The recent outbreak of meningitis in Ghana, with over 30 reported deaths in three months, is a worrying situation in the West African nation, according to Catholic medics in the country. They say that the relevant institutions in their country has shifted attention from the deadly viral infection in favour of the fight against COVID-19.
At least 37 Ghanaians have died from Cerebrospinal Meningitis (CSM), also referred to meningitis, with 223 cases confirmed in Ghana in the past 13 weeks, according to News Ghana reports, presenting the country with a second medical challenge as governments across the world fight to combat the spread of COVID-19.
Ghana has reported at least 636 COVID-19 cases and eight deaths due to the pandemic; by April 14, some 17 patients had recovered from the virus that has claimed over 125,800 lives globally.
The medics have urged Ghanaians to ensure that cases of CSM, which are equally as deadly as COVID-19, are reported early enough and diagnosed for effective intervention ahead of the World Meningitis Day celebrations on April 24.
“Because of its potentially fatal nature, CSM requires early reporting of symptoms, early case detection and early initiation of treatment and the appropriate antibiotics must be initiated as soon as possible, ideally after the lumbar puncture has been carried out especially if the facility can support it,” said Dr. Frederick Mawuli Agbemafoh, a Catholic Medical Practitioner in an interview with ACI Africa correspondent Thursday, April 9.
Dr. Agbemafoh pointed out that if confirmation of diagnosis by a lumbar puncture and CSF microscopy is not possible immediately, treatment should not be delayed.
The Deputy Medical Manager at Cocoa Clinic at Sefwi-Debiso in the North West Region of Ghana has, however, decried the late reporting of symptoms of meningitis, a situation he blames on the government’s focus of attention on COVID-19 at the expense of other equally deadly diseases.
“The late reporting or a failure to report to health facilities is a very worrying trend especially because it lacks the needed national attention due to the outbreak of COVID19. All national efforts and resources are now directed towards the novel viral pneumonia while Meningitis whose case fatality far exceeds that of COVID-19 is neglected,” said Dr. Agbemafoh.
He added, “As governments in the world, and Ghana in particular channel their efforts and resources towards fighting this COVID-19 pandemic, there is an old and seemingly well-known Cerebrospinal meningitis, which now lacks the needed attention, claiming precious lives in Ghana, particularly lives of our brothers and sister and their children in the northern half of the country.”
While COVID-19 is caused by a virus, meningitis can be caused by different pathogens including viruses, bacteria and fungi. Bacterial caused meningitis, however, is responsible for the highest global burden and mortality.
Dr. Agbemafoh noted that both COVID-19 and meningitis are transmitted by droplet infection, meaning when an infected person sheds the pathogen in saliva or throat and nasal secretions through a cough or a sneeze respectively, the aerosolized pathogen can be spread airborne or from touching a surface with the droplet and infecting oneself through touching the eyes, mouth or nostrils.
“COVID-19 symptoms are mostly respiratory in nature such as sore throat, dry cough, unexplained loss of taste and smell and shortness of breath. Fever and muscle aches are two other symptoms,” he added.
Symptoms of meningitis, on the other hand, include severe headaches, fever, neck stiffness, vomiting, nausea, and photophobia.
The medic also observed that COVID-19 patients may be asymptomatic, with 95 percent presenting mild disease and the other 5 percent requiring intensive care.
He further indicated that while fatality rate for COVID-19 is estimated at 5.9 percent, that of meningitis is higher, at 50 percent mortality rate if not treated.
Meningitis is also said to leave serious permanent brain damage in up to 20 percent of cases where treatment is delayed.
“As a matter of urgency, there is a call (on) relevant stakeholders to action. The Ministry of Health must intensify efforts in surveillance, laboratory case detection, case management and public education,” he noted, adding, “This can be done through early health alerts to health facilities in the meningitis belt, line listing of suspected cases and monitoring of alert and epidemic thresholds.”
The Catholic medic has further proposed immediate free laboratory testing in all affected regions in the country and treatment of cases at all health facilities free of charge.
“There should also be orientation of all health staff, orientation of community-based surveillance volunteers, and the training of health staff on case management and case definitions,” he stated.
The Catholic doctor has advised the people in the meningitis belt especially the Upper West Region to observe spatial distancing particularly avoiding persons sneezing and coughing and to wash their hands as often as possible under running water or use alcohol-based sanitizers even as they adhere to similar directives to prevent the spread of COVID-19.
He has also encouraged drinking a lot of water to keep the throat moist at all times, keeping windows open to improve ventilation and ultimately, reporting to the nearest health facility early with symptoms of fever, headache and pain in the neck.
On her part, Dr. Diana Abobi-Kanbigs, a member of the Catholic Health Professionals Guild of the Accra Archdiocese, in an interview with ACI Africa correspondent insisted on awareness about meningitis, maintaining that early treatment saves lives.
“People should be educated on condition and encouraged to report early to the nearest health facility for early treatment. We are all concentrating on fighting the current coronavirus pandemic, so there is the tendency not to pay much attention to other conditions,” said Dr. Abobi-Kanbigs, a medical Doctor at Ghana’s Korle-Bu Teaching Hospital.
Dr. Abobi-Kanbigs appealed to the people of areas where the CSM is rampant especially in the arid region of the North to report early to the hospital once they start experiencing any of the symptoms associated with meningitis.
Ghana experiences seasonal reports of meningitis normally during the dry periods of October to March. These are months characterized by dry winds with relatively low humidity and abundance of dust – there is a considerably reduced local immunity of the upper airway (pharynx) and individuals become susceptible to meningitis infection.
Meningitis is endemic in the northern regions of Ghana. Occasionally, coastal or regions in the Southern belt such as Eastern and Greater Accra Regions also report cases.
The change in epidemiology of the meningitis and the way it is occurring and spreading beyond the traditional meningitis belt can be attributed to the introduction of the Meningitis vaccine, climate change with subsequent extension of drought areas, increased mobility of the population triggered by economic demands and introduction of new strains of organisms into susceptible populations.
Outbreaks due to meningococcal meningitis remain a major public health challenge in Ghana since the first recorded outbreak in Cape Coast in 1900, among East African labourers who were brought to the Gold Coast to support the British campaign against the Ashanti tribe of central Ghana. One of the worst meningitis outbreaks in Ghana, recorded in between the years 1906 and 1908, is said to have claimed an estimated 20,000 lives.