Meningococcus serogroup C clonal complex ST-10217 outbreak in Zamfara State, Northern Nigeria

Brenda A. Kwambana-Adams, Rahab C. Amaza, Catherine Okoi, Murtala Rabiu, Archibald Worwui, Ebenezer Foster-Nyarko, Bernard Ebruke, Abdul K. Sesay, Madikay Senghore, Abdullahi S. Umar, Rabi Usman, Adamu Atiku, Garba Abdullahi, Yahaya Buhari, Rabiu Sani, Husaini U. Bako, Bashir Abdullahi, Alliyu I. Yarima, Badaru Sikiru, Aderinola Olaolu MosesMichael O. Popoola, Eme Ekeng, Adebola Olayinka, Nwando Mba, Adamu Kankia, Ibrahim N. Mamadu, Ifeanyi Okudo, Mary Stephen, Olivier Ronveaux, Jason Busuttil, Jason M. Mwenda, Mohammed Abdulaziz, Sulaiman A. Gummi, Adebayo Adedeji, Andre Bita, Linda Omar, Mamoudou Harouna Djingarey, Wondimagegnehu Alemu, Umberto D’Alessandro, Chikwe Ihekweazu, Martin Antonio*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

After the successful roll out of MenAfriVac, Nigeria has experienced sequential meningitis outbreaks attributed to meningococcus serogroup C (NmC). Zamfara State in North-western Nigeria recently was at the epicentre of the largest NmC outbreak in the 21st Century with 7,140 suspected meningitis cases and 553 deaths reported between December 2016 and May 2017. The overall attack rate was 155 per 100,000 population and children 5–14 years accounted for 47% (3,369/7,140) of suspected cases. The case fatality rate (CFR) among children 5–9 years was 10%, double that reported among adults ≥ 30 years (5%). NmC and pneumococcus accounted for 94% (172/184) and 5% (9/184) of the laboratory-confirmed cases, respectively. The sequenced NmC belonged to the ST-10217 clonal complex (CC). All serotyped pneumococci were PCV10 serotypes. The emergence of NmC ST-10217 CC outbreaks threatens the public health gains made by MenAfriVac, which calls for an urgent strategic action against meningitis outbreaks.

Original languageEnglish
Article number14194
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - 1 Dec 2018

Bibliographical note

Funding Information:
Between December 2016 and May 2017, a total of 14,280 suspected meningitis cases were reported across 23 of the 36 states in Nigeria. The descriptive characterization of the 2016–2017 cerebrospinal meningitis outbreak in Nigeria is reported elsewhere20. There were 1,145 deaths (8% case fatality rate) amongst suspected cases. Zamfara and Sokoto states were at the epicenter of the meningitis epidemic in Nigeria. The World Health Organization Collaborating Center (WHO CC) for New Vaccines hosted at the Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, supports surveillance of invasive bacterial diseases (IBD) in West and Central Africa. The WHO CC with its partners, supported the Nigeria Center for Disease Control (NCDC) to confirm the causative agent of the outbreak in Zamfara state. The WHO CC also trained and supported the laboratory teams at regional and district hospitals in Zamfara for bacteriologic analysis and processing of CSF specimens for molecular analysis.

Funding Information:
?World Health Organization, Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 砃紃礁 Banjul, The Gambia. ?Nigeria Center for Disease Control, Abuja, Nigeria. ?Ahmad Sani YarimanBakura Specialist Hospital Gusau, Zamfara State, Gusau, Nigeria. ?Zamfara State Ministry of Health, Gusau, Nigeria. ?Africa Centres for Diseases Control and Prevention, Addis Ababa, Ethiopia. ?World Health Organization, Country Office Nigeria, Abuja, Nigeria. ?World Health Organization, Geneva, Switzerland. ?UK-Public Health Rapid Support Team, Public Health England, Salisbury, UK. ?World Health Organization, Regional office for Africa, Brazzaville, Congo. 眃?World Health Organization Inter-Country Support Teams for West Africa, Ouagadougou, Burkina Faso. 眃?Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 砃紃礁 Banjul, The Gam眃?bDiaiv.i sion of Microbiology & Immunity, Warwick Medical School, University of Warwick, Coventry, UK. Brenda A. Kwambana-Adams, Rahab C. Amaza, Catherine Okoi and Murtala Rabiu contributed equally. Chikwe Ihekweazu and Martin Antonio jointly supervised this work. Correspondence and requests for materials should be addressed to M.A. (email: mantonio@mrc.gm)

Publisher Copyright:
© 2018, The Author(s).

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