Surge in Measles-Related Admissions in Maiduguri Worries MSF

By Modupe Gbadeyanka

Measles-related admissions spiked to record numbers between October and December 2023 in the facilities of Médecins Sans Frontières (MSF) in Maiduguri, Borno State.

MSF Medical Activity Manager at Gwange Paediatric Hospital, Dr Jombo Tochukwu-Okoli, attributed this to an inability of public health actors “to achieve the 95 per cent vaccination rate, required to suppress measles.”

“This is notably due to the difficulties for the health workers in accessing rural communities surrounding Maiduguri” as the insecurity has made vaccination campaigns a difficult endeavour, the healthcare professional added.

MSF expressed concerns that this worrying situation calls for a rapid reinforcement of routine immunization campaigns.

In 2023, MSF teams treated a total of 9,618 patients with measles in both of its healthcare facilities at the Gwange Paediatric Hospital and the Nilefa Kiji Nutrition Hospital, as well as in MSF-supported primary healthcare (PHC) centres in Maiduguri.

“We did not expect such a large influx of patients, particularly at the end of the year,” MSF medical coordinator, Abdulwahab Mohamed, stated, referring to the 3,965 patients treated from October to December, which represents almost three times more than for the same period in 2022.

This is not the only difficulty in achieving higher vaccination coverage. The interruption of routine childhood vaccination during the Covid-19 pandemic has disrupted the health systems thus hurting the implementation of routine immunisation campaigns. Technical complications also lead to interruptions in the cold chain making the vaccine defective.

The measles spike coincides with an unprecedented diphtheria outbreak in Northern Nigeria and a longer-than-usual malaria season.

The diphtheria outbreak, with 24,500 suspected cases and more than 600 deaths reported since it was officially declared in January 2023, is yet another strong indicator of the dramatic setback in routine immunisation programs and the lack of long-term efforts to increase vaccination coverage in the country.

Measles is one of the most contagious viral diseases in the world. Infecting the immune cells, the virus quickly spreads all over the body and eventually affects the respiratory system. This causes a cough that can spread the virus to others.

As the virus affects the immune system, it can lead to serious complications long after measles is gone, making it very deadly as it leaves a child open to other, specifically diarrhoeal and diseases.

In the Northeast of Nigeria, where access to nutritious food is seasonally limited, diseases like measles among other factors, lead to higher levels of malnutrition and create a vicious cycle, as the malnourished status also leads to further immune suppression. In turn, this generates greater morbidity and mortality linked to measles and other diseases.

The complex security situation in Northern Nigeria, significant funding cuts by international donors for Nigeria, and the continuous neglect of public health infrastructure are alarming.

Considering the high prevalence of vaccine-preventable outbreaks, such as measles, diphtheria and meningitis, MSF is cautioning international and national stakeholders not to look away at what could be an oncoming perfect storm for a worsening of the humanitarian crisis in 2024.