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The Role of Weather in Meningitis Outbreaks in Navrongo, Ghana: A Generalized Additive Modeling Approach

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An Erratum to this article was published on 21 August 2012

Abstract

Bacterial (meningococcal) meningitis is a devastating infectious disease with outbreaks occurring annually during the dry season in locations within the ‘Meningitis Belt’, a region in sub-Saharan Africa stretching from Ethiopia to Senegal. Meningococcal meningitis occurs from December to May in the Sahel with large epidemics every 5–10 years and attack rates of up to 1000 infections per 100,000 people. High temperatures coupled with low humidity may favor the conversion of carriage to disease as the meningococcal bacteria in the nose and throat are better able to cross the mucosal membranes into the blood stream. Similarly, respiratory diseases such as influenza and pneumonia might weaken the immune defenses and add to the mucosa damage. Although the transmission dynamics are poorly understood, outbreaks regularly end with the onset of the rainy season and may begin anew with the following dry season. In this paper, we employ a generalized additive modeling approach to assess the association between number of reported meningitis cases and a set of weather variables (relative humidity, rain, wind, sunshine, maximum and minimum temperature). The association is adjusted for air quality (dust, carbon monoxide), as well as varying degrees of unobserved time-varying confounding processes that co-vary with both the disease incidence and weather. We present the analysis of monthly reported meningitis counts in Navrongo, Ghana, from 1998–2008.

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References

  • Besancenot, J. P., Boko, M., and Oke, P. C. (1997), “Weather Conditions and Cerebrospinal Meningitis in Benin (Gulf of Guinea, West Africa),” European Journal of Epidemiology, 13 (7), 807–815.

    Article  Google Scholar 

  • Cheesbrough, J. S., Morse, A. P., and Green, S. D. R. (1995), “Meningococcal Meningitis and Carriage in Western Zaire—a Hypoendemic Zone Related to Climate,” Epidemiology and Infection, 114 (1), 75–92.

    Article  Google Scholar 

  • Christensen, J. H., et al. (2007), “Regional Climate Projections,” in Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, eds. S. Solomon et al., Cambridge: Cambridge University Press.

    Google Scholar 

  • Cuevas, L. E., et al. (2007), “Risk Mapping and Early Warning Systems for the Control of Meningitis in Africa,” Vaccine, 25, A12–A17.

    Article  Google Scholar 

  • Dominici, F., Samet, J. M., and Zeger, S. L. (2000), “Combining Evidence on Air Pollution and Daily Mortality from the 20 Largest US Cities: A Hierarchical Modeling Strategy,” Journal of the Royal Statistical Society, Series A, 163 (3), 263–284.

    Google Scholar 

  • Dominici, F., McDermott, A., and Hastie, T. J. (2004), “Improved Semiparametric Time Series Models of Air Pollution and Mortality,” Journal of the American Statistical Association, 99 (468), 938–948.

    Article  MathSciNet  MATH  Google Scholar 

  • Greenwood, B. M., Blakebrough, I. S., Bradley, A. K., Wali, S., and Whittle, H. C. (1984), “Meningococcal Disease and Season in Sub-Saharan Africa,” Lancet, 1, 1339–1342.

    Article  Google Scholar 

  • Greenwood, B. M., Greenwood, A. M., and Bradley, A. K., et al. (1987), “Factors Influencing the Susceptibility to Meningococcal Disease During an Epidemic in The Gambia, West Africa,” The Journal of Infectious Diseases, 14, 167–184.

    Google Scholar 

  • Greenwood, B. (1999), “Meningococcal Meningitis in Africa,” Transactions of the Royal Society of Tropical Medicine and Hygiene, 93 (4), 341–353.

    Article  MathSciNet  Google Scholar 

  • Hastie, T., and Tibshirani, R. (1999), Generalized Additive Models, London: Chapman & Hall.

    Google Scholar 

  • Hayden, M. H., Dalaba, M., Awine, T., Akweongo, P., Hodgson, A., Nyaaba, G., Anesaba, D., Pelzman, J., and Pandya, R. (in preparation for submission to the AJTMH), “Knowledge, Attitudes and Practices Related to Meningitis in Northern Ghana.”

  • Hodgson, A., Smith, T., Gagneux, S., Adjuik, M., Pluschke, G., Kumasenu Mensah, N., Binka, F., and Genton, B. (2001), “Risk Factors for Meningococcal Meningitis in Northern Ghana,” Transactions of the Royal Society of Tropical Medicine and Hygiene, 95, 477–480.

    Article  Google Scholar 

  • Lapeyssonnie, L. (1963), “Cerebrospinal Meningitis in Africa,” Bulletin of the World Health Organization, 28, 3–114.

    Google Scholar 

  • Leimkugel, J., Hodgson, A., Adams Forgor, A., Pfluger, V., Dangy, J. P., Smith, T., Achtman, M., Gagneux, S., and Pluschke, G. (2007), “Clonal Waves of Neisseria Colonisation and Disease in the African Meningitis Belt: Eight-Year Longitudinal Study in Northern Ghana,” PLoS Medicine, 4 (3), 535–544.

