World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Regional Meningitis Surveillance Information bulletin_ Situation end of Week 23 (02 to 08.06.03) Date of report: 17.06.2003

Highlights:

S Epidemic declared over in Burkina Faso

S No district in alert in during week 23

Number of Cases and Deaths of Suspected Meningitis Reported to WHO by Countries of the African Meningitis Belt and pathogens identifieda. January 1 - June 8 (Week 23), 2003. Country Reporting Cases Deaths CFR No Nm positive Observations (Epidemic Districts) weeks %

Beninb W1 - W22 357 77 21.6 3 Nm W135c Vaccination done in two (None) 8 Nm Ad districts (Tangieta, Toucountouna)

No district in alert since Burkina Faso W1 - W23 7,720 1,153 14.9 264 Nm A week 20 (none) 104 Nm W135 No lab results since w 18 (until week 18) Chad W1 – W16 468 77 16.5 N/A (None)

Ghana W1 - W19 1,393 177 12.7 26 Nm A IW135 found in none (None) 2 Nm W135 epidemic areas

Mali W1 - W23 840 59 7.0 12 Nm A (none) 11 Nm W135e

Niger W1 - W23 7,953 625 7.9 346 Nm A No district in alert w 23 (none) 42 Nm W135f

Nigeria W1 - W19 3,477 296 8.5 5 Nm A (N/A) 2 Nm W135g No data since week 19

Togo W1 - W22 313 65 20.8 35 Nm spp h Some Nm. confirmed to be A (None) Jan-March 03 No W135 found.

a Results obtained by culture and/or Agglutination b Data for all districts c 1 isolated in on 17-03-2003 and 1 in Banikouara on 26-03-2003 d 1 in Sinende, 1 in and 4 in Tanguieta isolated between January 1st and March 12th, 2003 e 1 in Kangaba, 3 in Yanfolila, before w13, and1 in Koutiala, 3 in Kangaba, 2 in Selingue, 1 in Kati since w13 f in Niamey 15) Illela (5), N'Konni (2), Boboye (4), Dosso (1), Gaya (3), Loga (1) , Birni N' Koumi (2), Illela (5) Madoua (4), Tahoua (1), Tillaberi (3), Say (1), Tanout (1), Zinder (1) g 1 in Miga and 1 in Sule Tankarka h including 5 in Central region, 4 in Kara region, 26 in Savanes region World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Summary on Meningitis Epidemic per country up to week 23, 2003

Country Districts* where the Alert threshold Districts where the Epidemic threshold (reporting weeks) of 5 cases / 100,000 / week of 10 cases / 100,000 / week was exceeded at least once was exceeded at least once , Bembèrèkè, N'Dali, Tanguiéta, (w1-20) Kérou, Matéri, Sinendé. Toucountouna BURKINA FASO Barsalogho, Boromo, Batie, Bogande, Boulsa, (w1-21) Dande, Dano, Diapaga, Diebougou, Bousse, Kongoussi, Leo, Fada, Hounde, Kombissiri, Manga, Pama, Po, Kossodo, Koudougou**, Koupela**, Nanoro, Sapone, Tenkodogo, Zabre Ouragaye, Reo**, Sebba, Titao, Yako, Zorgho**. CHAD Kourma - (w1-16) Moïssala GHANA Bongo, Builsa, Kassena-Nankana, Bole, East Mamprusi, (w1-19) Lawra, Wa, West Mamprusi Ho, North Tongu, MALI Banamba, Kangaba, - (w1-21) Kadiolo, San NIGER Abalak, Birni N'Konni,Boboye, Aguié, Illela, Madarounfa, (w1-19) Madaoua,Maradi, Mayahi, Magaria, Matamèye, Mirriah, Niamey I, Tahoua Tanout, Tessaoua, Zinder. (w1-20) , , K/Kasamma, , , Garki, , Taura, , , , , M.Madori, , Roni, Bindawa, Kaita, Kafur, Kankarka, Batagarawa, Batsari, Daura, (w1-15) Kanku, Karfi, Rimi Katsina, Musang, Mana, Dutsi, Maiduna N/A N/A Yobbe State N/A N/A TOGO Keran, Amou, - (w1-21) Est-Mono, Wawa * Districts = LGAs in Nigeria ** district neighbouring a district in epidemic, when they passed the alert threshold World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Situation of the Suspected Meningitis Cases by Country

M eningitis in Benin, 2003 w eekly num ber of cases and case fatality ratio

200 100

150 75 CFR (%)

100 50 number of cases of number

50 25

0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 weeks

num ber of cases c a s e fa ta lity ra te (% )

Meningitis in Burkina Faso, 2003 weekly number of cases and case fatality ratio

900 100 800

700 75 600 CFR (%) CFR 500 50 400 300 number of cases 200 25 100 0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24 weeks

number of cases case fatality rate (%)

M eningitis in C had, 2003 weekly num ber of cases and case fatality ratio

100 100 90 80 75 70

60 CFR (%) 50 50 40

number of cases of number 30 25 20 10 0 0

0 1 2 6 7 8 9 w1 w2 w3 w4 w5 w6 w7 w8 w9 1 w1 w1 w w13 w14 w15 w1 w1 w1 w1 w20 w21 weeks

num ber of cases case fatality rate (% ) World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Meningitis in Ghana, 2003 weekly number of cases and case fatality ratio

300 100 90 250 80 70 200 60 CFR (%) 150 50 40 100 30 cases per 100,000 cases per 20 50 10 0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24 number ofweeks cases case fatality ratio (%)

Meningitis in Mali, 2003 weekly number of cases and case fatality ratio

300 100

250 75 200 CFR

150 50 ( % ) 100 number of cases 25 50

0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24 weeks

number of cases case fatality rate (%)

M e n in g itis in N ig er, 20 0 3 weekly num ber of cases and case fatality ratio

900 100

800

700 75 600 CFR (%) 500 50 400

300 number of cases of number 25 200

100

0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24 weeks

num ber of cases ca se fa tality ra te (% ) World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Situation of the Suspected Meningitis Cases by Country

(data from week 52 for Jigawa and from w1 for Benue and Katsina)

Meningitis in 3 , 2002-03 (Jigawa, Benue and Katsina) weekly number of cases and case fatality ratio

300 100

250 75 200 CFR (%)

150 50

100

number of cases number 25 50

0 0 w52w1w2w3w4w5w6w7w8w9w10w11w12w13w14w15w16 weeks

number of cases case fatality rate (%)

Meningitis in TOGO, 2003 weekly number of cases and case fatality rati

100 100

80 80 CFR 60 60 ( %

40 40 )

20 20 cases per 100,000 per cases

0 0 w1 w3 w5 w7 w9 w11 w13 w15 w17 w19 w21 w23 weeks

number of cases case fatality ratio (%)