Outbreak Response and Routine Immunization Intensification in Kano State, Nigeria: Lessons from the RI–Diphtheria Campaign
1
Disease Prevention and Control, World health organization, Kano, Nigeria
2
School of Public Health, University of Portharcout, Rivers, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Title: Diphtheria Outbreak Response in Kano State, Nigeria: Lessons from the RI–Diphtheria Intensification Campaign
BACKGROUND:
Since November 2022, Kano State, Nigeria, experienced a large-scale diphtheria outbreak affecting all 44 LGAs, with multiple peaks. Surveillance reported 26,121 suspected and 19,928 confirmed cases, resulting in 997 deaths (CFR 5.0%). Females accounted for 63% of suspected cases, and 5–14-year-olds were most affected. About 60% were unvaccinated.¹² WHO supported a Routine Immunization–Diphtheria Intensification Campaign.
METHODS:
Round 1 of the Routine Immunization–Diphtheria Intensification Campaign was conducted from 15–18 December 2025 in 10 LGAs, targeting under-1 and 2–5-year-old children via outreach and mop-up strategies through 194 health facilities. Vaccines administered included routine antigens (HepB0, OPV0, BCG, OPV1–3, Penta1–3, PCV1–3, Rota1–3, MR1) and Td for 2–5-year-olds. Coverage data were summarized by age group and LGA to identify gaps and guide planning for subsequent rounds (Round 2: 26–29 February 2026; Round 3: 23–26 February 2026).
RESULTS:
Round 1 reached 34,406 children, including 14,380 under-1s. Td doses administered to 2–5-year-olds totaled 21,854 (Td1) and 7,993 (Td2+). Coverage varied across LGAs due to high turnout and limited Td supply. Mop-up activities were essential for reaching missed children.
CONCLUSIONS:
The campaign effectively increased coverage among targeted children and identified persistent immunity gaps in older, outbreak-affected age groups. Expanding Td vaccination in subsequent rounds is expected to improve population immunity and interrupt transmission. Kano State’s experience provides practical lessons for outbreak response in high-burden, low-resource settings and demonstrates the value of integrating routine immunization with targeted outbreak interventions.
Title: Diphtheria Outbreak Response in Kano State, Nigeria: Lessons from the RI–Diphtheria Intensification Campaign
BACKGROUND:
Since November 2022, Kano State, Nigeria, experienced a large-scale diphtheria outbreak affecting all 44 LGAs, with multiple peaks. Surveillance reported 26,121 suspected and 19,928 confirmed cases, resulting in 997 deaths (CFR 5.0%). Females accounted for 63% of suspected cases, and 5–14-year-olds were most affected. About 60% were unvaccinated.¹² WHO supported a Routine Immunization–Diphtheria Intensification Campaign.
METHODS:
Round 1 of the Routine Immunization–Diphtheria Intensification Campaign was conducted from 15–18 December 2025 in 10 LGAs, targeting under-1 and 2–5-year-old children via outreach and mop-up strategies through 194 health facilities. Vaccines administered included routine antigens (HepB0, OPV0, BCG, OPV1–3, Penta1–3, PCV1–3, Rota1–3, MR1) and Td for 2–5-year-olds. Coverage data were summarized by age group and LGA to identify gaps and guide planning for subsequent rounds (Round 2: 26–29 February 2026; Round 3: 23–26 February 2026).
RESULTS:
Round 1 reached 34,406 children, including 14,380 under-1s. Td doses administered to 2–5-year-olds totaled 21,854 (Td1) and 7,993 (Td2+). Coverage varied across LGAs due to high turnout and limited Td supply. Mop-up activities were essential for reaching missed children.
CONCLUSIONS:
The campaign effectively increased coverage among targeted children and identified persistent immunity gaps in older, outbreak-affected age groups. Expanding Td vaccination in subsequent rounds is expected to improve population immunity and interrupt transmission. Kano State’s experience provides practical lessons for outbreak response in high-burden, low-resource settings and demonstrates the value of integrating routine immunization with targeted outbreak interventions.
| eISSN: | 2654-1459 |
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