How MSF supported fight against meningitis outbreak in northwest Nigeria

ISHOLA MICHAEL writes about the recent outbreak of meningitis, a deadly disease, in northwestern Nigeria, and how it was brought under control as government health authorities collaborated with Médecins Sans Frontières (MSF) teams in the region.

Meningitis is considered a major global health threat. According to a study based on 2021 data and published in The Lancet, more than two million cases of meningitis are estimated to occur globally each year, with over 200,000 resulting in death. 

The disease, which records recurrent outbreaks in the vast African belt area stretching from Senegal to Ethiopia—known as the “meningitis belt”—is highly lethal if left untreated. Studies show that 50 to 80 percent of patients may die without prompt medical care.

Meningitis, particularly meningococcal meningitis, is a significant health concern in Northern Nigeria, which lies within the “African meningitis belt,” a region known for seasonal outbreaks. 

Meningitis can be caused by viral or bacterial infections and spreads from person to person by respiratory droplets, throat secretions, or by faecal contamination. 

Bacterial meningitis—commonly found in Nigeria—is the most serious type of meningitis and can cause inflammation of the tissues surrounding the brain and spinal cord.

The outbreaks, which are most common during the dry season, are linked to factors like hot and dry conditions, low humidity, and dusty atmospheric conditions. Meningitis can cause severe illness, leading to complications like hearing loss, behavioral changes, and neurodevelopmental deficits. 

Meningitis can affect people of all ages, but the highest proportion of reported cases is among children aged one to 15 years. Children under the age of five, due to their weaker immune systems, are especially at high risk of dying.

In late 2024 to early 2025, there was a serious outbreak of the disease across the 19 northern states of Nigeria. However, the worst hit were the states in the North-West, particularly, Kebbi, Sokoto and Zamfara. 

For several weeks, Doctors Without Borders also known as Médecins Sans Frontières (MSF) teams in northwest Nigeria battled a meningitis outbreak, providing vital care for hundreds of patients and supporting a mass vaccination campaign. It was a mobilisation that significantly contributed to saving lives and reducing the number of cases.

In the first days of February 2025, many men, women, and children in northwestern Nigeria suddenly became very ill. Some experienced convulsions or became unconscious. For those affected, the cause of the mystery disease was not immediately clear.

Soon after, the cause was officially confirmed: meningitis was behind the surge in admissions to health facilities in Kebbi and Sokoto states.

26-year-old Aisha Faruq, while recovering in the MSF-supported General Hospital of Gwandu, a local government area (LGA) in Kebbi, the most hit Northwestern state of Nigeria said, “I woke up one morning with pain in the neck, stiffness in one leg, and back pain. I vaguely remembered what happened next, like going to school. That’s where I lost consciousness. When I woke up, I was here.”

As hospitals filled with patients, MSF Health Educators connected with the hardest hit communities to raise awareness and direct residents to MSF-supported medical facilities.

David Musa, an MSF Community Health Educator in Gwandu stated, “Initially, community members often thought they had contracted malaria, as they were suffering from fever and headache.” 

He added, “But some distinct symptoms such as neck stiffness or brain swelling in infants alerted health professionals that we were dealing with something else.”

In order to help authorities respond to this dangerous outbreak, MSF teams in Kebbi and Sokoto states quickly provided support by deploying staff and medical supplies to hard-hit areas, expanding bed capacity in several health facilities, training medical staff from the state ministries of health, and launching awareness-raising campaigns.

“In Kebbi, where most cases were reported, we admitted over 500 patients in the first 12 days of our intervention in the LGAs of Gwandu, Jega, and Aliero,” said Dr Sham’un Abubakar, MSF’s emergency coordinator in Kebbi. 

He stressed, “Even with the additional beds we installed, we had to place mattresses on the floor to accommodate the overflow of patients.”

Over a nine-week period, 2,095 patients were admitted for meningitis in the facilities supported by MSF in Kebbi.

In neighbouring Sokoto State, MSF teams supported case management (including remote assistance), training, and the supply of medical supplies in five primary health care centres and two general hospitals in Tambuwal Local Government Area (LGA). 

By early May, MSF teams in Sokoto had treated a total of 880 meningitis patients in MSF-supported facilities.

“Unfortunately, survivours are also at risk of developing long-term neurological and cognitive problems,” said Dr. Abubakar adding that, “Patients may suffer hearing loss, vision problems, and seizures, as well as increased pressure on the skull and brain. Many survivors also remain at risk of experiencing a stroke.”

Ten-month-old Sha’ayau was admitted to the Jega General Hospital in late April with multiple symptoms, including brain swelling. He was discharged many days later but referred to a specialist to evaluate potential neurological complications.

“His older brother was hospitalised [for meningitis] weeks ago,” said his mother, Saratu Hamza. “But now he has lost his hearing.”

In order to fight the outbreak, a mass vaccination campaign was embarked upon in order to curtail it and protect others that were not affected. 

While providing rapid treatment is key to preventing fatalities and long-term consequences, fighting meningitis also requires vaccinating as many people as possible to break the transmission chain. 

“Conducting a mass vaccination is essential, as it provides immunity against the disease for up to five to eight years, hence significantly reducing the risk of infection—even in the event of another outbreak,” said Dr Abubakar.

In Kebbi State, MSF teams partnered with UNICEF and WHO to support the state Ministry of Health in setting up an immunisation campaign. In just one week, close to half a million people were vaccinated, with two-thirds of them under the age of 15.

While official figures are still being compiled, the Nigerian Centre for Disease Control (NCDC) recorded more than 4,000 meningitis cases nationwide between early February and early May. Seventy percent of those cases were treated in MSF-supported facilities in Kebbi and Sokoto states.

However, today, thanks in part to MSF’s swift and effective response, the number of cases in both states has declined. Its teams have gradually wound down emergency responses and are transitioning back to routine treatment and regular medical activities while continuing to support staff of state Ministries of Health.

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