The incidence of meningitis is highest from five to 15 years of age, and more frequent in males. It is uncommon in the very young, and rare in the old
Dr Ojum Ekeoma Ogwo
Doc, please tell us something about meningitis, and why does it occur during dry-season?
I was to discuss “marijuana”, this week, based on interactions with my young patients. But when two people from the northern part of the country, who had no contact with each other, variously requested that I discuss meningitis, I acquiesced.
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What actually is meningitis?
Meningitis is defined as an inflammation of the meninges, which surround the brain and spinal-cord. It is common in Northern Savannah of Africa, which includes Northern Nigeria, but can occur anywhere in Nigeria. The disease is known as “sankara”, by the Hausas, which means “stiff-neck.” According to Prof. Perry, it is greatly feared in the North, and it is thought to be caused by evil spirits.
With advent of modern medicine and the discovery of penicillin therapy, the disease is now easily treated.
Epidemiology of meningitis
■ Close contact of people promotes transmission of meningitis.
■ Infected individuals usually carry the organism in the nose and throat for some time, varying from two weeks to 10 months. This local infection immunises the host from meningitis infection, but can still transmit it to whoever he comes in contact with.
■ In a few people, who have no antibody to the invading strain, the organism enters the blood. Here, it multiplies and causes septicaemia.
In about one in 1000 people, it lodges in the meninges to multiply further and cause meningitis.
■ Epidemics of meningitis occur in a great belt of Northern Savannah, which stretches from old Sudan, and the north of Uganda across Chad, the North of Nigeria, southern Niger, into Ivory Coast and Mali.
■ The number of cases of meningitis starts to increase as the temperature and humidity rise and reaches a peak in March and April when it is very hot, and humid, according to Prof E H Parry. The incidence drops sharply when the rains begin. The explanation derived from studies conducted in Jos University Teaching Hospital (JUTH) is that during the cold dry season, people crowd together in the small huts for shelter. Transmission is high and the number of carriers increases greatly.
■ The incidence of meningitis is highest from five to 15 years of age, and more frequent in males. It is uncommon in the very young, and rare in the old, probably because they have frequently been exposed to meningococcus and are immune.
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What are the clinical symptoms of meningitis?
■ Disease starts with fever.
■ Increasingly severe bursting headache, which may radiate down the neck.
■ Neck and back become stiff. Photophobia, patient lie curled up.
■ Young children may convulse.
■ Ten percent of patients complain of muscle and joint pains, plus abdominal pain with diarrhoea.
■ A few patients become blind or deaf, but this is not noticed in their confusion.
■ Conjunctivitis, sore throats and red spots on the body due to septicaemia.
■ Signs of heart failure may be present or develop, due to overload with intravenous fluid.
■ An occasional patient bleeds from the nose, with redness of the skin, and inflammation of the sclera.
■ There may be allergic complications, due to drug reaction.
How is meningitis treated? This is three pronged:
1) Ameliorate signs and symptoms – doctors and nurses will take charge.
2) Eradication of infections through intravenous drugs like benzyl penicillin and chloramphenicol.
3) Prevention of neurological sequelae.