Posted on: Tue 18-03-2025

The Paediatric Association of Nigeria has decried the outbreak of vaccine-preventable diseases such as diphtheria and cerebrospinal meningitis in the country.

The association noted that the outbreak of these diseases questioned the immunisation status of children admitted into schools, asserting that it “reflects the failure of the immunisation programme and the infection prevention and control activities in general.”

The PAN president, Prof Ekanem Ekure, called for a closer look at the country’s immunisation programme and urged school managers to request the immunisation history and status of children admitted into schools.

PUNCH Healthwise reports that there was a suspected outbreak of cerebrospinal meningitis in Kebbi State last week, which has led to the death of 26 persons.

According to the NCDC, cerebrospinal meningitis CSM is an epidemic-prone disease with cases reported all year round in Nigeria, especially in the 19 Northern states and some states in the south.

CSM occurs when there is an acute inflammation of the covering of the brain and the spinal cord.

Last week, there were reports of a diphtheria outbreak in Kings College Lagos that led to the death of one of the students and the hospitalisation of 14 others at the Lagos University Teaching Hospital.

To curtail the spread, the Lagos State Government began immunising students and staff of the school, last week.

On Sunday, NCDC reported that deaths from diphtheria have risen to 1,319, with a total of 25,812 confirmed cases across the country.

Reacting to these vaccine-preventable disease outbreaks, the PAN president in a statement sent to PUNCH Healthwise, said, “The Paediatric Association of Nigeria, still basking in the excitement of the recently concluded annual conference in Gombe, where the huge success in the Human Papillomavirus Vaccination rollout in the 36 states of the federation and FCT was celebrated, received with dismay, media reports of outbreaks of some vaccine-preventable diseases in the country.

“An outbreak of diphtheria occurred in a Lagos school while there was an outbreak of cerebrospinal meningitis in some parts of northwest Nigeria.

“PAN is aware that these outbreaks suggest, among other things, the need for closer looks at our national immunisation program.”

Ekure further noted that while cerebrospinal meningitis was known to be endemic in the northern part of the country with outbreaks often occurring at the peak of the dry season, Nigeria in April 2024, was the first country to roll out a new five-in-one vaccine for the disease.

She added that the vaccine was recommended by the World Health Organisation and targeted five strains of the bacteria known to cause cerebrospinal meningitis, the Meningococcus.

The consultant paediatric cardiologist further queried the progress of the meningococcal vaccine roll-out, following the recent outbreak of the disease in northern Nigeria.

The PAN president also questioned the immunisation status of children after the diphtheria outbreak in Lagos.

“Similarly, the diphtheria outbreak in Lagos raises questions about the immunisation status of children admitted into schools.

“Children who are partly vaccinated or whose immune responses to primary immunisation have waned, serve as reservoirs from which outbreaks are launched,” she said.

Ekure further commended the concerned State Governments for their quick responses to the outbreaks, stating that confirmed and suspected cases were hospitalised while close contacts of the cases were being vaccinated and the general public was being educated.

She added that health workers in Lagos were being vaccinated and there was ongoing surveillance with major hospitals put on preparedness alert.

“PAN notes that the current national immunisation program only makes provision for primary diphtheria vaccination within the first fourteen weeks of life without official provisions for booster dosing yet.

“Although the WHO recommends three booster doses of diphtheria vaccine to be administered at 12-23 months, four to seven years and nine to 15 years, this is yet to be operational in the country.

“Episodic outbreaks of vaccine-preventable diseases reflect the failure of the immunisation program and the infection prevention and control activities in general,” the don asserted.

She advocated that children be taught basic personal hygiene, including cough hygiene as measures to slow down the spread of infective droplets.

The PAN president stated that overcrowding was a strong risk factor for the spread of diphtheria and cerebrospinal meningitis, urging residential homes, school hostels and dormitories to consider this in their design and planning.

She added, “The school health program needs to be re-invigorated, especially in the areas of policy review, implementation and utilisation of standardised pre-entry medical fitness documentations as it concerns immunisation status of students and proper linkage to health services.

“This step will play great roles in the prevention, early detection and in curtailing the spread of infections among school children.

“Government, at all levels, is encouraged to consider developing blueprints for preparedness against disease outbreaks, not just preparedness for disasters and accidents.”

Ekure advocated the inclusion of disease outbreak preparedness in the annual budget, stating that it should encompass specific public education, clinical and laboratory surveillance to confirm cases, multi-sectoral collaborations, facilities for quarantine and isolation, contact tracing, post-exposure prophylactic measures, and treatment of confirmed cases.

She noted that this allocation would improve the speed and quality of government response to disease outbreaks.

“The government also needs to invest more in vaccine procurement to create resources for introducing booster dosing. It is a scientific fact that the protection conferred on children following primary vaccination in early infancy wanes with time, thus predisposing them to natural infections, without booster dosing.

“It is attractive to make the booster dosing school-based since the school provides ready access to a catchment population.

“The schedule should be reviewed to include booster doses of diphtheria vaccines as recommended by the WHO. The school health program will be an effective tool for the implementation of these innovations,” the paediatrician stated.

The cardiologist urged parents to ensure their children were fully vaccinated and missed doses were promptly taken at the next opportunity.

She encouraged them to disclose their children’s vaccination history during pre-admission medical screening to ensure infection risks were appropriately classified and precautionary measures applied by the school management.

“Community involvement is also important as a potent weapon against vaccine hesitancy which is still a formidable force against satisfactory vaccine coverage.

“PAN has always been in the forefront of the vanguard for the survival of children in Nigeria through strong advocacies and networking.

“We are currently working on improving the school health program on a national scale. We are also willing to provide the needed technical support to reduce the frequency and impact of outbreaks of vaccine-preventable diseases,” the PAN president said.

 

By

Janet Ogundepo

Punch News

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