Conference abstract

Analysis of laboratory confirmed meningitis data after an outbreak of meningitis in Brong Ahafo Region, Ghana, 2016

Pan African Medical Journal - Conference Proceedings. 2017:3(14).16 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.14.102

Contact the corresponding author
Keywords: Meningitis, laboratory confirmed, outbreak, laboratory data
Oral presentation

Analysis of laboratory confirmed meningitis data after an outbreak of meningitis in Brong Ahafo Region, Ghana, 2016

George Khumalo Kuma1,2,&, Donne Ameme1, Ernest Kenu1

1Ghana Field Epidemiology and Laboratory Training Programme, Ghana, 2Ghana Health Service, Ghana

&Corresponding author
George Khumalo Kuma, Ghana Field Epidemiology and Laboratory Training Programme, Ghana Health Service, Accra, Ghana

Abstract

Introduction: laboratory confirmation of etiologic agents of meningitis is important for disease classification, treatment decisions, and surveillance. In 2016, there was a major outbreak of meningitis in the Brong Ahafo Region (BAR), with 968 cases and 87 deaths (CFR 9.0%). Most of the Cerebro-spinal fluid (CSF) samples collected during the outbreak were sent to Brong Ahafo Regional Hospital Laboratory (BARHL), for the confirmation of etiologic agent(s). We analyzed laboratory data for meningitis at the BARHL to establish the predominant causative agent(s), their distribution and antibiotic susceptibility profiles.

Methods: we conducted a retrospective descriptive study. We extracted and reviewed meningitis data from the BARHL registers and meningitis case-based forms for the 2016 outbreak. Variables collected included the district of residence, sex, age, etiologic agent, and antibiotic results. Univariate analyses were done to generate frequencies, ranges, percentages, and proportions. These were presented as text and graphs.

Results: samples were received from 20 (74%) of 27 districts in BAR. Of 608 samples, 537(88.3%) had confirmed results. Majority of confirmed cases were females, 297(55.3%), and, ages ranged from 7 days to 98 years (modal age 18 years). A total of 125 (23.7%) were positive for bacterial pathogens. The distribution of pathogens were Streptococcus pneumonia, 97 (77.6%), Neisseria meningitides, 27 (21.6%), Haemophilus influenza type B, 2(1.6%) and Group B Streptococcus, 1 (0.8%). Majority of pathogens, 46(36.8%) were isolated from age-group, 10-19 years. Over 80% of the pathogens were susceptible to Ciprofloxacin and Ceftriaxone, but resistant to co-trimoxazole, (77.4%) and tetracycline, (91.0%). Of the districts, Jaman North, 36 (28.8%), Wenchi, 16 (12.8) and Tain, 13 (10.4) had the highest proportion of confirmed meningitis pathogens.

Conclusion: predominant pathogen identified during the outbreak was Streptococcus pneumoniae. Most were susceptible to Ceftriaxone and Ciprofloxacin. Majority of identified pathogens were amongst age-group 10-19years and from Jaman North District. We recommend the use of Ceftriaxone antibiotic during meningitis outbreaks and vaccination of at risk populations in BAR.