title: Review of meningitis surveillance data, upper West Region, Ghana 2009-2013.
abstract: BACKGROUND
  The Upper West region of Ghana is within the meningitis belt. Analysis of long term surveillance data is necessary for understanding changes in the disease occurrence. We analyzed five years of surveillance data to describe by person, place and time and to determine trends in meningitis.
  
  
  METHODS
  Meningitis surveillance data from Ghana Health Service in the Upper West Region, from 2009 to 2013 were reviewed. Data was obtained from District-Health Information Management System and line list from the Disease Control Unit. Population figures (denominators) and rainfall data were also analyzed.
  
  
  RESULTS
  Within the period 980 cases of meningitis were reported in the region, 507(52%) females and 473(48%) males. The mean age of cases was 20.1years and standard deviation 18.8 years with, 77.6 %( 761/980) cases occurring in persons aged under 30 years. Children under five years were 19.3% (190/980). Attack rates ranged from 6.1/100,000 population in the Daffiama-bussei-Issa-district to 47.5/100,000 in Jirapa. Overall case fatality rate of meningitis was 12.2% with 14deaths/100,000 population. Bacterial agents were isolated from 35% (245/702) of CSF. Majority were Streptococcus pneumonia 48.2 % ( 122/258), and N. meningitides Y/W 135 40.3% (102/258). Meningitis was found to be seasonal with peaks in the dry season.
  
  
  CONCLUSIONS
  Meningitis in the region is seasonal, and showed a decreasing trend. Jirapa, Lawra, Nadowli and Wa West districts had the highest burden. Control effort of the disease should focus on vaccination against streptococcus pneumonia and N. meningitis W135 especially within crowded settlements such as boarding schools.
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service.
authors.forename: Robert Domo
authors.initials: RD
authors.lastname: Nuoh
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service.
authors.forename: Kofi Mensah
authors.initials: KM
authors.lastname: Nyarko
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Nortey
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Samuel Oko
authors.initials: SO
authors.lastname: Sackey
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service.
authors.forename: Noora Charles
authors.initials: NC
authors.lastname: Lwanga
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Donne Kofi
authors.initials: DK
authors.lastname: Ameme
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Culbert
authors.initials: C
authors.lastname: Nuolabong
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra; Ghana Health Service.
authors.forename: Marijanatu
authors.initials: M
authors.lastname: Abdulai
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Wurapa
authors.affiliation: Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra.
authors.forename: Edwin
authors.initials: E
authors.lastname: Afari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008297:Male; D008581:Meningitis / Q000453:epidemiology* / Q000382:microbiology; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000302:isolation & purification; D011159:Population Surveillance; D012621:Seasons; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D055815:Young Adult
keywords: Ghana; Meningitis; data; surveillance