Domo Nuoh R, Nuolabong Culbert, Nyarko Kofi M, Kenu Ernest, Balagumyetime Phoebe, Konnyebal Godfrey, Noora Charles L, Ameme Kofi D, Wurapa Fred, Afari Edwin
Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Legon, Accra, Ghana.
Fevers Unit, Department of Internal Medicine, Korle-Bu Teaching Hospital, Accra, Ghana.
Ghana Med J. 2017 Dec;51(4):149-155.
The Jirapa District in Ghana falls within the African meningitis belt where over 500 million people are at risk of epidemic meningitis. The district suffered an outbreak of Neisseria meningitides, W (NMW) in 2012 and a mixed outbreak of Streptococcus pneumonia and NMW in early 2016. We investigated the outbreak to identify the source, causative agents, and magnitude and assess health facility preparedness and propose control measures.
We conducted a descriptive study in all sub-districts of Jirapa, between 28 February to 10th April 2016. We reviewed records at health facilities, assessed health facility preparedness, searched for cases, traced contacts of case to administer chemoprophylaxis and collect CSF for laboratory analysis. Data were entered in Microsoft excel cleaned, and exported to stata-13 for analysis by person place and time.
A total 233 meningitis cases were reported with mean age of 22.4years and standard deviation 21.6. Males were (57%), females (43%) and 60.8% were less than 19 years. Attack rate of meningitis was 214/100,000 with case fatality rate (CFR) of 12.4% (29/233). Causative agents were NMW (69.5%) and streptococcus pneumonia (27.1%), mainly serotype STN1 and H. influenza (3.4%). The index case had travel history to dollar power, close to Tain District which is the epicentre for the 2016 meningitis outbreak in Ghana.
The Jirapa district experienced a mixed outbreak of streptococcal and meningococcal meningitis in early 2016, facilitated by migration. Active surveillance and mass vaccination with multivalent vaccines is required to protect the population.
Ghana Field Epidemiology and Laboratory Training Programme (GFELTP).
加纳的吉拉帕区位于非洲脑膜炎带内，有超过5亿人面临流行性脑膜炎的风险。该地区在2012年爆发了W群脑膜炎奈瑟菌（NMW）疫情，并在2016年初爆发了肺炎链球菌和NMW的混合疫情。我们对此次疫情进行了调查，以确定传染源、病原体、疫情规模，并评估医疗机构的准备情况，进而提出控制措施。
2016年2月28日至4月10日期间，我们在吉拉帕的所有分区开展了一项描述性研究。我们查阅了医疗机构的记录，评估了医疗机构的准备情况，查找病例，追踪病例的接触者以进行化学预防，并采集脑脊液进行实验室分析。数据录入Microsoft excel进行清理，然后导出到Stata-13，按人、地点和时间进行分析。
共报告了233例脑膜炎病例，平均年龄为22.4岁，标准差为21.6。男性占57%，女性占43%，60.8%的患者年龄小于19岁。脑膜炎的发病率为214/10万，病死率（CFR）为12.4%（29/233）。病原体为NMW（69.5%）和肺炎链球菌（27.1%），主要血清型为STN1和流感嗜血杆菌（3.4%）。首例病例有前往靠近塔因区的美元角的旅行史，塔因区是2016年加纳脑膜炎疫情的中心。
2016年初，吉拉帕区因人口迁移出现了链球菌性和脑膜炎球菌性脑膜炎的混合疫情。需要进行主动监测并使用多价疫苗进行大规模接种，以保护民众。
加纳现场流行病学和实验室培训项目（GFELTP）。
