Reemergence of Human Monkeypox in Nigeria, 2017.

In Nigeria, before 2017 the most recent case of human monkeypox had been reported in 1978. By mid-November 2017, a large outbreak caused by the West African clade resulted in 146 suspected cases and 42 laboratory-confirmed cases from 14 states. Although the source is unknown, multiple sources are suspected.

Large Outbreak of Neisseria meningitidis Serogroup C - Nigeria, December 2016-June 2017.

On February 16, 2017, the Ministry of Health in Zamfara State, in northwestern Nigeria, notified the Nigeria Centre for Disease Control (NCDC) of an increased number of suspected cerebrospinal meningitis (meningitis) cases reported from four local government areas (LGAs). Meningitis cases were subsequently also reported from Katsina, Kebbi, Niger, and Sokoto states, all of which share borders with Zamfara State, and from Yobe State in northeastern Nigeria. On April 3, 2017, NCDC activated an Emergency Operations Center (EOC) to coordinate rapid development and implementation of a national meningitis emergency outbreak response plan. After the outbreak was reported, surveillance activities for meningitis cases were enhanced, including retrospective searches for previously unreported cases, implementation of intensified new case finding, and strengthened laboratory confirmation. A total of 14,518 suspected meningitis cases were reported for the period December 13, 2016-June 15, 2017. Among 1,339 cases with laboratory testing, 433 (32%) were positive for bacterial pathogens, including 358 (82.7%) confirmed cases of Neisseria meningitidis serogroup C. In response, approximately 2.1 million persons aged 2-29 years were vaccinated with meningococcal serogroup C-containing vaccines in Katsina, Sokoto, Yobe, and Zamfara states during April-May 2017. The outbreak was declared over on June 15, 2017, after high-quality surveillance yielded no evidence of outbreak-linked cases for 2 consecutive weeks. Routine high-quality surveillance, including a strong laboratory system to test specimens from persons with suspected meningitis, is critical to rapidly detect and confirm future outbreaks and inform decisions regarding response vaccination.

Prevalence of obesity and associated factors in Benue State, Nigeria: A population-based study.

Background: The prevalence of obesity has risen to over 650 million adults in 2016, and accounts for 41 million deaths globally. It is a major contributor to the burden of noncommunicable diseases. We determined the prevalence and associated factors of obesity to inform policy decisions toward developing robust prevention and management strategies. Materials and Methods: We conducted a population-based cross-sectional study in July 2017 among 1265 adults in urban and rural communities in Benue State. We used multistage sampling technique in selecting the participants. The WHO standardized and validated tool were used to collect information on sociodemographic and anthropometric measurements. We calculated age standardized prevalence of obesity and determined factors associated with obesity using logistic regression at 5% level of significance. Results: The age standardized prevalence of obesity was 11.1% (rural 4.2%, urban 14.3%). The odds for obesity was higher among females (adjusted odds ratio [aOR]: 3.4; 95% confidence interval [CI]: 2.27-4.99), those with tertiary education (aOR: 3.3; 95% CI: 1.61-6.95), married (aOR: 2.1; 95% CI: 1.37-3.36), and those residing in urban areas (aOR: 3.0; 95% CI: 1.73-5.05) compared to rural dwellers. Conclusions: The prevalence of obesity was high among adults in Benue State. It is more prevalent among females, married, educated, and urban dwellers. Interventions targeted at healthy lifestyle choices should be directed at these populations for effective control.

RésuméContexte: La prévalence de l'obésité est passée à plus de 650 millions d'adultes en 2016 et représente 41 millions de décès dans le monde. C'est un majeur contribuant au fardeau des maladies non transmissibles. Nous avons déterminé la prévalence et les facteurs associés de l'obésité pour éclairer les décisions politiques vers l'élaboration de stratégies solides de prévention et de gestion. Matériel et méthodes: Nous avons réalisé une analyse transversale basée sur la population étude réalisée en juillet 2017 auprès de 1265 adultes des communautés urbaines et rurales de l'État de Benue. Nous avons utilisé une technique d'échantillonnage à plusieurs degrés pour sélectionner les participants. L'outil normalisé et validé de l'OMS a été utilisé pour collecter des informations sur les mesures sociodémographiques et anthropométriques. Nous avons calculé la prévalence standardisée selon l'âge de l'obésité et déterminé les facteurs associés à l'obésité en utilisant une régression logistique à un niveau de 5% de importance. Résultats: La prévalence de l'obésité normalisée selon l'âge était de 11,1% (rurale 4,2%, urbaine 14,3%). Les probabilités d'obésité étaient plus élevées chez femmes (rapport de cotes ajusté [aOR]: 3,4; intervalle de confiance à 95% [IC]: 2,27­4,99), celles ayant fait des études supérieures (aOR: 3,3; IC à 95%: 1,61­6,95), mariés (aOR: 2,1; IC à 95%: 1,37­3,36) et ceux résidant dans les zones urbaines (aOR: 3,0; IC à 95%: 1,73­5,05) par rapport aux habitants des zones rurales. Conclusions: La prévalence de l'obésité était élevée chez les adultes de l'État de Benue. Il est plus répandu chez les femmes mariées, instruites et citadins. Les interventions ciblées sur les choix de modes de vie sains devraient être dirigées vers ces populations pour un contrôle efficace.

Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report.

BACKGROUND: In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017-18 human monkeypox outbreak in Nigeria. METHODS: We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. FINDINGS: 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. INTERPRETATION: This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. FUNDING: None.