Climate change is one of the most topical environmental problems affecting all countries. Numerous extreme weather events are associated with climate change. These include widespread wildfires, drought, flooding, storms, heatwaves and the rising number of insect-borne diseases in Northern Ghana.
The adverse impacts of climate change on human health and healthcare systems are alarmingly comprehensive as they affect every human organ system and challenge the smooth running of health systems and organizations.
In most tropical countries such as Ghana, heatwaves, high temperatures, dusty and dry weather conditions give rise to a range of infectious diseases epidemics, including cerebrospinal Meningitis (CSM). CSM is an airborne bacterial disease usually caused by the Neisseria meningitides bacteria.
This bacterial mainly causes an infection of the meninges resulting in Meningitis. CSM agent is highly communicable and easily transmitted via person-to-person through respiratory and throat secretions.
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord, collectively known as the meninges. This inflammation of the meninges often results in an obstruction in the normal circulation of blood and oxygen to the brain tissue, which sometimes leads to brain damage, sight problems, seizures, hearing deficiency, and arthritis, among other sequelae.
The swelling membranes can result from infection with bacteria, viruses, fungi, or some other microorganisms and rarely by certain drugs. Meningitis is caused by different agents and “manifests itself in various forms depending on the type of infectious agent. Acute purulent
Meningitis is the predominant form of Meningitis under non-epidemic conditions. Cerebrospinal Meningitis, also known as meningococcal Meningitis, is the most common type of Meningitis that is very epidemic and endemic under infectious Meningitis.
Cerebrospinal Meningitis is a climate-sensitive disease that is fatal within a few hours if it is not treated early. Even with appropriate treatment, about 10% -15% of the patients die, and about 20% of the survivors have permanent health conditions such as epilepsy, deafness, mental retardation, etc. Between 2015 and 2019.
CSM studies dates back to 1900s when it was first discovered. The first recorded outbreak was in Cape Coast in Southern Ghana.The next epidemic in the Gold coast started in 1906 from the northwest and spread through the northern territory during the following dry season. Estimates show that the disease was responsible for the deaths of 2000 people between 1906 and 1908. Since that period, the epidemics were recorded every 8-12 years.
According to the Ghana Health Service, In 1996/1997, the worst epidemic in CSM hit in the nation where 18703 cases were reported with 1356 deaths mostly recorded in the Northern Regions. Between 2015 and 2019, a total of 2446 suspected bacterial meningitis cases were recorded. Out of which 842(34.4%) were confirmed. Among the confirmed cases, males constituted majority 55.3%. Children below 14years of age were not affected (51.4%).
In 2017,the Upper West Region recorded a total of 425 cases of CSM and 54 deaths and in 2018, the number of cases increased slightly to 428 with a total number of deaths decreasing to 37. In 2019, total number of cases and death both declined to 354 and 16 deaths respectively, then in 2020 when COVID 19 emerged and succeeded in shifting attention and resources to itself, CSM secretly claimed 56 lives out of a total of 421 cases recorded in the region.
Meanwhile in the same year, COVID 19 recorded a total of 97 cases and 3 deaths. Comparatively, since March 12,2020 till August 18 2021, there are 519 confirmed cases of COVID 19 in the Upper West Region with death 19 deaths whereas that of CSM stands at 582 cases and 57 deaths, so from 2017 to August 2021,CSM recorded a total of 1789 cases out of which 164 persons lost their lives.
Through direct and indirect channels such as climate-element variations and frequent occurrences of disease-producing agents respectively, human populations have become susceptible to health risks resulting from climate change. Cerebrospinal Meningitis is one of the contagious diseases that have existed for over two centuries and remains a significant public health burden globally but more disproportionate to Sub-Saharan Africa’s meningitis belt.
Environmental factors such as poor sanitation, congestion of structures, the immune receptivity of individuals and some specific climatic circumstances often result in CSM outbreaks within the local population. Meningitis thrives well in warm environments; hence poorly ventilated and crowded rooms are a risk factor for the disease.
During warm season, the risk of CSM spread is facilitated by poor socioeconomic conditions, including overcrowded living areas, malnutrition, poor access to health services and social and religious congregations.
In addition, climatic conditions such as high temperature, intensive sunshine, low relative humidity and poor rainfall promote a stable progression of asymptomatic pneumococcal nasopharyngeal carriage to pneumonia and invasive diseases.
Globally, many people asymptomatically carry the CSM causative bacterial in their nose and throat but may be healthy-looking. However, when these people meet risk factors such as compromised immune systems, it can trigger the invasion of nasopharyngeal epithelial cells into the bloodstream, resulting in fatal cases. The most common symptoms of CSM in adults and the aged include but are not limited to severe headache, high fever, stiff neck, vomiting, rashes, sight problems, loss of appetite and convulsion. Children and infants constantly cry, sleep excessively, feed poorly, become sluggish or inactive, and with a stiffness of the body or neck.
The disease is mainly caused by climatic, environmental and socioeconomic factors. The climatic factors are exacerbated by the global climate change, thereby reinforcing the occurrence of meningitis in Ghana especially in Northern Ghana where temperatures are high.
Meningitis could be prevented if its drivers are put under control. It is therefore imperative for policymakers to take practical and proactive measures to prevent and control the endemic nature of the disease.
Hence, public health departments at the study districts’ health directorates and hospitals must be well resourced to embark on intensive mass early public health education via TV programs and radio discussions on the importance of minimizing overcrowding at public gatherings during the meningitis epidemic.
Health providers and volunteers should also embark on periodic community sensitizations on the need to modify their traditional buildings to make room for better air circulation. There should be early mass vaccination of the population against CSM. Vaccines such as Trivalent A, C. conjugate vaccine, and W135 polysaccharide have been proven to be very potent in preventing CSM.
Policymakers should prioritizeclimate change actions by putting measures in place to help mitigate CSM occurrence. This can be done through afforestation and reforestation, proper waste management, efficient energy utilization, modernization of our transport system to discourage overcrowding in the busses etc.
By TIBANYE B. GEORGE
MSc. CLIMATE CHANGE
RUDN UNIVERSITY, RUSSIA
(georgetibanye2@gmail.com)
The views expressed in this article are the author’s own and do not necessarily reflect The Chronicle’s stance.
