World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Regional Meningitis Surveillance Information bulletin_ Situation end of Week 19 (05 to 11.05.03) Date of report: 24.05.2003 Highlights:

S : 42 Nm W135 isolated in Niger from week 1 to 18, 2003 in 5 regions out of 8 By regions : Dosso (9), (15), (12), Tillaberi (4) and (2)

S Decreasing trend in all reporting countries

Number of Cases and Deaths of Suspected Meningitis Reported to WHO by Countries of the African Meningitis Belt and pathogens identifieda. January 1 - May 11 (Week 19), 2003. Country Reporting Cases Deaths CFR No Nm positive Observations (Epidemic Districts) weeks %

Beninb W1 - W19 350 76 21.7 2 Nm W135c Vaccination done in two (None) 6 Nm Ad districts (Tangieta, Toucountouna)

Burkina Faso W1 - W19 7,417 1,104 14.9 264 Nm A Laboratory results until week (none) 104 Nm W135 18

Chad W1 – W16 468 72 15.4 N/A No cases week 16 (None) Ghana W1 - W19 1,399 177 12.6 8 Nm A in Bole (None) 11 Nm A in Maprusi 7 Nm A in WA 2 W135 found in none epidemic area Mali W1 - W18 723 49 6.8 16 Nm A No circle in alert (none) 11 Nm W135e Lab results until wekk13 to be cross-checked Niger W1 - W19 7.029 566 8.05 346 Nm A 3 districts still in alert (,Matameye) 42 Nm W135f Matameye, Magaria,

Significant under reporting. On going CSM activity in Yobbe State but no data available up to date. The maximum weekly number of cases was seen in Nigeria W1 - W19 3,348 257 7.7 3 Nm A late March early April. (N/A) 2 Nm W135g Vaccinations held on a low scale around affected area.

Togo W1 - W17 298 61 21.1 35 Nesseriae No reagents available (None) Meningoccocush for serogrouping Jan-March 03 a Results obtained by culture and/or Agglutination b Data for all districts c 1 isolated in Malanville on 17-03-2003 and 1 in Banikouara on 26-03-2003 d 1 in Sinende, 1 in Parakou 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), Birni 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), (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

Situation of the Suspected Meningitis Cases by Country

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

100 100

90

80 75 70

60 CFR (%) CFR

50 50

40 number of cases of number

30 25 20

10

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

number of cases case fatality rate (% )

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

800 100 700 600 75

500 (%) CFR 400 50 300

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 weeks

number of cases case fatality rate (%)

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

100 100 90 80 75 70

60 CFR (%) 50 50 40

number of cases 30 25 20 10 0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 weeks

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

Situation of the Suspected Meningitis Cases by Country

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

225 100 200 90 175 80 70 000

, 150

60 (%) CFR 125

er 100 er 50

p 100 40 75 30 cases 50 20 25 10 0 0 w1w2w3w4w5w6w7w8w9w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 number ofw caseseeks case fatality ratio (%)

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

225 100 200

175 75 150 CFR (%) 125 50 100 75 number of cases of number 50 25 25 0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 weeks

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

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

800 100

700

600 75

500 CFR (%)

400 50

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 weeks

number of cases case fatality rate (% )

Niger : Weekly incidence rate per district during W19 (cases /100,000)

0 0,1 – 4,9 5 – 9.9

>= 10

Meningitis in Niger in 2003 pathogen distribution in percentage of the total, per region and corresponding number of isolate for which identification was possible (N=499 on 570 positive samples out of 1218 studied)

4 100% 2 2 2

90% 8 11 10 11 80% 18

70% 3 60% 3 29 50% 244 1 30 19 Hemophilus Influenzae non B 40% 19 44 Hemophilus Influenzae B 30% St.Pneumoniae 20% Nm Y 15 12 Nm A 10% 9 4 2 Nm W 135 0% NIAMEY DOSSO ZINDER World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

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

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

300 100

250 75 200 F (%) CFR

150 50

100

number of cases 25 50

0 0 w52 w1w2w3w4w5w6w7w8w9w10 w11 w12 w13 w14 w15 w16 weeks

number of cases case fatality rate (%)

Meningitis in Nigeria from 1991 to May 2003* Suspected Cases and Case Fatality Ratio

120,000 100

100,000 80

80,000 60 CFR (%) 60,000 40 40,000 number of cases number 20 20,000

0 0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

weeks

* Yobbe State : No data available Jigawa State : partial data until week 18 Kano State : data until week 17 Katsina State : partial data until week 15 Sokoto State : data until week 13 Kwara State : data until mid-week 8 Zamfara State: data until mid-week 8 Ebonyi State : data until week 5 World Health Organization - Multi-Disease Surveillance Centre Ouagadougou

Meni ngi ti s in TOGO, 2003 weekly number of cases and case fatality rati

100 100 90 90 80 80 70 70 CFR 60 60

50 50 ( er 100,000 % p

40 40 ) 30 30

cases cases 20 20 10 10 0 0 w1 w2 w3 w4 w5 w6 w7 w8 w9 w10 w11 w12 w13 w14 w15 w16 w17 weeks

number of cases case fatality ratio (%)