Title : Epidemiology and public health response to a 2026 meningitis outbreak in sokoto state, Nigeria: A descriptive cross-sectional study

Background: Bacterial meningitis continues to pose a recurring public health threat across the African meningitis belt despite ongoing vaccination programs. After the introduction of the Meningococcal Africa vaccine, the distribution of causative pathogens has changed. In early 2026, Sokoto State, Nigeria, experienced another meningitis outbreak that required a comprehensive epidemiological investigation and response assessment.

Methodology: We conducted a retrospective descriptive cross-sectional analysis of surveillance data from all 9 Local government areas in Sokoto state, Nigeria. Records of suspected meningitis cases reported between epidemiological weeks 5 and 23 of 2026 were reviewed. Data were obtained from state line lists, case-based investigation forms, laboratory reports, and weekly situational updates. Variables analysed included age, sex, LGAs, laboratory confirmation, bacterial aetiology, case fatality rate, and outbreak response activities.

Result: A total of 556 suspected meningitis cases and 37 deaths were reported, yielding an overall case fatality rate of 6.7%. Twenty-nine cases (5.2%) were laboratory confirmed, with Neisseria meningitidis C accounting for 96.6% of confirmed cases, followed by Neisseria meningitidis W (4.6%). Children and young adults aged 18-29 years were most affected, with a slight male predominance. The outbreak peaked during epidemiological weeks 18-20, with spatial clustering in Tambuwal, Sabon Birni, Wamakko, and Shagari LGAs. Public health response measures included activating rapid response teams, intensifying surveillance through the surveillance outbreak response management and analysis system, and retraining health workers. Key Challenges identified were limited laboratory capacity and insufficient sustainable funding.

Conclusion: The 2026 meningitis outbreak in Sokoto highlights a pronounced emergence of Neisseria meningitidis serogroup C across the meningitis belt. Although coordinated multisectoral actions effectively limited transmission, ongoing weaknesses in diagnostic capacity, workforce availability, and sustainable financing jeopardize future preparedness. Reinforcing subnational laboratory networks, broadening multivalent vaccination approaches, and ensuring reliable outbreak-response funding are essential to meet the WHO’s “Defeating Meningitis by 2030” objectives.

To be updated shortly..