In eastern Chad, Médecins Sans Frontières (MSF) teams, working in coordination with the Ministry of Health, are responding to a dual outbreak of measles and meningitis C amid a growing influx of refugees fleeing the war in Sudan.
Since January 2026, more than 1,500 patients have been admitted to MSF isolation units. Meningitis cases are surging in Adré: between March and April, of 212 children admitted to MSF facilities with meningitis, 25 died, a shocking case fatality rate of nearly 12%.
In Adré, near the Sudanese border, the situation has deteriorated sharply in just a few weeks. Measles cases are rising rapidly: 16 cases in January, 371 in March, and already 161 cases in just the first two weeks of April. Meningitis is following the same trend: 18 cases in January, 109 in March, and 101 cases in the first two weeks of April.
“Every day, we see children arriving with severe measles, often complicated by pneumonia, requiring urgent hospitalization,” says Isabelle Kavira, MSF medical activity manager in Adré. “At the same time, bed occupancy for meningitis is close to 100%, saturating our capacity and compromising care for other conditions.”
“The vast majority of children affected by meningitis present severe forms,” adds Léa Ledru, MSF coordinator in Adré. “Our teams are forced to move constantly from one isolation unit to another.”
In response to the influx, MSF has tripled its paediatrics isolation capacity in Adré, increasing measles beds from 5 to 15, and has set up a dedicated 30-bed tent for meningitis patients. Over three weeks, the Ministry of Health, with MSF support, carried out emergency vaccinations, reaching more than 95,500 children against measles and 337,800 people against meningitis in the most affected areas.
From April 7 to 13, a further 62,500 people were vaccinated against meningitis in Aboutengué camp, a remote desert site hosting 50,000 people, including Sudanese refugees and the host population. Since April 15, a campaign has been underway in Metche, targeting refugees in the camp as well as surrounding communities. To date, more than 16,600 people have been vaccinated against meningitis and over 9,400 against measles.
However, these response campaigns face persistent challenges: disruptions in the cold chain and gaps in routine immunization leave entire populations exposed. Strengthening routine vaccination at the primary healthcare level is essential, notably through the deployment of mobile teams from health centres to surrounding areas. Without these sustainable measures, reactive campaigns alone will not be sufficient.
In Sila province, south of Adré, the measles outbreak declared in early January quickly spread from a gold mining site to the wider community, increasingly affecting children under 15. The Ministry of Health, with MSF support, vaccinated more than 113,000 children aged 9 months to 14 years in just 15 days between late March and early April.
The crisis is further exacerbated by the continued arrival of refugee families from Sudan, where measles and meningitis outbreaks are ongoing. In the camps, overcrowding, limited access to water and healthcare, and malnutrition facilitate rapid transmission and increase the risk of severe complications, particularly among children under five.
As of April 2026, nearly 926,000 Sudanese refugees1 were recorded in Ouaddaï, Sila, Wadi Fira and Ennedi Est, placing additional strain on already fragile health services.
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