An Evaluation of Meningitis Surveillance in Northern Ghana

Introduction: Public health surveillance is a key strategy in controlling and preventing meningitis outbreaks especially in northern Ghana which continues to suffer yearly focal outbreaks. The aim of this study was to evaluate the performance of the meningitis surveillance system and to determine whether the surveillance system as established within the Ministry of Health is achieving its objectives.

Design: This was a cross sectional study conducted in the Talensi District between February and March, 2015. The study employed a qualitative method approach. Nine In-depth interviews (IDIs) and two Focussed Group Discussions (FGDs) were held with key informants involved in meningitis surveillance. Surveillance records for meningitis were also reviewed and analysed at community, sub-district, district and regional levels.

Results: The study revealed that the surveillance system was simple, flexible and highly accepted by healthcare workers. The system was fairly representative, stable with good data quality. However, it had a low sensitivity and a low positive predictive value in detecting/reporting cases of meningitis. Cerebrospinal fluid samples of suspected cases were timely presented to the public health reference laboratory. On the contrary, feedback of confirmation results was delayed. Also, lack of funding and motivation for surveillance activities, inadequate technical personnel to carry out lumbar puncture and unavailability of case definition at health facilities were system challenges that affected meningitis surveillance.

Conclusion: Relatively, some of the primary objectives of the surveillance system were met. However, we believe that motivation of the community-based surveillance volunteers, a construction of a regional public health laboratory and an effective training for healthcare workers would strengthen the surveillance system in northern Ghana. Consequently, adequate financial investment (especially through the government and other health-related international organisations) is required.