Risk factors for meningococcal meningitis in northern Ghana

Meningococcal meningitis is a major cause of morbidity and mortality in the meningitis belt of sub-Saharan Africa where it occurs in epidemics every 8 -12 years. Risk factors for the disease in this setting remain largely unkn own. We carried out a case-control study to investigate possible risk facto rs among survivors of a meningitis epidemic occurring in 1997 in northern G hana. A structured questionnaire on socio-economic factors, housing and hou sehold overcrowding, smoking and exposure to smoke and close contact with a case was administered to 505 of the survivors and 505 of age-, sex- and lo cation-matched controls. Cooking in kitchens with firewood stoves (OR 9.00, CI 1.25-395) and sharing a bedroom with a case (OR 2.18 CI 1.43-3.4) were found to be risk factors for disease. Socio-economic factors, overcrowding, smoking and passive exposure to tobacco smoke were not found to be risk fa ctors. Exposure to smoke from cooking fires or close contact with a case pu ts people at risk of contracting meningococcal meningitis. In the hot dry m onths, exposure to smoke from cooking fires should be minimized by encourag ing alternatives to cooking over wood fires, or cooking outside. If wood-bu rning stoves cannot be avoided, kitchens should be made larger with improve d ventilation. Meningitis cases should be nursed in well-ventilated rooms a nd the number of people sharing a room with a case kept at a minimum.