specimen of blood and other blood work up may be done. Nasopharyngeal swab test maybe carried out amongst asymptomatic close contacts of cases to identify nasopharyngeal carriers.
The Minister of Innovation, Science and Technology, Chief Uche Geoffrey Nnaji, said under his watch, Nigeria Natural Medicine Development Agency ( NNMDA), said his ministry has developed natural medicines that could cure sickle cell anaemia, old age, diabetes, malaria, among others, said his agency would soon develop medicine that could cure meningitis.
He said Nigeria has natural herbs and plants that could be developed and they would cure malaria, diabetes, cancers, among other other health challenges that would help medical tourism in the country.
The Director General/ Chief Executive Officer Nigeria Natural Medicine Development Agency, Prof. Martins Emeje, whose agency is working in the 36 states of the country “to ensure it develops natural medicines that could cure meningitis and other related ailments.”