Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017
Introduction: On 20th February 2017, health officials in Nadowli-Kaleo District (NKD) of Ghana's Upper West Region received reports of an upsurge in the number of meningitis case-patients reporting to the district's health facilities. The number of cases had exceeded the alert but not epid...
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African Field Epidemiology Network
2022-06-01
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| Series: | Journal of Interventional Epidemiology and Public Health |
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| Online Access: | https://www.afenet-journal.net/content/article/5/12/full/ |
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| author | Gyesi Razak Issahaku Daniel Amobtiwon Amoatika Donne Kofi Ameme Delia Akosua Bandoh Samuel Oko Sackey Ernest Kenu |
| author_facet | Gyesi Razak Issahaku Daniel Amobtiwon Amoatika Donne Kofi Ameme Delia Akosua Bandoh Samuel Oko Sackey Ernest Kenu |
| author_sort | Gyesi Razak Issahaku |
| collection | DOAJ |
| description | Introduction: On 20th February 2017, health officials in Nadowli-Kaleo District (NKD) of Ghana's Upper West Region received reports of an upsurge in the number of meningitis case-patients reporting to the district's health facilities. The number of cases had exceeded the alert but not epidemic threshold for meningitis for the district. We investigated to identify the aetiologic agent, determine the risk factors and implement control measures.
Methods: We conducted an unmatched case-control study. A meningitis case-patient was any NKD resident with any of the following signs and symptoms: neck stiffness, convulsion, bulging fontanelle (infants), altered consciousness or other meningeal signs with or without fever, from 1st January to 30th March 2017. For each case-patient, 2 controls (neighbours of case-patients without meningitis signs and symptoms) were identified. Demographic and clinical data were obtained through records review and case-patient interviews. Cerebrospinal fluid (CSF) samples were collected for laboratory investigation. Significant risk factors were identified using multivariable logistic regression.
Results: In all 67 case-patients comprising 35 (52.2%) males and two (3%) children aged < 5 years were identified. The median age of case-patients was 24 years (interquartile range: 15–46 years). Ten deaths were recorded (case fatality rate: 14.9%). Most affected age group was 15-24 years with 18 (26.9%) case-patients and an age-specific attack rate of 170.8/100000 population. Nadowli Central sub-district, the epicenter, recorded 14 (22.4%) cases. Dominant aetiologic agent was Neisseria meningitidis isolated from 17 (58.6%) of 29 culture-positive CSF samples. Compared to controls, meningitis case-patients had higher odds of living in single window rooms (adjusted odds ratio (aOR) =5.05; 95% confidence interval (CI) =1.35-11.66), or in rooms inhabited by more than two people (aOR=3.28, CI=1.57-7.73).
Conclusion: Neisseria meningitidis caused the upsurge in meningitis cases in NKD, with the youth being the most affected age group. Living in poorly ventilated rooms and overcrowded rooms were risk factors. Prompt case-management and health education helped control the occurrence and prevented an outbreak. |
| format | Article |
| id | doaj-art-fd5d07d84d984e7ea3f6096bb1125134 |
| institution | OA Journals |
| issn | 2664-2824 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | African Field Epidemiology Network |
| record_format | Article |
| series | Journal of Interventional Epidemiology and Public Health |
| spelling | doaj-art-fd5d07d84d984e7ea3f6096bb11251342025-08-20T02:26:19ZengAfrican Field Epidemiology NetworkJournal of Interventional Epidemiology and Public Health2664-28242022-06-0152https://doi.org/10.37432/jieph.2022.5.2.60Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017Gyesi Razak Issahaku0Daniel Amobtiwon Amoatika1Donne Kofi Ameme2Delia Akosua Bandoh3Samuel Oko Sackey4Ernest Kenu5Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Tamale Teaching Hospital, Tamale, GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, GhanaIntroduction: On 20th February 2017, health officials in Nadowli-Kaleo District (NKD) of Ghana's Upper West Region received reports of an upsurge in the number of meningitis case-patients reporting to the district's health facilities. The number of cases had exceeded the alert but not epidemic threshold for meningitis for the district. We investigated to identify the aetiologic agent, determine the risk factors and implement control measures. Methods: We conducted an unmatched case-control study. A meningitis case-patient was any NKD resident with any of the following signs and symptoms: neck stiffness, convulsion, bulging fontanelle (infants), altered consciousness or other meningeal signs with or without fever, from 1st January to 30th March 2017. For each case-patient, 2 controls (neighbours of case-patients without meningitis signs and symptoms) were identified. Demographic and clinical data were obtained through records review and case-patient interviews. Cerebrospinal fluid (CSF) samples were collected for laboratory investigation. Significant risk factors were identified using multivariable logistic regression. Results: In all 67 case-patients comprising 35 (52.2%) males and two (3%) children aged < 5 years were identified. The median age of case-patients was 24 years (interquartile range: 15–46 years). Ten deaths were recorded (case fatality rate: 14.9%). Most affected age group was 15-24 years with 18 (26.9%) case-patients and an age-specific attack rate of 170.8/100000 population. Nadowli Central sub-district, the epicenter, recorded 14 (22.4%) cases. Dominant aetiologic agent was Neisseria meningitidis isolated from 17 (58.6%) of 29 culture-positive CSF samples. Compared to controls, meningitis case-patients had higher odds of living in single window rooms (adjusted odds ratio (aOR) =5.05; 95% confidence interval (CI) =1.35-11.66), or in rooms inhabited by more than two people (aOR=3.28, CI=1.57-7.73). Conclusion: Neisseria meningitidis caused the upsurge in meningitis cases in NKD, with the youth being the most affected age group. Living in poorly ventilated rooms and overcrowded rooms were risk factors. Prompt case-management and health education helped control the occurrence and prevented an outbreak.https://www.afenet-journal.net/content/article/5/12/full/neisseria meningitidisnadowli-kaleo district cerebrospinal fluid |
| spellingShingle | Gyesi Razak Issahaku Daniel Amobtiwon Amoatika Donne Kofi Ameme Delia Akosua Bandoh Samuel Oko Sackey Ernest Kenu Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 Journal of Interventional Epidemiology and Public Health neisseria meningitidis nadowli-kaleo district cerebrospinal fluid |
| title | Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 |
| title_full | Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 |
| title_fullStr | Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 |
| title_full_unstemmed | Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 |
| title_short | Imminent meningitis outbreak prevented by early warning and response action: Nadowli-Kaleo District, Upper West Region, Ghana-2017 |
| title_sort | imminent meningitis outbreak prevented by early warning and response action nadowli kaleo district upper west region ghana 2017 |
| topic | neisseria meningitidis nadowli-kaleo district cerebrospinal fluid |
| url | https://www.afenet-journal.net/content/article/5/12/full/ |
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