6 th EAHSC Cluster of meningococcal meningitis in

6 th EAHSC Cluster of meningococcal meningitis in a rural district of Western Province, Rwanda, 2015 JEAN LEONARD HAKIZIMANA 1, 2, J. OMOLO 2, 3, J. NYAMUSORE¹ ¹RWANDA BIOMEDICAL CENTER 2 RWANDA 3 CDC FELTP RWANDA E. NSHIMIYIMANA¹, F. NIZEYIMANA¹,

Outline Introduction/ background Objectives Methods Results Discussion Acknowledgements

Introduction Meningococcal meningitis, a life-threatening infection caused by Neisseria meningitidis It is associated with high death rates in communities within the African meningitis belt where outbreaks are most prevalent Rwanda is within the WHO-defined extended meningitis belt and conducts health-facility based surveillance through the e. IDSR

Background No meningococcal meningitis outbreak has been reported since 2001 On 16 th June 2015, three suspected cases of meningococcal meningitis were reported by a rural District Hospital of Kibogora in Western Province of Rwanda through the e. IDSR We conducted a field investigation to verify the diagnosis and guide prevention and control measures

Specific Objectives Confirm etiology Establish Evaluate magnitude and describe cases weekly incidence of meningococcal cases by affected areas

Methods Conducted active case searches through record review and community visits We set a case definition for case identification We collected data on socio-demographics Incidence was calculated at weekly basis to evaluate thresholds

RESULTS Affected sectors

Description of cases A total of 18 case-patients were identified including 9 confirmed positive to Neisseria meningitidis W 135 from week 24 to week 31 of 2015 No history of vaccination and other underlying health conditions among cases and contacts Two patients died (Case Fatality Rate=11%) All case-patients were from different households and villages Median age was 14 years (range 3 -62 years) Fourteen of the 18 case-patients were aged under 15 years

Cases of meningococcal meningitis by date of consultation, Nyamasheke District, Rwanda, June-August 2015 First case at the HC Active surveillance and Response

Weekly incidence of meningococcal meningitis cases by affected sectors , week 24 -31 , 2015

Public health interventions initiated Health workers sensitization on meningitis We established an active surveillance at community level for early detection of cases 116 close contacts were identified and provided with chemoprophylaxis (ciprofloxacin) No close contact presented with symptoms

Discussion The investigation showed that Rwanda remains at risk of meningococcal meningitis outbreaks The weekly incidence remained below the thresholds needed to declare an outbreak during the eight-week duration It demonstrated the value of timely epidemiological surveillance and the importance of early case detection and management to prevent secondary transmission that may have led to a meningococcal meningitis outbreak

Recommendations Continued sensitization of health workers at all levels Strengthening of infrastructure and provision of commodities necessary for timely laboratory confirmation Advocate for continued support of the e-IDSR

Acknowledgments Government Rwanda of Rwanda Ministry of Health/ RBC University of Rwanda Science/Rwanda FELTP EAC /College of Medicine and Health

Thank you Murakoze