Public-private co-ordination in the meningitis surveillance system - East Khasi Hills District, Meghalaya, India, 2010


Background: Meningitis is endemic in India. Meghalaya witnessed an outbreak of meningococcal disease in 2008-09 (attack rate 78/100,000). East Khasi Hills, the most affected district, had an attack rate of 135/100,000 and case fatality ratio of 13%. We evaluated the meningitis surveillance system to assess its efficiency and identify its strengths and constraints. Method: We used data abstraction form to extract the data from records and reporting formats of all 120 reporting units in the district. We used pretested questionnaires to interview the medical officers and health workers of the district and undertook one community based cross-sectional survey of the most affected and least affected primary health centre of the district. We used WHO standard case definition to identify cases. Result: Forty seven percent rural and 83% urban suspected cases of meningitis went to the private health facilities. Active (mostly during outbreaks) and routinely passive surveillance was operational in the State through publ