Responding to a Meningitis Outbreak in Niger

Augustin Ngoyi/MSF

Since the beginning of 2016, an outbreak of meningitis C has hit every region of Niger. Doctors Without Borders/Médecins Sans Frontières (MSF) emergency teams have been working with the Nigerien Ministry of Health (MoH) to contain the epidemic since January. The number of weekly cases is now decreasing, but there are insufficient stocks of vaccine available to protect those at risk in the event of another outbreak.

According to official figures, 1,199 cases of meningitis C have been identified and 87 people have died of the disease, mostly in the western part of the country. There was a steady rise in cases from January to mid-March, after which the number of new infections started to fall.

Since the beginning of the epidemic, MSF has been supporting the MoH in monitoring the affected areas, vaccinating people, and providing free treatment to patients. To contain the epidemic in the worst-affected areas, MSF conducted targeted vaccination campaigns in collaboration with the MoH. More than 254,000 people were vaccinated in the health districts of Tillabéri, Dosso, and Tahoua regions, using doses obtained from the International Coordination Group for the supply of vaccines, as well as MoH and MSF stocks. Another 126,000 vaccine doses are expected to arrive at the end of April.

A Lack of Vaccines Worldwide

According to the preparedness and response plan for meningitis epidemics in Niger, 2.8 million people should be vaccinated if an outbreak affects 21 health districts. Thus far, however, immunization campaigns have been carried out in just six. "The problem is that, nationally and globally, not enough meningitis C vaccines are available and the vaccine is expensive," says Dr. Idrissa Compaoré, MSF medical coordinator. "Manufacturers need to urgently increase their production and sell it at an affordable price, but they are not doing so."

In addition to organizing vaccination activities, MSF works with the MoH to prevent new cases by training public sector laboratory staff in diagnostics, testing, and the transport of samples. "If we don’t have vaccines, it is essential that we identify and confirm new cases as soon as possible, to prevent the disease from spreading. Information must be collected and shared, and patients treated without delay," says Dr. Compaoré.

Training, Donations, Monitoring, and Responding to Alerts

MSF has trained 80 laboratory technicians in 32 medical facilities and donated equipment to boost testing capacity in laboratories across all eight regions of the country. MSF teams also travel with MoH staff to places where there have been confirmed cases to assess and support treatment. MSF provides equipment, medicines, and staff to health centers and trains local health staff to care for meningitis patients. So far MSF has trained 148 health center managers and 51 health staff members working in seven district hospitals.

MSF teams previously supported the Nigerien MoH in responding to a meningitis epidemic affecting Niamey, Zinder, Tahoua, Tillabéri, and Dosso regions in 2015. There were 8,500 cases, including 573 deaths, during this epidemic.

Vaccination nurses (from the ministry of health) vaccinate against meningitis on the sitesof the sanitary district of Kollo, Tallabéri region, west of Niger.
Augustin Ngoyi/MSF