Descriptive analysis of meningitis surveillance data, Upper East Region, Ghana, 2019–2023

Abstract

Introduction: The global incidence of meningitis is estimated at 20 per 100,000 population. Ghana, located within the “African meningitis belt”, has experienced recurrent outbreaks with case fatalities ranging from 36% to 50%. In 2008, the Upper East Region recorded an incidence of 15 per 100,000 population. Data analysis is a core component of enhanced meningitis surveillance for early case detection and response. However, routine analyses were not consistently conducted. We therefore analysed surveillance data from 2019 to 2023 in the region to describe the distribution of cases and deaths to inform decisions. Methods: We conducted a descriptive analysis of meningitis surveillance data in the Upper East Region from 2019-2023. An adapted checklist was used to extract variables from line lists and case-based forms. Data were triangulated and validated. Microsoft Excel 365, Epi Info 7.2.6.0, and Quantum Geographic Information System (QGIS) software were used for analysis. Frequencies, proportions, and rates were computed and presented in tables, charts, and maps. Results: A total of 239 suspected cases were reported, of which 21.8% (52/239) were confirmed. The case fatality rate among confirmed cases was 44.2% (23/52). The most affected age group was 10-19 years, 26.9% (14/52), with a median age of 34 years (range: 0-89). Males accounted for 63.5% (33/52) of confirmed cases and 56.5% (13/23) of deaths. The highest proportion of cases occurred in 2020; 53.8% (28/52), with peaks in February and March. Cases were reported in 86.7% (13/15) of districts. Non-residents accounted for 5.8% (3/52) of cases and 13.0% (3/23) of deaths. The cumulative incidence was approximately 4 per 100,000 population. Conclusion: Meningitis incidence fluctuated over the study period, with higher occurrence among males and adolescents. Cases peaked during the dry season and were widely distributed geographically. Persistently high fatality rates highlight the need to strengthen surveillance, early detection, and cross-regional coordination.