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Am. J. Trop. Med. Hyg., 80(4), 2009, pp. 619-624
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Epidemiology and Risk Factors for Serogroup X Meningococcal Meningitis during an Outbreak in Western Kenya, 2005–2006

David M. Mutonga, Guillermo Pimentel, Judith Muindi, Charles Nzioka, Julius Mutiso, John D. Klena, Myriam Morcos, Thomas Ogaro, Sadiki Materu, Christopher Tetteh, Nancy E. Messonnier, Robert F. Breiman, AND Daniel R. Feikin*
Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

The epidemiology of serogroup X meningococcal meningitis in Africa is unknown. During a serogroup X meningococcus outbreak in Kenya, case finding involved record review at health facilities and interviews with health workers and community leaders in West Pokot district. An age- and location-matched case-control study for risk factors was done. From December 2005 to April 2006, 82 suspect cases of meningitis were reported; the epidemic threshold was surpassed within two administrative divisions. Most (58%) cases were 5–24 years old; the case-fatality ratio was 21%. Serogroup X meningococcus was the most common serogroup – 5 (63%) of eight isolates serogrouped. Living in the same compound as another case, preceding upper respiratory tract infection and cooking outside the house were significant risk factors for disease. Serogroup X meningococcus caused an outbreak with similar epidemiology and risk factors as other serogroups. Serogroup-specific laboratory-based surveillance for meningococcus in Africa to detect serogroup X disease should be enhanced.

Received September 4, 2008. Accepted for publication November 26, 2008.

Acknowledgments: The authors thank the following people and institutions for their contribution in diverse ways: Ministry of Health Kenya, Disease Outbreak Management Unit officials, Jackson Njoroge, Rosalia Kalani; West Pokot District Ministry of Health Officials, Dr. Kimei, Chepkwony, Lokorkol Tarus, and Fred Machini; the community leaders, villagers, and the participants from West Pokot District.

Disclaimers: The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the US Department of the Navy. This information is distributed solely for the purpose of pre dissemination peer review under applicable information quality guidelines. It has not been formally disseminated by the Centers for Disease Control and Prevention. It does not represent and should not be construed to represent any agency determination or policy.

* Address correspondence to Daniel R. Feikin, CDC, Unit 64112, APO, AE 09831. E-mail: dfeikin{at}ke.cdc.gov

Authors’ addresses: David M. Mutonga, Judith Muindi, and Christopher Tetteh, Field Epidemiology and Laboratory Training Program, CDC/KEMRI, Off Mbagathi Way, Nairobi, Kenya, Tel: +254-721203157, Fax: +254-572022981, E-mails: davidmutonga{at}yahoo.com, judithmuindi{at}yahoo.com, and TettehC{at}sa.cdc.gov. Guillermo Pimentiel, John D. Klena, and Myriam Morcos, U.S. Naval Research Program #3, Disease Surveillance Program, PSC 452 Box 116, FPO, AE 09835, Tel: +2-02-348-0333, Fax: +2-02-342-7121, E-mails: Guillermo.Pimentel{at}med.navy.mil, KlenaJ{at}namru3.med.navy.mil, and MorcosM{at}namru3.med.navy.mil. Charles Nzioka, Julius Mutiso, and Thomas Ogaro, Division of Disease Surveillance and Response, Kenya Ministry of Public Health and Sanitation, Afya House, Nairobi, Kenya, Tel: +254-733753541, E-mail: DOMU{at}africaonline.co.ke. Sadiki Matera, African Medical and Research Foundation, Langata Road, PO Box 27691, Nairobi, Kenya, Tel: +254-206993000, Fax: +254-20609518, E-mail: sadikim{at}amrefke.org. Nancy E. Messonnier, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Mailstop C09, Atlanta, GA 30329-4018, Tel: 404-639-4734, E-mail: nar5{at}cdc.gov. Robert Breiman and Daniel Feikin, CDC/KEMRI, Unit 64112, APO, AE 09831, Tel: +254-202717529, Fax: +254-572022981, E-mails: rbreiman{at}ke.cdc.gov and dfeikin{at}ke.cdc.gov.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.