Epidemiology of bacterial meningitis in the Upper West Region, Ghana, 2024

Introduction: Meningitis causes about 2.5 million new cases and over 200,000 deaths annually. The Upper West Region (UWR) of Ghana, situated within the African meningitis belt, experiences periodic outbreaks. The World Health Organisation aims to defeat meningitis as a public health threat and reduce the number of cases by 2030. To achieve this, it is necessary to reassess and understand the current trends in meningitis. Also, up-to-date analyses of local epidemiological patterns are limited. This study analysed meningitis surveillance data from 2015 to 2023 to estimate the burden, describe case distribution by age and sex, assess geographic patterns, and examine temporal trends. Methods: A secondary analysis of the UWR meningitis line list (2015 – 2023) was conducted. The data was cleaned, anonymised and analysed using Microsoft Excel 365. Descriptive statistics were generated. Incidence and case-fatality rates (CFRs) were calculated by district and presented on choropleth maps using QGIS v3.36. Monthly case trends were visualised using a line graph. Results: A total of 2,315 suspected meningitis cases were reported, peaking in 2017 (431 cases) and declining to 96 cases in 2023. Lumbar puncture was performed in 97.7% (2,261/2,315) of cases, but laboratory confirmation was available for only 59.1% (1,336/2,261). Among these, 27.7% (370/1,336) were confirmed positive, with Streptococcus pneumoniae being responsible for 56.8% (210/370) of the cases. Males (56.2%) and individuals aged 5–29 years (60.6%) were the most affected. Nandom recorded the highest incidence (129/100,000), while Jirapa had the highest CFR (13.8%). Cases occurred cyclically from January to April, peaking in February. Conclusion: Bacterial meningitis in the UWR has declined but remains a seasonal concern, predominantly caused by S. pneumoniae. Males and individuals aged 5–29 years were the most affected. Strengthening laboratory capacity and vaccination campaigns targeting multiple strains are recommended to sustain progress towards meningitis elimination by 2030.