Nigeria’s weak Primary Health Care system, low knowledge of disease symptoms among health workers and poor disease surveillance outlook across the country are the major contributing factors to epidemic outbreak of preventable diseases across the country.
The Minister of Health, Isaac Adewole, made this observation on Tuesday in Kaduna at an emergency meeting of Northern traditional leaders and stakeholders summoned over the outbreak of Cerebro Spinal Meningitis, CSM, in Nigeria.
The northern part of Nigeria has been worst hit by the epidemic since the first meningitis outbreak was recorded in Zamfara State in November 2016.
The outbreak has quickly spread across 130 local government areas in 21 states in the country, with the current reported suspected cases put at 4,637 and the death toll put at 489.
The enlightenment meeting on Tuesday in Kaduna, which was at the instance of the Sultan of Sokoto, Sa’ad Abubakar, was attended by traditional rulers from across the 19 northern states, representatives of the state governors and their commissioners of health.
Mr. Adewole stressed the need for the traditional rulers to assist government in educating their people on the need to always seek medical attention when ill and to exhibit good health practices.
He, however, attributed the current epidemic to the inefficiency of health facilities at the local level, saying most of them are not capable of quickly picking up disease cases when presented.
“There is a need for retraining health of workers, especially at the (Primary Health Centres) PHCs level on pathological symptoms of diseases for them to understand and pick up the disease”, the minister told the meeting.
“Because easy and early identification of cases when presented would make it easier to treat the disease and to nip it in the bud before there is an epidemic outbreak”.
The minister said Nigeria needs a functional and efficient primary health care delivery system at community and rural levels, stressing that it was for this reason that the federal government has planned to revitalise 10,000 PHCs across the country.
“Because if the PHCs were effectively functional, most diseases will be nipped in the bud at initial presentation, because most of the cases of epidemic diseases outbreak in the country; be it polio, meningitis, measles, among others, often begin from the rural setting,” Mr. Adewole stated.
He added that it was necessary, however, not just to revitalize the PHCs, but to also equip them and employ competent hands to function there.
Speaking along the same line, the Executive Director of the National Centre for Disease Control, Chikwe Ihekweazu, lamented that his agency did not get to know about the meningitis outbreak in Zamfara State until February this year.
The first outbreak was recorded in the state in November 2016.
Mr. Ihekweazu said the epidemic would have been prevented if the agency had been quickly made aware of the suspected cases of the disease in the state.
“Our colleagues in Zamfara did not pick up the cases on time. That is the reason for the slow response from the government”, he stressed.
“We need to re-educate our people so that they can have enough skills to handle such cases in the future and so as to send signal to appropriate agencies so that we can contain diseases from becoming epidemic”, Mr. Ihekweazu pleaded.
He said the major challenge faced by Zamfara State was inadequate skilled personnel to collect CSM fluid. He said it requires specific fluid to be collected at the spine of the patient and that only doctors are allowed to retrieve such fluid and send to laboratory for testing.
Mr. Ihekweazu lamented that while the lifespan of the fluid is between 10 to 20 minutes, most of the laboratories are in urban areas, far from the rural areas where most cases are recorded.
“We have learnt from the outbreak this year and we won’t want such to repeat itself next year”, he stated.
The director joined the minister in calling for “a strong primary health care system to address our challenges at rural and community level, especially for mothers and children, as there is little or nothing at the federal and state levels”.
In his presentation, Nasir Sani-Gwarzo, a chief epidemiologist at the Federal Ministry of Health, said the reason why the outbreak was high in Zamfara was because of the state’s history of lead poison.
“When there is lead poison, and combined with meningitis, it is usually more disastrous and children and people with immunodeficiencies are often at risk”, Mr. Sani-Gwarzo said.
He however warned that all hands must be on deck “to curtail the spread of the disease so that it does not get to the IDP camps, barracks, traditional markets and places with large crowd congestion, because (otherwise) the spread would be disastrous”.
He also warned that the new strain of Meningitis Type C has only displaced the A type but has not eliminated it.
“There is a need for continuous vaccination and surveillance monitoring of both, because the moment we take our eyes off it and not concentrate on it, it can return as a deadly epidemic in 10 years.
“We are asking for a conjugate vaccine that will protect for all meningitis strains, that is why we are soliciting the support of the traditional rulers for advocacy as they are closer to the people, well respected and most times their words are final in the society; so that we can focus the funds for advocacy on getting the drugs”, the epidemiologist added.
The Sultan of Sokoto, who was represented by the Emir of Zazzau, Shehu Idris, in his opening speech, said the meeting was very crucial to the people of the North, as the region has been the worst hit by the current epidemic in the country.
He said it was thus necessary to find out how to nip the disease in the bud across the region and to curtail future occurrence.