A. SITUATION ANALYSIS
Description of the disaster
On 7 September 2021, the National Minister of Public Health declared a meningitis outbreak in the health zone of Banalia, Tshopo. province of The democratic Republic of Congo (DRC). The last emergence of meningitis outbreak in DRC dates back to November 2009 with 214 cases and 18 deaths (a fatality rate of 8%) in the town of Kisangani, still in Tshopo province. This situation, which putputs additional pressure on the DRC's health system already weakened by multiple epidemics, the most current of which are Ebola virus disease (EVD), cholera, measles and COVID-19 pandemic, required rapid involvement of the DRC RC volunteers in Tshopo to slow down the spread of meningitis within communities and mitigate its impact.
The 2021 declaration came following confirmation by the National Institute for Biomedical Research (INRB) and the Institut Pasteur in Paris of the presence of meningococcal meningitis type W in the samples of some patients taken in the province of Tshopo. The population which was most exposed to this outbreak resides in the Banalia health zone in Tshopo province. The total population of the Banalia health zone is 162,723 people, spread over 20 health areas.
Although the outbreak was confined to the Banalia health zone, it had had shown an evolving trend justifying the launch of a DREF operation on 21 September 2021, for CHF 207,685 to reduce the mortality rate and prevent further spread of the disease in the Tsopo province in coordination with local partners. The operation was planned to be implemented within a four (4) months period.
As of 16 November 2021, the most affected age group was 30-49 years, representing 37.5% of all cases. Out of a total of 2,661 notified suspected cases, 313 (11.76%) reported having been vaccinated during the meningitis A preventive campaign with MenAfriVac in May 2016.
The overall number of fatalities had also reduced to 7.7% by 20 December 2021 compared to the beginning of the epidemic, when it was at 100%. This decrease in fatality cases was due to early consultation of patients thanks to increased communication, surveillance and improved case management. The most affected health zones were Panga (epicenter) followed by Mangi, Lukelo, Mosanda, Bongonza, Docteur Sharpe and Kole, etc. The epidemic remained limited in Banalia health zone where all 20 health zones reported at least 1 suspected case. Nevertheless, suspected cases were under investigation in the health zones at risk, notably in the health zones of the city of Kisangani (Tshopo, Makiso, Mangobo), Bengamisa, Bafwagbobo and Yakusu.
By 28 November (week 47), out of a total of 20 health zones, 18 or 90%, had returned to normal, i.e., neither in epidemic nor on alert, and two health zones (Lukelo and Mosanda) had returned to alert. Following the gradual improvement of the situation, surveillance, social mobilization, community engagement and accountability (CEA) activities continued in the affected communities. The DRC RC and other partners, such as the MoH, WHO, UNICEF and MSF/Switzerland continued their interventions.
On 24 December 2021, the provincial minister declared the end of the meningococcal meningitis epidemic in the health zone of Banalia (Tshopo province) with some post epidemiological key response measures to be followed through risk communication and community engagement (RRCE) activities. To align with MoH, the DRC RC extended the DREF operation by an additional month through an Operation Update in January 2022 to continue engaging communities, keeping risk communication to ensure contribution to government measures in strengthening the epidemiological surveillance system, as well as conduct the lessons learned workshop which had been delayed. At the end of the outbreak, a total of 2,662 cases and 205 deaths had been recorded.