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Tagbo BN, Bancroft RE, Fajolu I, Abdulkadir MB, Bashir MF, Okunola OP, Isiaka AH, Lawal NM, Edelu BO, Onyejiaka N, Ihuoma CJ, Ndu F, Ozumba UC, Udeinya F, Ogunsola F, Saka AO, Fadeyi A, Aderibigbe SA, Abdulraheem J, Yusuf AG, Sylvanus Ndow P, Ogbogu P, Kanu C, Emina V, Makinwa OJ, Gehre F, Yusuf K, Braka F, Mwenda JM, Ticha JM, Nwodo D, Worwui A, Biey JN, Kwambana-Adams BA, Antonio M. Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine. Clin Infect Dis 2020; 69:S81-S88. [PMID: 31505626 PMCID: PMC6736152 DOI: 10.1093/cid/ciz474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). Methods From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. Results A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. Conclusions Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the country.
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Affiliation(s)
- Beckie N Tagbo
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, and.,Department of Paediatrics University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State
| | - Rowan E Bancroft
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Iretiola Fajolu
- Department of Paediatrics, Lagos University Teaching Hospital.,Department of Paediatrics, College of Medicine, University of Lagos
| | | | - Muhammad F Bashir
- Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
| | | | | | - Namadi M Lawal
- Department of Disease Control and Immunization, National Primary Health Care Development Agency, Abuja
| | - Benedict O Edelu
- Department of Paediatrics University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State
| | - Ngozi Onyejiaka
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital
| | - Chinonyerem J Ihuoma
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State
| | | | - Uchenna C Ozumba
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State
| | - Frances Udeinya
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State
| | - Folasade Ogunsola
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital
| | - Aishat O Saka
- Department of Paediatrics and Child Health, University of Ilorin Teaching Hospital
| | - Abayomi Fadeyi
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Kwara
| | - Sunday A Aderibigbe
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Kwara
| | - Jimoh Abdulraheem
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Kwara
| | - Adamu G Yusuf
- Medical Microbiology Department, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi
| | - Peter Sylvanus Ndow
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Philomena Ogbogu
- Department of Medical Microbiology, University of Benin Teaching Hospital
| | - Chinomnso Kanu
- Department of Community Health, University of Benin Teaching Hospital, and
| | - Velly Emina
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Nigeria
| | - Olajumoke J Makinwa
- Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital
| | - Florian Gehre
- Department of Paediatrics University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State.,Department of Infectious Disease Epidemiology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Kabir Yusuf
- Department of Disease Control and Immunization, National Primary Health Care Development Agency, Abuja
| | | | - Jason M Mwenda
- WHO Regional Office for Africa WHO/AFRO, Republic of Congo, Brazzaville
| | | | | | - Archibald Worwui
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Joseph N Biey
- WHO Regional Office for Africa WHO/AFRO, Republic of Congo, Brazzaville
| | - Brenda A Kwambana-Adams
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Martin Antonio
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul.,Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Omoleke SA, Alabi O, Shuaib F, Braka F, Tegegne SG, Umeh GC, Ticha JM, Onimisin A, Nsubuga P, Adamu U, Mohammed K, Onoka C, Alemu W. Environmental, economic and socio-cultural risk factors of recurrent seasonal epidemics of cerebrospinal meningitis in Kebbi state, northwestern Nigeria: a qualitative approach. BMC Public Health 2018; 18:1318. [PMID: 30541535 PMCID: PMC6292165 DOI: 10.1186/s12889-018-6196-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Kebbi State remains the epicentre of the seasonal epidemic meningitis in northwestern Nigeria despite interventions. In this setting, no previous study has been conducted to understand the risk factors of the recurrent meningitis epidemics using qualitative approach. Consequently, this study intends to explore and better understand the environmental, economic and socio-cultural factors of recurrent seasonal epidemic meninigitis using a qualitative approach. Methods We conducted in-depth interview (40 IDIs) and focus group discussions (6 FGDs) in two local government areas (LGAs) in Kebbi State, Northwestern Nigeria to understand the environmental, economic and socio-cultural factors of recurrent meningitis outbreaks. Routine surveillance data were used to guide the selection of settlements, wards and local government areas based on the frequency of re-occurrences and magnitude of the outbreaks. Results The discussions revealed certain elements capable of potentiating the recurrence of seasonal meningitis epidemics. These are environmental issues, such as poorly-designed built environment, crowded sleeping and poorly ventilated rooms, dry and dusty weather condition. Other elements were economic challenges, such as poor household living conditions, neighbourhood deprivation, and socio-cultural elements, such as poor healthcare seeking behaviour, social mixing patterns, inadequate vaccination and vaccine hesitancy. Conclusion As suggested by participants, there are potential environmental, socio-cultural and economic factors in the study area that might have been driving recurrent epidemics of cerebrospinal meningitis. In a bid to addressing this perennial challenge, governments at various levels supported by health development partners such as the World Health Organisation (WHO), United Nation Habitat, and United National Development Programme can use the findings of this study to design policies and programmes targeting these factors towards complementing other preventive and control strategies.
