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 Niger : 42 Nm W135 isolated in Niger from week 1 to 18, 2003 in 5 regions out of 8 By regions : Dosso (9), Niamey (15), Tahoua (12), Tillaberi (4) and Zinder (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 (Magaria,Matameye) 42 Nm W135f Matameye, Magaria, Aguie 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), 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 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 (%) 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 (%)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 AGADEZ 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 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 (%).