The burden and distribution of meningococcal meningitis in Meghalaya, India, 2009


Background: Meningococcal meningitis is endemic in India with a case fatality of 80% (untreated) to 10% (early intervention). Serogroup A has been associated with all the outbreaks as well as sporadic cases. We analysed the meningitis surveillance data in Meghalaya to estimate the incidence, trend and burden of disease and to identify areas and population at risk. Methods: Cases were defined as per WHO guidelines. All the cases from the aggregated data format from the surveillance units were included into a normalized database to calculate population based incidence. We calculated incidence by time (yearly trends and seasonality), place (districts and blocks) and person (attack rate/case fatality ratio by age and sex). Result: There were 2187 cases of meningitis: 256 (12%) confirmed, 1727 (79%) suspected and 208 (9%) probable cases. Overall attack rate was 78/100,000 and CFR was 13% (274/2187). Incidence was 87/100,000 among males. The attack rate in 15-29 years age group was 100/100,000. CFR was 17% in the 0