    Article  Google Scholar 

  • Molesworth, A. M., Cuevas, L., and Thomson, M. C. (2002), Forecasting Meningitis Epidemics in Africa, Liverpool: LSTM.

    Google Scholar 

  • Molesworth, A. M., Cuevas, L. E., Connor, S. J., Morse, A. P., and Thomson, M. C. (2003), “Environmental Risk and Meningitis Epidemics in Africa,” Emerging Infectious Diseases, 9 (10), 1287–1293.

    Article  Google Scholar 

  • Moore, P. S., Reeves, M. W., Schwartz, B., Gellin, B. G., and Broome, C. V. (1989), “Intercontinental Spread of an Epidemic Group A Neisseria Meningitidis Strain,” Lancet, 2, 260–263.

    Article  Google Scholar 

  • Moore, P. S., Hierholzer, J., and DeWitt, W., et al. (1990), “Respiratory Viruses and Mycoplasma as Cofactors for Epidemic Group A Meningococcal Meningitis,” Journal of the American Medical Association, 264, 1271–1275.

    Article  Google Scholar 

  • Moore, P. (1992), “Meningococcal Meningitis in Sub-Saharan Africa: A Model for the Epidemic Process,” Clinical Infectious Diseases, 14, 515–525.

    Article  Google Scholar 

  • Nyarko, P., Wontuo, P., Nazzar, A., Phillips, J., Ngom, P., et al. (2002), Navrongo DSS Ghana. Population, Health and Survival at INDEPTH Sites, Accra (Ghana): INDEPTH, Vol. 1. Available at: http://www.indepth-network.net/dss_site_profiles/navrongo.

  • Peng, R. D., Dominici, F., and Louis, T. A. (2006), “Model Choice in Time Series Studies of Air Pollution and Mortality,” Journal of the Royal Statistical Society, Series A, 169 (2), 179–203.

    MathSciNet  Google Scholar 

  • Roberts, L. (2008), “An ill Wind, Bringing Meningitis,” Science, 320 (5884), 1710–1715.

    Article  Google Scholar 

  • Schwartz, J. (1994a), “Nonparametric Smoothing in the Analysis of Air Pollution and Respiratory Illness,” Canadian Journal of Statistics, 22, 471–487.

    Article  Google Scholar 

  • — (1994b), “PM10, Ozone, and Hospital Admissions for the Elderly in Minneapolis-St. Paul, Minnesota,” Archives of Environmental Health, 49, 366–374.

    Article  Google Scholar 

  • Sultan, B. et al. (2005a), “Climate Drives the Meningitis Epidemics Onset in West Africa,” PLoS Medicine, 2 (1), 43–49.

    Article  Google Scholar 

  • Sultan, B. (2005b), “Influence of Climate Upon the Meningitis Onset in West Africa,” Medicine Sciences, 21 (5), 470–471.

    Google Scholar 

  • Sultan, B., Labadi, K., Guegan, J. F., and Janicot, S. (2005c), “Climate Drives the Meningitis Epidemics Onset in West Africa,” PLoS Medicine, 2, e6.

    Article  Google Scholar 

  • Sultan, B., Chiapello, I., and Aouam, M., (2007), “Le Rôle du Climat et des Aérosols sur les Épidémies de Méningite en Afrique de l’Ouest,” Colloque MSG, 13-14, Dijon.

  • Thomson, M. C., et al. (2006), “Potential of Environmental Models to Predict Meningitis Epidemics in Africa,” Tropical Medicine and International Health, 11 (6), 781–788.

    Article  MathSciNet  Google Scholar 

  • Trenberth, K. E., et al. (2007), “Observations: Surface and Atmospheric Climate Change,” in Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, eds. S. Solomon et al., Cambridge: Cambridge University Press.

    Google Scholar 

  • Wiedinmyer, C., Akagi, S. K., Yokelson, R. J., Emmons, L. K., Al-Saadi, J. A., Orlando, J. J., and Soja, A. J. (2011), “The Fire Inventory from NCAR (FINN)—A High Resolution Global Model to Estimate the Emissions From Open Burning,” Geoscientific Model Development Discussions, 3, 2439–2476.

    Article  Google Scholar 

  • Yaka, P., Sultan, B., Broutin, H., Janicot, S., Philippon, S., and Fourquet, N. (2008), “Relationships Between Climate and Year-to-Year Variability in Meningitis Outbreaks: A Case Study in Burkina Faso and Niger,” International Journal of Health Geographics, 7, 34.

    Article  Google Scholar 

  • Zibman, C. (2009), “Methods for Confounding Adjustment in Time Series Data: Applications to Short Term Effects of Air Pollution on Respiratory Health,” PhD Thesis, Department of Statistics, University of Chicago.

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Correspondence to Vanja Dukić.

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Mary Hayden joint first authorship.

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Dukić, V., Hayden, M., Forgor, A.A. et al. The Role of Weather in Meningitis Outbreaks in Navrongo, Ghana: A Generalized Additive Modeling Approach. JABES 17, 442–460 (2012). https://doi.org/10.1007/s13253-012-0095-9

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  • DOI: https://doi.org/10.1007/s13253-012-0095-9

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