Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Centre for Health System Strengthening, Kumasi, Ghana.
PLoS One. 2024 Aug 26;19(8):e0305416. doi: 10.1371/journal.pone.0305416. eCollection 2024.
The Northern part of Ghana lies within the African meningitis belt and has historically been experiencing seasonal meningitis outbreaks. Despite the continuous meningitis outbreak in the region, the risk factors contributing to the occurrence of these outbreaks have not been clearly identified. This study, therefore, sought to describe the clinical characteristics and possible risk factors associated with meningitis outbreaks in the Upper West Region (UWR). A 1:2 matched case-control study was conducted in May-December 2021 to retrospectively investigate possible risk factors for meningitis outbreak in the UWR of Ghana between January and December 2020. Cases were persons with laboratory confirmed meningitis, and controls were persons of similar age and sex without meningitis living in the same house or neighborhood with a confirmed case. Both primary and secondary data including clinical, socio-demographic and laboratory information were collected and entered on standard questionnaires. Data was analyzed using descriptive statistics and conditional logistic regression. Meningitis cases were mostly due to Streptococcus pneumoniae (67/98; 68.37%), followed by Neisseria meningitides serogroup X (27/98; 27.55%). Fever occurred in 94.03% (63/67) of Streptococcus pneumoniae cases and 100% in both Neisseria meningitidis serogroup X (27/27) and Neisseria meningitidis serogroup W groups (3/3). CSF white cell count was significantly associated with the causative agents of meningitis. Conditional logistic regression analysis showed that, passive exposure to tobacco [AOR = 3.65, 95%CI = 1.03-12.96], bedrooms with 3 or more people [AOR = 4.70, 95%CI = 1.48-14.89] and persons with sore throat infection [AOR = 8.97, 95%CI = 2.73-29.43] were independent risk factors for meningitis infection. Headache, fever and neck pain continue to be the most common symptoms reported by meningitis patients. Education and other preventive interventions targeting exposure to tobacco smoke and crowded rooms would be helpful in reducing meningitis outbreaks in the Upper West Region of Ghana.
加纳北部位于非洲脑膜炎带内，历史上一直经历季节性脑膜炎爆发。尽管该地区持续爆发脑膜炎，但导致这些爆发的风险因素仍未明确确定。因此，本研究旨在描述加纳上西部（UWR）脑膜炎爆发的临床特征和可能的危险因素。2021 年 5 月至 12 月期间进行了 1:2 配比病例对照研究，以回顾性调查 2020 年 1 月至 12 月期间加纳上西部脑膜炎爆发的可能危险因素。病例为实验室确诊的脑膜炎患者，对照组为年龄和性别相似、家中或附近无脑膜炎且与确诊病例同住的患者。收集了包括临床、社会人口学和实验室信息在内的初级和二级数据，并输入标准问卷。使用描述性统计和条件逻辑回归分析数据。脑膜炎病例主要由肺炎链球菌（67/98；68.37%）引起，其次是脑膜炎奈瑟菌 X 群（27/98；27.55%）。肺炎链球菌引起的脑膜炎病例中 94.03%（63/67）有发热，脑膜炎奈瑟菌 X 群（27/27）和脑膜炎奈瑟菌 W 群（3/3）均有 100%发热。CSF 白细胞计数与脑膜炎的病原体显著相关。条件逻辑回归分析表明，被动接触烟草[比值比（AOR）=3.65，95%置信区间（CI）=1.03-12.96]、有 3 人或以上居住的卧室[AOR=4.70，95%CI=1.48-14.89]和患有咽痛感染的人[AOR=8.97，95%CI=2.73-29.43]是脑膜炎感染的独立危险因素。头痛、发热和颈部疼痛仍然是脑膜炎患者最常见的报告症状。针对接触烟草烟雾和拥挤房间的教育和其他预防干预措施将有助于减少加纳上西部的脑膜炎爆发。
