CHAPTER ONE

INTRODUCTION

Background of the Study

Cerebrospinal Meningitis (CSM) is a major public health problem in many parts of the world. Cerebrospinal Meningitis is one among the first category of Epidemic Prone Diseases in Gombe State and equally among the first category of revised list of Nigeria Integrated Disease Surveillance Response (IDSR) priority diseases, conditions and events. Cerebro-spinal Meningitis (CSM) is a disease of public health importance considering the synergy between cases and case fatality rate do occurs. The worst CSM epidemics experienced in Nigeria occurred in 1996 when about 109,580 cases and 11,717 deaths were recorded, followed by the one in 2003; 4,130 cases with 401 deaths recorded then in 2008; 9,086 cases and 562 deaths (WHO, 2010).

The current Cerebro-Spinal Meningitis (CSM) outbreak in Nigeria continues to pose a public health concern. According to the Nigeria Centre for Disease Control (NCDC), cases of CSM were first reported in Zamfara State in 2016 and have since spread to sixteen (16) States including the Federal Capital Territory (FCT). Ninety (90) Local Government Areas (LGAs) in Sixteen (16) States across the federation  are so far affected which includes Zamfara, Kastina, Sokoto, Kebbi, Niger, Nassarawo, Jigawa, FCT, Gombe, Taraba, Yobe, Kano, Osun, Cross Rivers, Lagos and Plateau. The total number of people affected across these States is 2524 with 328 Deaths (case fatality rate) as of Friday, March 31, 2017 (FMOH). These indicators shows that Nigeria is repeatedly experiencing an outbreak of Cerebrospinal Meningitis (CSM) that has spread across the country and mostly affecting States in the upper parts of the country which falls within the African Meningitis Belt. Other countries that are facing similar outbreaks at the moment include our West-African Neighbours like Niger, Chad, Cameroun, Togo and Burkina Faso (WHO, 2010). 

An extensive survey of published and unpublished records, obtained by personal visits to hospitals and Ministries of Health across West Africa, enabled Lapey (2010) to produce the definitive report on CSM in West Africa during the first half of the 20th century. He documented in detail the epidemiological features of CSM in Africa and drew attention to the fact that it is only in a restricted area of Africa that the infection behaves in such a characteristic and peculiar way. This led him to define the ‘‘African meningitis belt’’ bounded to the North by the Sahara and to the south by areas of tropical rain forest. Various mining activities augment the spread of diseases. Activities of surface mining in and around textiles areas pollute the air with a lot of dust which caused upper respiratory tract infections. Secondly, disposal of mining waste such as cyanide in rivers exposes the inhabitants to the risk of meningitis (Lapey, 2010).

Statement of the Problem

Infection of the meningitis affects the thin lining that surrounds the brain and the spinal cord. Cerebro-Spinal Meninigitis infection spread mainly by contact with an infected person usually through sneezing, coughing and nose secretions from infected person and is particularly worse in overcrowded areas. Perhaps indicators shows that Nigeria is repeatedly experiencing an outbreak of Cerebrospinal Meningitis (CSM) that has spread across the country and mostly affecting States in the upper parts of the country which falls within the African Meningitis Belt of which Gombe State is inclusive (see map in appendix.…. and graphic illustration in appendix.…). Meningococcal meningitis remains associated with a high mortality rate and persistent neurological defects particularly among infants and young children. As a way of prevention, it is important to avoid overcrowded spaces, sleep in well-ventilated rooms and avoid close and prolonged contacts with infected individuals. Therefore, the study is geared toward appraising the prevalence of cerebrospinal meningitis infections which comes year-in year-out frequently in Gombe Local Government Area of Gombe State.

Purpose of the Study

The purpose of this study is to assess the Prevalence of Cerebrospinal Meningitis in Gombe Local Government Area, Gombe State. Specifically, it seeks to:

(i) Investigate the epidemiology of Cerebrospinal Meningitis in Gombe Local

    Government Area.

(ii) Determine the factors that predispose to Cerebrospinal Meningitis in

      Gombe Local Government Area, Gombe State.

(iii) Determine the strategies that could be adopted to solve the prevalence

      Cerebrospinal Meningitis in Gombe Local Government Area of Gombe State.

Significance of the Study

This study aims at finding out predisposing factors, epidemiological strength, determine and suggest the best intervention and preventive strategies to curb with the prevalence of cerebrospinal meningitis infections in Gombe Local Government Area of Gombe State. Furthermore, findings from this study and the appropriate recommendations if implemented, will be of great help to the health institutions, concerns authorities and or the country at large in reducing morbidity and mortality through new intervention programs, update the treatment protocols for proper management, follow up and care of all patients with Cerebrospinal Meningitis case and it’s complications associated. It should be used to formulate the policy and make public awareness regarding Cerebrospinal Meningitis within the study area. The findings of this study also could of help to improve upon the welfare of the people, as persons recovered from the sickness and are able to earn their livelihood and improve their lot.

Research Questions

(i)  What is the epidemiology of Cerebrospinal Meningitis in Gombe Local

    Government Area?

(ii) What are the factors that predispose to Cerebrospinal Meningitis in

      Gombe Local Government Area, Gombe State?

(iii) What strategies could be adopted to solve the problem of Cerebrospinal

      Meningitis in Gombe Local Government Area of Gombe State?

Scope of the Study

This study is centered on the Prevalence of Cerebrospinal Meningitis in Gombe Local Government Area, Gombe State. It would focus on the factors and effects of Cerebrospinal Meningitis and also it is expected to note that the preventive measures to curb the problems of Cerebrospinal Meningitis would have been known in the course of this study.