MENINGOCOCCAL MENINGITIS

Meningococcal meningitis has been recognised as serious problem for al most 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the ''meningitis belt'' and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from per son to person by nasopharyngeal carriers in crowded places like refuge e camps and army barracks. The rural/urban migration, the basic struct ural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the tran smission of meningococcal meningitis. The earlier treatment of meningo coccal meningitis was by the way of repeated CSF drainage. The first i mportant advance in the treatment was intrathecal injection of antimen ingococcal serum. A major break through in the treatment was the intro duction of sulphonamides which was the preferred treatment until emerg ence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communties using polyvalent A and C polysaccharide vaccine is a useful control m easure. Chemoprophylaxis is generally not recommended during epidemics . Given the current population densities and rural/urban migration tog ether with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.