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Of the 36 states in Nigeria, 25 States and the Federal Capital Territory (FCT) are in the African meningitis belt.

Image/NCDC

States in the meningitis belt were formally placed on alert on the 8th of November 2018 as during the dry season ((i.e. November through May)), high temperatures and low humidity increase the likelihood of transmission of organisms causing Cerebrospinal Meningitis (CSM) in Nigeria.

The Nigeria Centre for Disease Control (NCDC) reported in a recent situation report that 760 suspected CSM cases have been reported from 15 states from Oct. 1, 2018-Apr. 19, 2019. Ninety of the cases were culture confirmed. 58 deaths (CFR=7.6%) have been recorded among all suspected cases.

Neisseria meningitidis serogroup C (NmC) accounted for 28.9% (26) of the positive cases.

The countries of the African Meningitis Belt face outbreaks of the deadly bacterial disease every year. About 26 countries and 450 million people live in this area.

According to WHO, meningococcus is transmitted by aerosol or direct contact with respiratory secretions of patients or healthy human carriers. As a rule, endemic disease occurs primarily in children and adolescents, with highest attack rates in infants aged 3-12 months, whereas in epidemics older children and young adults may be more involved.


Nasopharyngeal carriage of meningococci is most common among adolescents and young adults, less so among young children and relatively rare in adult populations. Transient nasopharyngeal carriage rather than disease is the normal outcome of meningococcal colonization.

Meningitis in Africa: ‘The risk of imminent large-scale epidemics is dangerously high’

However, the rapid progression of meningococcal disease frequently results in death within 1-2 days after onset. 5-15% of children and young adults carry meningococci in the nose and throat, so chemoprophylaxis is of little value for the control of most endemic and epidemic disease. Immunization is the only rational approach to the control of meningococcal disease.