Proceedings of 1st Ghana Field Epidemiology and Laboratory Training Programme Scientific conference (Accra, 2017)

Oral presentation

Pneumococcal meningitis outbreak and associated factors in Six Districts of Brong Ahafo Region, Ghana, 2016

Cite this: Pan African Medical Journal - Conference Proceedings. Nov 2017; 3(3): 120. doi:10.11604/pamj.cp.2017.3.120.470

Submitted: 30 Oct 17   Accepted: 30 Oct 17   Published: 01 Nov 17

Key words: Meningitis, outbreak, Brong Ahafo Region, case-control

© Charles Lwanga Noora et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2017/3/120/abstract

Corresponding author: Charles Lwanga Noora, GFELTP, Ghana Health Service, Brong Ahafo Region, Ghana (nooralwanga@gmail.com)

This abstract is published as part of the proceedings of 1st Ghana Field Epidemiology and Laboratory Training Programme Scientific conference (GHANA, )

Pneumococcal meningitis outbreak and associated factors in Six Districts of Brong Ahafo Region, Ghana, 2016

Charles Lwanga Noora1,2,&, Timothy Letsa2, George Khumalo Kuma1, Ernest Asiedu1, Gideon Kye-duodu1, Edwin Afari1, Osei Afreh Kuffour2, Joseph Opare1, Kofi Nyarko3, Donne Ameme1, Emmanuel Bachan2, Kofi Issah2, Franklin Aseidu Bekoe2, Moses Aikins4, Ernest Kenu1

 

1Ghana Field Epidemiology and Laboratory Training Program, Ghana, 2Ghana Health Service, Ghana, 3Namibia FELTP, Namibia, 4University of Ghana School of Public Health, Ghana

 

 

&Corresponding author
Charles Lwanga Noora, GFELTP, Ghana Health Service, Brong Ahafo Region, Ghana

 

 

Abstract

Introduction: meningitis, a disease of the central nervous system is described as inflammation of the covering of the brain and spinal cord (meninges). It is characterized by fever, severe headache, nausea, vomiting, stiff neck, photophobia, altered consciousness, convulsion/seizures and coma. In December, 2015, twelve suspected cases of meningitis were reported in Tain district in Brong Ahafo region (BAR). Subsequently, dozens of suspected cases were hospitalized in five district hospitals in BAR. We investigated to determine the magnitude, causative agent and risk factors for the disease transmission.

 

Methods: we defined a suspected case of meningitis as anyone living in BAR reporting with sudden onset of headache and fever (Temp. > 38.0C) with one of the following signs neck stiffness, altered consciousness, convulsions, other meningeal signs, and bulging fontanelle (infants) from 10/12/15 to 26/03/16. We collected CSF samples and performed serological testing using Pastorex-Meningitis-Kit and culture for bacterial isolation. A community-based 12 case-control study (sample-size of 126) was conducted. Controls were selected as persons from neighborhood of cases without the defined symptoms. We collected data on socio-demographics, living conditions, health status and other risk factors. We conducted univariate data analysis and logistic regressions to study disease-exposure associations using STATA.

 

Results: total of 969 suspected cases with 85 deaths (CFR = 9.0%) were recorded between December, 2015 and March, 2016. Majority, 55.9% (542/969) were females aged between 10months-74 years (median 20 years, IQR; 14-34). Of the 969 cases, 141 were confirmed by Laboratory test with Streptococcus pneumoniae identified as the causative agent. Twenty districts recoded cases with six reporting cases above threshold levels. The outbreak peaked in week 6 with 178 cases. Overall attack rate (AR) was 235.0/100,000 population. District specific ARs were: Tain: 143.6/100,000, Wenchi: 110.0/100,000, Techiman: 46.6/100,000, Jaman North: 382.3/100,000 and Nkoranza South: 86.4/100,000. Female and male specific ARs were 251.3/100,000 and 214.5/100,000 respectively. Age-group 10-19 years were most 33.8% (317/940) affected. We identified sore throat [aOR = 5.2, 95% (CI 1.1-26.1)] and alcohol use [aOR = 9.1, 95 %( CI 1.4-55.7)] as factors associated with the disease transmission.

 

Conclusion: meningitis outbreak due to Streptococcus pneumoniae was established in BAR. Upper respiratory tract infection and alcohol use were associated with the outbreak. Mass educational campaigns on healthy living habits, signs and symptoms of meningitis, need for early reporting were some of the control measures instituted. We further recommend Pneumococcal vaccination in BAR to prevent future outbreaks.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1st Ghana Field Epidemiology and Laboratory Training Programme Scientific conference (Accra)

Country: GHANA

Dates: 18 Sep 17 - 21 Sep 17

Venue: Swiss Spirit and Suites Alisa Hotels

Organizers: Ghana Field Epidemiology and Laboratory Training Programme

Secretariat: gfeltp@gmail.com

Contact person: Dr. Ernest Kenu (ernest_kenu@yahoo.com)