Streptococcus Pneumoniae and Neisseria Meningitides X Outbreak Investigation in three Districts in Upper West Region, Ghana, 2020 Streptococcus Pneumoniae and Neisseria Meningitides X Outbreak

Authors : Aabalekuu Simon; Charles B. Bakin; Shamir A. Mohammed

Volume/Issue : Volume 6 - 2021, Issue 12 - December

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Meningitis is a severe, acute inflammation of the coverings of the brain and spinal cord (meninges). The disease is caused by different micro-organisms, viruses and bacteria and exhibits signs/symptoms including stiff neck, vomiting, nausea, severe headache, fever, seizures, altered consciousness, photophobia, and coma. In January 2020, suspected cases of meningitis were reported at the Nandom District Hospital. Eventually, many more cases were recorded in health facilities in other districts. We conducted investigations to; identify the causative agent of outbreak determine the magnitude and factors responsible for the outbreak We defined suspected meningitis case as anyone presenting with sudden headache and fever (Temp > 38.0 °C) with one of the following signs: neck stiffness, altered consciousness, convulsions, and a bulging fontanelle (infants). We conducted case searches at health facilities and at community levels. Contacts of confirmed cases were identified, line-listed, and followed up for 21 days. Lumbar puncture was performed on all suspected meningitis cases and cerebra spinal fluid (CSF) collected for laboratory isolation of causative organism. We conducted a descriptive data analysis. A total of 381 suspected cases with 50 deaths (CFR = 13.1%) were recorded. Majority, 53.3% (203/381) were males. Of the 381 cases, 65 were confirmed with Streptococcus pneumoniae and Neisseria meningitides X(NmX) as the causative agents. The outbreak peaked in week 11 with 40 cases. The overall attack rate (AR) was 44.1/100,000 population. District specific ARs were; Jirapa; 66.9/100,000, Nadowli; 143.1/100,000, Nandom; 192.5/100,000. Female and male specific AR were 20.5/100,000 and 23.4/100,000 respectively. The most, 49.6% (189/381) affected age group was 15-29 years. Neck pain (57.5%), fever (73.8%), and headache (36.0%) were the main sign and symptoms. As expected for streptococcus to be responsible for outbreaks, Nmx was rather established as the causative agent. We embarked on a widespread public education on mode the transmission and early reporting to health facilities and the government should collaborate with scientists to develop a vaccine against this strain

Keywords : Meningitis; Outbreak; Streptococcus Pneumoniae ; Neisseria Meningitides X(NmX)


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