Meningococcal meningitis epidemic in Arua district North West of Uganda

Abstract

Background: Meningitis due to Neisseria meningitidis has an epidemic potential and a high case fatality rate. On 3rd September 2008, a meningitis epidemic was reported in Arua district health office, in north western Uganda. The objective of the investigation was to confirm the meningitis epidemic, identify the causative agent, risk factors and assess the district response capacity to handle the epidemic. Methods: Community based cross-sectional study. We purposively selected cases, their families, District health team & local leaders for interview. Cerebral spinal fluid samples were drawn from cases and sent to Central Public Health Laboratory of Ministry of Health to isolate the causative agent. Frequencies and distributions of cases with respect to age groups and affected communities with EPIINFO 2006 were done. Results: A total of 44 cases were detected and 10 deaths occurred to meningitis. The Case Fatality Rate was 22.7%: highest CFR (46.2%) occurred in those above 30years.Age range was 3months to 65years. The causative agent for this meningitis epidemic was identified to be Neisseria meningitides type A with latex rapid test. 70.5% of the cases were <30 years and the male to female ratio was 1:2. Characteristically, it was discovered that the epidemic occurred in the area which had missed vaccination against meningitis in the previous outbreak of meningitis. Sleeping in poorly ventilated huts and overcrowding: 3-5 huts with 7-10 people/family cluster were risk factors to this meningitis. Conclusion: Highest case fatality rate occurred amongst persons who are over 30 yrs old. Overcrowding, staying in poorly ventilated huts and lack of previous vaccination were thought to be predisposing factors to this meningitis epidemic. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive