The Ghana Health Service (GHS) is alerting the public, particularly people living in the meningitis belt of the country, to the risk of meningitis outbreak, for which reason they must avoid self-medication when they experience symptoms that look like malaria or flu.

It has urged the public to quickly report such symptoms to any health facility to help forestall a possible outbreak of the highly fatal but treatable condition.

The onset of the dry season initiates the meningitis season, which normally spans from November to March.

The meningitis belt includes the Upper East, Upper West, Northern, Savanna and North East regions and some parts of the Bono and Bono East regions.

In an exclusive interview with the Daily Graphic in Accra, the Director-General of the GHS, Dr Patrick Kuma-Aboagye, said the call was part of measures put in place to heighten surveillance nationwide.

He said because the highly fatal condition had a number of symptoms similar to malaria and flu, many affected persons resorted to self-medication, thinking it was malaria, and only reported to health facilities when they were not getting better.

“Quite a number of the cases come in very late because the affected persons often think it is malaria and so they stay at home, self-medicate and only report when they see no improvement following self-medication.

“The late report may lead to a stage where nothing or very little can be done regarding treating meningitis, causing most affected persons to lose their lives. Early diagnosis is the key to treatment,” Dr Kuma-Aboagye said.

He mentioned the similar symptoms to include high grade fever, stiff neck, severe headache that seems different from normal, headache with nausea or vomiting, convulsion or difficulty concentrating and seizures.

Other symptoms are sleepiness or difficulty waking, sensitivity to light, loss of appetite or thirst and skin rashes, sometimes (such as in meningococcal meningitis).

He said some affected persons often took malaria medication at home, instead of reporting at hospitals.

The director-general said although the condition was treatable, the country recorded a high fatality rate due to late reporting and referrals.

Medication/new strain

Dr Kuma-Aboagye said in spite of its deadly nature, the disease could be controlled once children, usually newborns, were vaccinated against it.

He said it was for that reason that it was added to the list of diseases against which newborns should be vaccinated, leading to no report of the disease until in recent times when a new strain of the infection showed up.

He gave an assurance that the GHS had put in place adequate measures, such as stocking medication, to ensure that people affected by the new strain were treated.

“Additionally, we have adequate stock of medication in preparation for any suspected cases or outbreaks. We must know that although there is a vaccine, which many have benefited from, there is a new strain of the bacteria detected in the regions of the north, which could not be managed with the existing vaccine.

“Nevertheless, there are medications that can effectively treat this new strain of meningitis, but the success of treatment purely depends on early reporting and referrals. And this is why we are appealing to you not to self-medicate when you feel you have malaria. It could be meningitis, and the longer you stay at home, the more vulnerable to death you become,” Dr Kuma-Aboagye said.

Country situation

Dr Kuma-Aboagye said outbreaks due to meningitis remained a major public health challenge, particularly in the meningitis belt.

The recurrent meningitis outbreaks in Ghana, particularly in the northern regions, led to the conduct of a mass preventive immunisation campaign in the country in 2012 to address the burden of Group A meningococcus strain.

Group A meningococcus was accounting for an estimated 80–85 per cent of all cases in the meningitis belt in the country, with epidemics occurring at intervals of seven to 14 years.

Following the successful conduct of the mass preventive campaign in the then three northern regions, the burden of meningococcus sero group A in Ghana was now non-existent, he said.

Public health threat

“A new concern is that outbreaks due to streptococcus pneumoniae have also become more pronounced and a public health threat, which demands effective preparedness and response strategies,” he said.

Dr Kuma-Aboagye said there had been seasonal reports of meningitis in Ghana, normally during the dry periods of November to March.

During these dry periods, with relatively low humidity and abundance of dust, individuals become susceptible to meningitis infection.

“Meningitis is somewhat endemic in the regions of the northern part of Ghana and, therefore, the report of one case of meningitis does not constitute an outbreak, although 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,” he said.

Background

An outbreak occurred in a secondary school in the Central Region that resulted in two deaths.

The vaccines available protect the body against the three major causes of bacterial meningitis — meningococcal disease, pneumococcal meningitis and haemophilus influenza Type b.

According to the GHS, the Upper West Region reported quite a number cases as of February this year.

As of April 15, this year, 258 cases had been reported in the Upper West, out of the 409 cases reported in the five northern regions, resulting in 40 deaths (case fatality of about 15 per cent).

The director-general said a laboratory in Wa was being upgraded to be a meningitis diagnostic laboratory with the provision of a PCR machine.

“This is to address the challenge of transporting samples all the way to the reference laboratory in Tamale,” Dr Kuma-Aboagye said.