Analysis of Bacterial Meningitis Surveillance Data, 2011-2015, East Mamprusi District, Ghana

Background: Globally meningitis mortality ranges between 2% and 30% and that of in Ghana it is estimated in range between 36% to 50%. The East Mamprusi district in Ghana reports cases due to its location in the meningitis belt. This study assessed the distribution of cases in the district by person, place and time from 2011-2015.

Methods: Meningitis surveillance data in the East Mamprusi district in northern Ghana from 2011- 2015 was analyzed. Case based forms, laboratory tests, results and weekly line lists were reviewed. MS excel was used to analyze the data. We calculated the incidence of the disease and assessed the trend using the alert and epidemic thresholds. We determined the distribution of cases by persons history. Case fatality rates and prevalence of etiological agents were estimated.

Results: The Northern Region recorded a total of 961 suspected meningitis cases from 2011-2015. Numerous subjects are identified, amongst them 205 were confirmed of various organisms with 77 deaths. Between 2011 and 2015, 293 suspected and 83 confirmed meningitis cases were reported from East Mamprusi district. Males are representing 57.5% (216/376) of the total population. About 20% (75/376) of the cases were below one year. The median age of cases was 15 (range 1-77years). The highest numbers of cases were 36.7% (138) reported from Nalerigu Sub-district. Every year, meningitis incidence increased between January and May. The case fatality rate increased from 4.0% in 2012 to 13.3% in 2015. N. meningitides, S. pneumonia were the common etiological agents in the East Mamprusi District. In 2011 nearly 111 and in 2012, 101 cases were recorded respectively. However in 2012 there was a vaccination campaign in the district. Subsequently after the campaign, in 2013, 2014 and 2015 the number of cases declined from 73, 61 and 30 respectively.

Conclusion: Most of the cases were reported among the venerable age group of 1-15 years and from the district capital. There is an observed impact of a 2012 vaccination campaign in the district. There have been reported outbreaks over the period and most outbreaks were reported during the dry and windy season. Case fatality rate is on the increase though incidence is declining of N. meningitides which is the prevalent etiological agent isolated.