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This paper presents a deterministic model for Neisseria meningitidis, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two controls avert more infections at low costs. Furthermore, a reciprocal relationship exists between the use of facial masks and vaccine. That is, when the use of facial masks is high, the use of vaccine is low and vice versa. Cost-effective analysis was applied to investigate the most cost-effective strategy from various combination of control strategies. The results show that strategy combining all the control variables is the most cost-effective strategy followed by the strategy involving both personal-protection, the vaccination-only strategy was the least cost-effective. Although vaccination strategy is not cost-effective in this study, it is as effective in curtailing the infection as the other two control strategies. The study suggests that governments of communities with limited resources should consider complementing the use of vaccine with the use of facial mask particularly in hard-to-reach places in their communities.

This paper presents a deterministic model for Neisseria meningitidis, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two controls avert more infections at low costs. Furthermore, a reciprocal relationship exists between the use of facial masks and vaccine. That is, when the use of facial masks is high, the use of vaccine is low and vice versa. Cost-effective analysis was applied to investigate the most cost-effective strategy from various combination of control strategies. The results show that strategy combining all the control variables is the most cost-effective strategy followed by the strategy involving both personal-protection, the vaccination-only strategy was the least cost-effective. Although vaccination strategy is not cost-effective in this study, it is as effective in curtailing the infection as the other two control strategies. The study suggests that governments of communities with limited resources should consider complementing the use of vaccine with the use of facial mask particularly in hard-to-reach places in their communities.

This paper presents a deterministic model for Neisseria meningitidis, a bacterium that causes meningitis. The model was parameterized using data from the 2017 meningitis outbreak in Nigeria. Optimal control theory was applied to investigate the optimal strategy for curtailing the spread of the disease using control variables determined from sensitivity analysis. These control variables are personal-protection such as the use of facial masks, and vaccination. The results show that the two controls avert more infections at low costs. Furthermore, a reciprocal relationship exists between the use of facial masks and vaccine. That is, when the use of facial masks is high, the use of vaccine is low and vice versa. Cost-effective analysis was applied to investigate the most cost-effective strategy from various combination of control strategies. The results show that strategy combining all the control variables is the most cost-effective strategy followed by the strategy involving both personal-protection, the vaccination-only strategy was the least cost-effective. Although vaccination strategy is not cost-effective in this study, it is as effective in curtailing the infection as the other two control strategies. The study suggests that governments of communities with limited resources should consider complementing the use of vaccine with the use of facial mask particularly in hard-to-reach places in their communities.

A 50 year old woman from Nepal had clinical features suggestive of meningitis. Cerebrospinal fluid (CSF) analysis was normal except for the presence of cryptococcal antigen. The inclusion of test for Cryptococcus in the CSF helped in making the diagnosis of cryptococcal meningitis in our patient who was apparently immunocompetent. Treatment with liposomal amphotericin B could not be started on time due to financial constraints. The patient had a stroke and further deteriorated. Liposomal amphotericin B is stocked by the government of Nepal for free supply to patients with visceral leishmaniasis, but the policy does not allow the drug to be dispensed for other infections. The family members of our patient acquired the drug within a few days from a government center using their political connections and following administering the treatment the patient improved. This case demonstrates the utility of considering cryptococcal meningitis as a differential diagnosis, and including tests for Cryptococcus when dealing with immunocompetent patients presenting with meningitis. It also demonstrates the effects of the sociopolitical situation on health care delivery in low- and middle-income countries (LMICs) such as Nepal.

The clinicopathological profile of 7 cases of Cryptococcal meningitis encountered over one year period in a military hospital has been described. Severe persistent headache was the main form of presentation followed by features of progressive ill-health. Age range of cases was 34–55 years (mean 40.8 years). All were males and 6 were serving soldiers. Duration of symptoms ranged from 10 days to 6 weeks. Six patients were positive for HIV-1 antibodies. This was the initial presentation of AIDS in 6 patients accounting for 10.34% among all cases of HIV infection during that year. Both clinical and laboratory findings were subtle. Nuchal rigidity was rare, cerebro spinal fluid (CSF) cell count and protein level was normal in 3 out of 7 cases. Although culture for Cryptococcus was positive in all, it took 10 days to grow in 2 cases. India-ink stain showed scanty number of organisms in 3 cases. Low cell counts in CSF and presence of associated hyponatremia appear to be bad prognostic indicators in Cryptococcal infections of central nervous system. Latex agglutination test is a worthwhile screening test.

This paper examines whether disease burdens, especially prevalent in the tropics, contribute significantly to widening gender gaps in educational attainment. We estimate the impact of sudden exposure to the 1986 meningitis epidemic in Niger on girls' education relative to boys. Our results suggest that increases in meningitis cases during epidemic years significantly reduce years of education disproportionately for primary school-aged going girls in areas with higher meningitis exposure. There is no significant effect for boys in the same cohort and no effects of meningitis exposure for non-epidemic years. Our findings have broader implications for climate-induced disease effects on social inequality.

