Eliminating another cause of febrile illness – megingitis

During a recent malaria diagnostics assessment to Burkina Faso, we found health workers who were concerned that malaria rapid diagnostic tests showed fewer positive results in the dry season even though they often suspected that their patients had malaria. The big challenge for health workers is accepting the fact that even when they use clinical algorithms, not all febrile illnesses that they suspect to be malaria are actually malaria.

The dry season in the African Sahel is the period for epidemics of meningitis. Seasonal epidemics of meningitis kill thousands in Africa every year.

According to CDC “Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck.” These are similar to early malaria symptoms, but in addition CDC says that people with meningitis may experience nausea, vomiting, photophobia (sensitivity to light), altered mental status.

BBC reports that, “For the people in Niger, Mali and Burkina Faso, a new meningitis vaccine offers hope of an escape from one of the world’s deadliest, most disabling and infectious diseases. So there is little wonder that the queues were enormous when a pilot project for the MenAfriVac vaccine got underway in the three West African countries in recent weeks.”

This vaccine was developed specially for Africa and costs around 50 US cents per dose and should be effective for 10-15 years. Meningitis A is “caused by the bacterium Neisseria meningitidis group A, which mostly attacks infants, children, and young adults. It accounts for ninety per cent of all meningitis epidemics in Africa. The outbreaks strike during the dry season. In 1997, in the worst epidemic on record, 25,000 people died,” as reported by the BBC.

map-meningitis-belt-eng2.gifAs with other public health interventions, scaling up of this new vaccine will be on overcoming dependent on logistical challenges, in this case the need for sustained funding. As noted, the effort will being in only 3 countries, but “450 million people … are at risk of this disease … in the very well known African meningitis belt.”

Preventing meningitis in Africa will not only save lives directly, but should reduce the chances that a febrile child is misdiagnosed as having malaria and allowed to die from another disease.

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