2010年02月26日



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最大死亡率 23% の細菌性髄膜炎の感染がアフリカで進行中



AFRICA: Early arrival of meningitis "alarming"
アフリカでの髄膜炎の早い流行への懸念

ロイター 2010.02.22

(要点)

・アフリカの「髄膜炎ベルト」と呼ばれるサハラ砂漠より南の地域で、細菌性髄膜炎の流行がいつもより早く始まっている。

・感染者数の最も多いのがブルキナファソでの1,251人で、死亡率が15.4%。

・死亡率が最も高いのがトーゴで、死亡率23%(感染した108人のうち25人が死亡)

・2月7日に健康省は、2,298例のケースを報告。死亡率は13%に達する。

・なぜ予想より早く流行したのかはわからない。

・専門家は「かつては、8年から10年毎に大規模な髄膜炎の発生が起こるような傾向にあったが、今や、4年毎に起きている」と言う。

・2009年の髄膜炎の流行では、アフリカの14の国から、合計7万8416人の患者が報告され、4,053人が死亡(1996年の流行病以来の感染力の最多数)している。



DAKAR, 22 February 2010 (IRIN) - A meningitis epidemic has struck earlier than usual and is spreading across sub-Saharan Africa's "meningitis belt" from Senegal to Ethiopia, according to health ministries in the region. The disease occurs during the dry season, with most cases reported in mid-April.

As of 7 February, health ministries in high-risk countries reported 2,298 cases, with a 13-percent fatality rate. Burkina Faso has reported the highest number of cases, but Togo has experienced the highest fatality rate, where 25 of 108 infected people died.

The World Health Organization (WHO) described the situation as "alarming".

Mamoudou Harouna Djingarey, a WHO epidemiologist and meningitis expert, told IRIN it was still not clear why infections were spreading earlier than expected. "This [timing] is a sign of a major epidemic risk if no action is taken," he warned. Extensive meningitis outbreaks tended to occur every eight to 10 years, he said, but were now occurring about every four years.

In the 2009 meningitis season, 14 African countries reported a total of 78,416 suspected cases, including 4,053 deaths, the largest number of infections since the 1996 epidemic.

Studies are being carried out to determine whether climatic and environmental factors might be influencing the extent of the current epidemic. Djingarey told IRIN that infections had also been reported further south than usual, including in Uganda, Kenya and Democratic Republic of Congo.

Burkina Faso

On 17 February the Health Ministry in Burkina Faso reported 1,251 meningitis cases, with a 15.4 percent fatality rate. This time last year there were 25 percent less infections, but a similar percentage of deaths.

The disease has reached epidemic proportions in Pama in the east, Titao in the north, Sapouy in the centre west, and Batié in the southeast, defined by WHO as areas where at least 10 out of 100,000 people are infected. Three other districts with half as many reported infections are on alert, according to Burkina Faso's Ministry of Health.

Vaccinations have been carried out in Pama and Titao, and more are scheduled to take place in the centre west on 20 February. "If we can react quickly the numbers will drop," Health Ministry epidemiologist Jean Ludovic Kambou told IRIN.

WHO recommends vaccinating everyone aged from 2 to 29 years and living in an epidemic zone, as well as people in neighbouring areas that are on "alert". If the country does not have enough vaccine, it can request no-cost or minimal-cost vaccines from a meningitis vaccine stock managed by WHO. Alejandro Costa, a WHO vaccine scientist, told IRIN no countries have requested vaccines as of 19 February.

Costa told IRIN 100,000 doses of vaccine from the stockpile had been sent to Chad, which did not have vaccines on hand but was facing an epidemic in the southern regions of Mandoul and Logone Orientale. Chad's Ministry of Health said 42,000 people in the southern town of Doba needed vaccination.

On 19 February the government reported 507 meningitis infections that have led to 56 deaths, an 11 percent fatality rate.