Aims: Meningitis is an important health issue. As crowded areas is a predisposing factor to the meningitis disease, thus, the aim of this study was to survey the effect of education by lecture and pamphlet methods on soldiers' knowledge about meningitis disease. Methods: This research is a Quasi-experimental study with a before and after design which was conducted among the air defense soldiers of Semnan. The sampling method in this study was census and the data gathering instrument was a self-made questionnaire. At first, the knowledge about meningitis disease among soldiers was measured. After on, training was conducted by presence education methods and distribution of educational pamphlet. At the end the questionnaires were given to the research samples. The obtained data were entered into SPSS 21 and were analyzed by using paired t-test, and descriptive statistics including mean and standard deviation. Results: The total score of knowledge about meningitis disease among soldiers before training was 36.3± 3.94 and after training was 65.76±3.57. Actually the paired t-test showed a significant difference between the training score of soldiers knowledge about meningitis before and after trainings (P = 0.001). Conclusion: According to the results of this study, educational interventions causes an increase in the knowledge of soldiers in regards to the meningitis disease. On the other hand, as all the men have to pass a military service period, this period is considered a great time to increase their knowledge.

Based on an analysis of the Meningitis Vaccine Project (MVP), a public-private partnership (PPP) set up to introduce the MenAfriVac® vaccine in African countries, this article examines the failures of an accelerated disease control programme that targeted a highly infectious disease. I argue that the integration of MenAfriVac® into the World Health Organization's (WHO) Expanded Programme on Immunisation had the effect of reinforcing inequalities in access, in particular during epidemic emergencies. I will also show how vaccine shortages during an outbreak in Niger led to political tensions and to the emergence of a parallel and unregulated 'black market' of vaccines.

Nigeria has high numbers of meningitis cases and related fatalities almost every year. This study explored the role of the media in meningitis campaigns using a documentary method of data gathering and analysis. The research objectives were to determine if the media played a positive role in campaigns against meningitis outbreaks in Nigeria and to determine the major obstacles to media coverage of meningitis outbreaks in Nigeria. The results revealed that the role of the media in Nigeria during meningitis outbreaks is positive and supportive. However, paid advertisements and announcements that support the media in health promotion campaigns were undermined by limited understanding of infectious diseases by politicians and some media sponsors. Therefore, the authors recommend the establishment of a permanent funded media structure charged with the responsibility of grassroots campaigns against meningitis, and the integration of the media into committees formed to combat the disease.

Based on an analysis of the Meningitis Vaccine Project (MVP), a public-private partnership (PPP) set up to introduce the MenAfriVac® vaccine in African countries, this article examines the failures of an accelerated disease control programme that targeted a highly infectious disease. I argue that the integration of MenAfriVac® into the World Health Organization's (WHO) Expanded Programme on Immunisation had the effect of reinforcing inequalities in access, in particular during epidemic emergencies. I will also show how vaccine shortages during an outbreak in Niger led to political tensions and to the emergence of a parallel and unregulated 'black market' of vaccines.

Bacterial meningitis in infants and children is a serious clinical entity with signs and symptoms that commonly do not allow distinguishing the diagnosis and the causative agents. The only method to determine if meningitis is the cause of these symptoms is a lumbar puncture. Lumbar puncture is the gold standard for the diagnosis and should be done in all suspected cases of meningitis unless contraindicated. Objectives: The purpose of this study is to identify the importance of the microbiological study of cerebrospinal fluid (CSF) in patients suspected to have acute meningitis. Despite the availability of all other investigations and Imaging for diagnosis of meningitis but CSF analysis remains the most available, accurate, and cheaper for diagnosis of meningitis in children. Methodology and result: This is a prospective study. 71 patients were included. All patients were clinically suspected to have acute meningitis. A lumbar puncture for CSF analysis was done for all patients. The data was collected and analysed. CSF culture was done. The culture was negative In 58 patients (81.7%) and positive in 13 patients (18.3%). Streptococcus was found in 3 patients (4.2 %), staphylococcus epidermidis in 2 patients (2.8%), E Coli in 2 patients (2.8%), klebsiella in 2 patients (2.8%), pneumococci in 2 patient (2.8%), salmonella in 1 patient (1,4%) and Bacilli in 1 patient (1.4 %). Recommendation: Lumbar Puncture (LP) remains the easiest, cheapest and accurate investigation for diagnosis of meningitis in children mainly in rural areas in Sudan and other developing countries. It's mandatory to offer training for doctors and medical staff for doing lumber punctures safely and accurately and to offer well-equipped laboratories for such essential investigations. It's not only the role of doctors and medical staff but is a governmental obligation as well. This can save a lot of sick children and prevent mortality and morbidity of acute meningitis in children.