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Affiliation(s)
- Semeeh A Omoleke
- World Health Organisation, Country Representative Office, Abuja, Nigeria. .,WHO Kebbi State Field Office, Brinin Kebbi, Kebbi State, Nigeria.
| | - Olatunji Alabi
- Department of Demography and Social Statistics, Federal University, Birnin Kebbi, Kebbi State, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fiona Braka
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Gregory C Umeh
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Johnson M Ticha
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Anthony Onimisin
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | | | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Kabiru Mohammed
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Chima Onoka
- National Primary Health Care Development Agency, Abuja, Nigeria
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Tagbo BN, Mwenda JM, Eke CB, Edelu BO, Chukwubuike C, Armah G, Seheri ML, Isiaka A, Namadi L, Okafor HU, Ozumba UC, Nnani RO, Okafor V, Njoku R, Odume C, Benjamin-Pujah C, Azubuike C, Umezinne N, Ogude N, Osarogborun VO, Okwesili MU, Ezebilo SK, Udemba O, Yusuf K, Mahmud Z, Ticha JM, Obidike EO, Mphahlele JM. Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011-2016. Vaccine 2018; 36:7759-7764. [PMID: 29802002 DOI: 10.1016/j.vaccine.2018.03.084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/10/2018] [Accepted: 03/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact. METHODS Routine rotavirus surveillance was conducted during 2011-2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA). RESULTS 2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases. CONCLUSION The high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program.
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Affiliation(s)
- B N Tagbo
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.
| | - J M Mwenda
- WHO African Regional Office, Brazzaville, Congo
| | - C B Eke
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - B O Edelu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - C Chukwubuike
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - G Armah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
| | - M L Seheri
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, Medunsa, Pretoria, South Africa
| | - A Isiaka
- World Health Organization Country Office, Abuja, Nigeria
| | - L Namadi
- National Primary Health Care Development Agency, Federal Ministry of Health, Abuja, Nigeria
| | - H U Okafor
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria; Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - U C Ozumba
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - R O Nnani
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - V Okafor
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - R Njoku
- Mother of Christ Specialist Hospital, Nigeria
| | - C Odume
- Tender Specialist Children's Hospital Enugu, Nigeria
| | - C Benjamin-Pujah
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - C Azubuike
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - N Umezinne
- Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - N Ogude
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - V O Osarogborun
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | | | - S K Ezebilo
- Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - O Udemba
- Mother of Christ Specialist Hospital, Nigeria
| | - K Yusuf
- National Primary Health Care Development Agency, Federal Ministry of Health, Abuja, Nigeria
| | - Z Mahmud
- National Primary Health Care Development Agency, Federal Ministry of Health, Abuja, Nigeria
| | - J M Ticha
- World Health Organization Country Office, Abuja, Nigeria
| | - E O Obidike
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - J M Mphahlele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University and National Health Laboratory Service, Medunsa, Pretoria, South Africa
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Etsano A, Gunnala R, Shuaib F, Damisa E, Mkanda P, Ticha JM, Banda R, Korir C, Chevez AE, Enemaku O, Corkum M, Davis LB, Nganda GW, Burns CC, Wassilak SG, Vertefeuille JF. Progress Toward Poliomyelitis Eradication--Nigeria, January 2014-July 2015. MMWR Morb Mortal Wkly Rep 2015; 64:878-82. [PMID: 26292207 PMCID: PMC5779584 DOI: 10.15585/mmwr.mm6432a5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Andrew Etsano
- National Primary Health Care Development Agency, Federal Republic of Nigeria
| | - Rajni Gunnala
- Global Immunization Division, Center for Global Health, CDC
- Corresponding author: Rajni Gunnala, , 404-718-6350
| | - Faisal Shuaib
- Federal Ministry of Health, Federal Republic of Nigeria
| | - Eunice Damisa
- National Primary Health Care Development Agency, Federal Republic of Nigeria
| | | | | | | | | | | | - Ogu Enemaku
- United Nations Children’s Fund, Nigeria Office
| | | | - Lora B. Davis
- Global Immunization Division, Center for Global Health, CDC
| | | | - Cara C. Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
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Wiysonge CS, Nomo E, Ticha JM, Shang JD, Njamnshi AK, Shey MS. Effectiveness of the oral polio vaccine and prospects for global eradication of polio. Trop Doct 2007; 37:125-6. [PMID: 17540110 DOI: 10.1177/004947550703700233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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