It was a hot afternoon on February 7, this year, when Adam Fuseina, a resident of Charikpong in the Nadowli-Kaleo District in the Upper West Region, noticed that her 10-year-old son had developed fever.  

At first, she thought it was just the usual afternoon warm temperature. But within hours, little Salifu Mashud’s (not real name) fever worsened, and he complained of a severe headache and stiffness in his neck. By nightfall, he was unresponsive. She rushed the child to hospital, but the doctors said it was too late. He succumbed to the illness. Mrs. Fuseina said doctors diagnosed the child with cerebrospinal meningitis (CSM) at the hospital but all efforts by the health workers to resuscitate him yielded no result.

When he started feeling feverish, I didn’t take it seriously, so I was treating him with some local herbs.” “When we rushed him to the hospital, they told me it was CSM, but they couldn’t manage it because it was too late, I have never heard of that illness before” she narrated. In Lawra, a 35-year-old man, Yussif Alhassan, barely survived CSM last year. “I was fine in the morning, then I started feeling headache and feverish. By the evening, I couldn’t even stand on my feet”. “When I was rushed to hospital, the doctor said if we had delayed a few more hours, I would have lost my life” he recounted to the Daily Graphic.

Mr. Alhassan said although he was lucky to be alive, the disease had left him with partial hearing loss, a common complication of CSM. He and little Yussif are part of many people in the Upper West Region who have fallen prey to the CSM disease. CSM, also known as Meningococcal meningitis, is a bacterial infection that inflames the membranes surrounding the brain and spinal cord. It is often caused by viral, fungal or bacterial infection.  Bacterial meningitis is caused by several bacterial pathogens but Neisseria meningitidis (Nm), Streptococcus pneumoniae and Hemophilus influenzae type B represent the triad causing over 80 per cent of all cases of bacterial meningitis.

It spreads through respiratory droplets, making it highly contagious in crowded and poorly ventilated spaces. Symptoms include headache, fever, stiff neck and back, vomiting, joint and muscle pain, drowsiness, light sensitivity and seizures. The disease is endemic in Northern Ghana, particularly in the Upper West Region, during the hottest months of every year, fueled by extreme heat and dry Harmattan winds. The recurrent meningitis outbreaks in Ghana, particularly in the regions of the north, led to the conduct of a mass preventive immunization campaign in the country in 2012 to address the burden of Group A meningococcus, which was accounting for an estimated 80–85 per cent of all cases in the meningitis belt in the country.

The successful immunization programme led to a dramatic decline and the occurrence of meningitis outbreaks due to other Nm serogroups as well as other bacteria which are rather a new concern, a new strain. As of Sunday, February 16, this year, 129 cases had been recorded in the Upper West Region, the Minister of Health, Kwabena Mintah Akandoh, told Parliament last week. Out of that, 16 deaths have been recorded while 29 individuals are currently receiving treatment at various health facilities, according to the Ghana Health Service (GHS).

Similarly, the United States’ National Institute of Health Centre for Biotechnology Information indicates that between 2018 and 2020, about 1,176 cases of CSM were recorded in the Upper West Region, with 118 deaths and 1,058 survivors. The Upper West Regional Director of Health Services, Dr Demain Punguyeri, identified the most affected districts as Nadowli-Kaleo, Wa Municipal, Wa West, Jirapa and Nandom. He attributed the increasing cases of mortalities to late reporting to health facilities, as most patients often arrived at hospitals in critical conditions, making it difficult for medical staff to provide effective treatment. “Another major challenge is that we have been dealing with a disease that does not transmit easily but it is very deadly, it is not like the previous one that can transmit to many people, so you have to vaccinate,” Dr Punguyeri said. “Unfortunately, there is no vaccine for this strain of disease so all that we have to do is to educate the public on preventive measures and ensure that cases are managed well to ensure the wellbeing of patients”.

Dr Punguyeri indicated that “we are in the early days yet because the period that we are likely to have higher numbers is March, that is when the heat is very high and we expect the transmission to be very high” The GHS estimates that CSM cases spike between November and April, when temperatures in Northern Ghana regularly exceed 40°C (104°F).