Effective primary healthcare systems and epidemic preparedness: lessons from the 2025 cerebrospinal meningitis outbreak in Sokoto State, Nigeria
1
Public Health Laboratory Services, Nigeria Centre for Disease Control and Prevention (NCDC), Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A3127
ABSTRACT
INTRODUCTION:
The Meningitis Belt spans more than 20 countries across the African continent of which Nigeria is one1. Sokoto State lies within the belt and records annual outbreaks of cerebrospinal meningitis2. Cerebrospinal Meningitis (CSM) is a contagious bacterial infection characterised by the inflammation of the meninges3. It is caused by the bacteria Neisseria meningtidis, Streptococcus pneumoniae, and Haemophilus influenzae4. Primary healthcare centres (PHCs) are the first point of healthcare and form integral part of the country’s health system5. Sokoto State has 824 PHCs spread across its 23 Local Government Areas and 240 political wards. We present the lessons learnt from 2025 CSM outbreak response in Sokoto state.
METHODS:
The study was conducted from March to June 2025 in selected PHCs across the State. A cumulative of 845 patients, 456(54%) males and 389(46%) females who met the case definition for CSM were enrolled. Standardized case investigation forms (CIF) were used to collect demographic and epidemiologic data with corresponding cerebrospinal fluid (CSF) samples (where possible). CFS samples were tested using Real-Time Polymerase Chain Reaction (qPCR) at the NCDC National Reference Laboratory. Results were analyzed using SPSS Version16 and interpreted for public health interventions and informed policy decisions.
RESULTS:
Only 13.4%(113/845) of the total cases were tested, with a positivity of 65.5%(74/113) and all NmC serotypes. Males and females’ positivity were at 56.8%(42/74) and 43.2%(32/74). The CFR is 97.3% (72/74) with males and females 104.8%(44/42) and 87.5%(28/32). Vaccines status were 3.6%(30/845), with 13.3%(4/30) vaccinated, and 86.7%(26/30) unvaccinated. Infection trends showed activity throughout the period of study with peak activities observed between epidemiological weeks 10 -17.
CONCLUSIONS:
The study showed PHC focused responses, CFR above WHO standards7, low sample collection, poor vaccine uptake resulting to increased cases and death, and recommends improved surveillance, vaccination campaigns, and training of clinicians on LP to boost testing.
The Meningitis Belt spans more than 20 countries across the African continent of which Nigeria is one1. Sokoto State lies within the belt and records annual outbreaks of cerebrospinal meningitis2. Cerebrospinal Meningitis (CSM) is a contagious bacterial infection characterised by the inflammation of the meninges3. It is caused by the bacteria Neisseria meningtidis, Streptococcus pneumoniae, and Haemophilus influenzae4. Primary healthcare centres (PHCs) are the first point of healthcare and form integral part of the country’s health system5. Sokoto State has 824 PHCs spread across its 23 Local Government Areas and 240 political wards. We present the lessons learnt from 2025 CSM outbreak response in Sokoto state.
METHODS:
The study was conducted from March to June 2025 in selected PHCs across the State. A cumulative of 845 patients, 456(54%) males and 389(46%) females who met the case definition for CSM were enrolled. Standardized case investigation forms (CIF) were used to collect demographic and epidemiologic data with corresponding cerebrospinal fluid (CSF) samples (where possible). CFS samples were tested using Real-Time Polymerase Chain Reaction (qPCR) at the NCDC National Reference Laboratory. Results were analyzed using SPSS Version16 and interpreted for public health interventions and informed policy decisions.
RESULTS:
Only 13.4%(113/845) of the total cases were tested, with a positivity of 65.5%(74/113) and all NmC serotypes. Males and females’ positivity were at 56.8%(42/74) and 43.2%(32/74). The CFR is 97.3% (72/74) with males and females 104.8%(44/42) and 87.5%(28/32). Vaccines status were 3.6%(30/845), with 13.3%(4/30) vaccinated, and 86.7%(26/30) unvaccinated. Infection trends showed activity throughout the period of study with peak activities observed between epidemiological weeks 10 -17.
CONCLUSIONS:
The study showed PHC focused responses, CFR above WHO standards7, low sample collection, poor vaccine uptake resulting to increased cases and death, and recommends improved surveillance, vaccination campaigns, and training of clinicians on LP to boost testing.
| eISSN: | 2654-1459 |
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