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Statement: Meningitis Outbreak Situation in Ghana

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Health Officials  from the Ministry of Health and the Ghana Health Service on Monday 25th of January 2016 issued a statement to address the current situation of the Meningitis Outbreak currently ongoing in some parts of the country. The statement reports that the there are 153 reported cases and 33 deaths with cases currently in seven districts in Bring Ahafo Region and two in Northern Region with the highest case loads are in Wenchi, Tain, Techiman Municipal and Techiman North.
It further stresses that cases in Bole district have reduced markedly whilst districts in the B/A and Northern Region are on high alert.

Read full statement below (or listen audio here)



Dr Franklin Asare Bekoe,Ghana Health Service
Dr Franklin Asare Bekoe,Dep. Dir & Head of Surveillance Ghana Health Service (Photo: Kobby Blay)

Ladies and Gentlemen of the Press
Hon. Deputy Minister
Directors of Ministry of Health/ Ghana Health Service
Rep. from WHO
Distinguished Health Professionals
Good morning

We are grateful to have you here this morning to brief you on the meningitis situation in the country since we have just come back from the field. Meningitis is an inflammation of the meninges, the covering of the brain and spinal cord. It is most often caused by infection (viral, fungal or bacterial). Bacterial meningitis is caused by several bacterial pathogens but Neisseria meningitidis (Nm), Streptococcus pneumoniae and Haemophilus influenzae type B represent the triad causing over 80% of all cases of bacterial meningitis.

Outbreaks due to meningococcal meningitis remain a major public health challenge in the meningitis belt. The recurrent meningitis outbreaks in Ghana particularly in the northern regions, led to the conduct of a mass preventive immunization campaign in the country in 2012 to address the burden of Group A meningococcus. Group A meningococcus was accounting for an estimated 80–85% of all cases in the meningitis belt in the country, with epidemics occurring at intervals of 7–14 years.

Following the successful conduct of the mass preventive campaign in the three northern regions, the proportion of meningococcus serogroup A has declined dramatically and the occurrence of meningitis outbreaks due to other Nm serogroups as well as other bacteria are rather a new concern. Additionally, outbreaks due to Streptococcus pneumoniae have also become more pronounced and a public health threat which demands effective preparedness and response strategies.

There have been seasonal reports of meningitis in Ghana normally during the dry periods of October to March. During these dry periods with relative low humidity and abundance of dust, individuals become susceptible to meningitis infection. Meningitis is somewhat endemic in the three northern regions of Ghana. Because meningitis is somewhat endemic in Ghana, reports of one case of meningitis does not constitute an outbreak though enhanced surveillance is required to prevent additional cases. Meningitis cases are actually monitored by what we call Alert and Epidemic Thresholds which are determined using the population of the locality.

The introduction of the Meningitis vaccine (MenAfriVac), climate change with subsequent extension of drought areas, increased mobility of the population and introduction of new strains of organisms into susceptible populations are accounting for the change in epidemiology of the meningitis and the way it is occurring and spreading.

Table 1: Meningitis Burden in Ghana, 2010-2015
Year Cases Deaths
2010 1164 128
2011 790 104
2012 956 90
2013 454 41
2014 477 39
2015 315 33

An outbreak of pneumococcal meningitis occurred in December 2015 in Brohani and Seikwa communities in Tain district of Brong Ahafo region during which, initially 31 people were affected of which 9 died. The causative agent was confirmed as Streptococcus pneumoniae. Response measures were initiated and the outbreak abated. Following this, there have been increased reports of meningitis cases due to the same organism in Wenchi, Techiman North, Nkoranza South and Atebubu districts in the Brong Ahafo region. Bole district in the Northern region (16 cases with 4 deaths) has also recorded Streptococcus pneumoniae

Other districts have reported cases of meningitides serogroup W135 namely Techiman Municipal, Sene West in Brong Ahafo Region and Sawla-Tuna-Kalba in the Northern Region. These focal outbreaks bring to the fore the changing epidemiology of meningitis in the country vis-a-vis challenges gaps in preparedness and response of the health system to outbreaks. Ashanti Region has reported 7 cases which is not very different from the numbers recorded in 2015 (THIS IS AN IMPORTANT POINT).

These reported cases are actually sporadic and are from 6 districts in the region including Ejisu Juabeng, Offinso Municipal, Offinso North, Asante Akim Central and Adansi South. I want to state that, currently there is no outbreak of meningitis in Ashanti Region, the organisms isolated in the reported cases are actually Neisseria meningitis type C, which is very different from Pneumococcal meningitis.

Table 2: Distribution of Meningitis cases, Brong Ahafo 2016
District Cases Deaths CFR (%)
Atebubu Municipal 6 1 16.7
Dormaa Municipal 4  0 0
Kintampo North 4  0 0
Nkoranza South 6 0  0
Sene West 11  0 0
Sunyani Municipal 1 1 100
Tain 39 12 30.8
Techiman Municipal 20 6 30
Techiman North 12 2 16.7
Wenchi 49 10 20.4
Grand Total 153 33 21.6

Bole has reported 16 cases with 4 deaths and the last reported cases were 4 days ago.
In total, there are 153 cases and 33 deaths, which may change with time. These figures are based on retrospective and new cases. There are cases in this total number which actually tested negative for meningitis and thus remain as suspected cases.

We are addressing the challenge and want to assure Ghanaians that the Ministry of Health, Ghana Health Service and its partners will do all it takes to halt this outbreak with your support.

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