The National Programme on Immunisation (NPI) has just released a report that shows a continuing and dramatic decline in the incidence of fatal childhood diseases in Nigeria.
Diseases covered by the report include tetanus, poliomyelitis, diphtheria, measles, tuberculosis, yellow fever, and cerebrospinal meningitis, which have been responsible for high infant mortality in the country.
The programme's chairman, Professor Idris Mohammed, said the key to the decline was a change in public perception about routine immunisation.
“The NPI began with social mobilisation and communication programmes, expanded partnerships for improved immunisation services, and changed public perception about routine immunisation,” Professor Mohammed said.
The report shows a decline in the number of cases of measles, neonatal tetanus, tuberculosis, cerebrospinal meningitis, diphtheria, and pertussis (see table). In contrast, the incidence of hepatitis changed relatively little.
Professor Mohammed said the considerable gains made in tackling the childhood killer diseases in Nigeria were also due to the strategy employed by the programme and the persistence of the immunisation teams, even in the face of hostility from some communities.
He said the programme adopted a house to house strategy, in which each immunisation team was permanently stationed in a community for the duration of the immunisation exercise. In earlier exercises the vaccination teams had been continually on the move.
Table.
Annual number of cases of childhood diseases in Nigeria
| 1999 | 2000 | 2001 | 2002 | |
|---|---|---|---|---|
| Cerebrospinal meningitis | 4 599 | 5 812 | 5 495 | 2 347 |
| Diphtheria | 3 996 | 1 545 | 2 468 | 790 |
| Hepatitis | 6 533 | 8 730 | 8 598 | 6 020 |
| Measles | 217 515 | 110 242 | 168 986 | 42 007 |
| Neonatal tetanus | 2 466 | 1 703 | 1 444 | 752 |
| Pertussis | 50 715 | 45 231 | 34 482 | 11 894 |
| Tuberculosis | 18 574 | 19 638 | 15 178 | 8 153 |
Footnotes
Competing interest: Idris Mohammed is one of the editors of BMJ West Africa.