At the center of the meningitis outbreak response in Ghana, the Medical Research Council Unit, The Gambia (MRCG) and the World Health Organisation (WHO) join forces. Official figures as of 17th Feb 2016, from the Ghana’s Health Ministry indicate that at least 86 people have died with 637 cases in the recent outbreak of a strain of pneumococcal meningitis in Ghana. According to the WHO, meningitis is a disease caused by the inflammation of the protective membranes covering the brain and the spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord. The WHO Regional Reference Laboratory (WHO RRL) at MRC for Invasive Bacterial Diseases, Headed by Dr Martin Antonio, responded instantly to the request by WHO and the Minister of Health in Ghana to support this outbreak by sending technical experts from MRC to Ghana. The MRC team from the WHO RRL on the ground include, Dr Brenda Kwambana- Adams (Molecular Biologist), Mr Jacob Otu (Clinical Microbiologist), Mr Ebenezer Foster Nyarko (Clinical Microbiologist) and Mr Archie Worwui (Clinical Manager). The WHO team consisted of Dr Jason Mwenda (WHO/AFRO Regional Coordinator for Vaccine preventable Diseases Surveillance), Dr Charles Okot (Epidemiologists), Godfred Owusu-Okyare (Senior Biomedical Scientist NPHRL) and Dr David Opare (Head NPHRL) from the Ghana Government.

Whilst the WHO RRL team was in Ghana, the WHO RRL at the MRCG was also actively involved in the analyzing the samples by molecular techniques sent to the MRC Unit The Gambia. Dr Martin Antonio provided overall coordination for the outbreak- mission. This coordination effort was also supported by Catherine Okoi (MRCG Molecular Microbiologist Lab Manager) who worked in the bacteriology laboratory to analyse samples from in the Brong Ahafo and Ashanti regions of Ghana to determine the pneumococcal serotypes and confirm laboratory results.

The dedicated team from the MRCG support for the outbreak included assisting in training laboratory personnel on basic bacteriology and antimicrobial testing as well as introducing them to latex serotyping. During this process, MRCG also shared relevant standard operating procedures and lab quality control/assurance guidelines to ensure accurate laboratory results. Consumables and equipment were also provided to perform bacteriology testing for S. pneumoniae, H. influenzae and N. meningitidis. Preliminary results from laboratory tests were done by both MRCG and WHO mission teams on few isolates tested alongside with Ghana ministry of health national laboratory colleagues. These tests were done using reagents brought into Ghana by the joint mission team were the first to confirm that the outbreak was mostly caused by pneumococcal serotype 1 and meningococcal W15 to a lesser extent. Results have been shared with Ghana Health Service, MOH and WHO and other partners. Surveillance needs to continue to collect a sufficient number of samples to fully confirm that this outbreak is primarily caused by pneumococcal serotype 1, a rare but not uncommon observation.

Discussion is currently ongoing for the possibility of long-term collaboration with WHO RRL at MRCG to enhance the skills of laboratory staffs at the health facilities in Ghana including the possibility of follow up training sessions either in house or at the MRCG for advanced training.

Professor Umberto D’Alessandro, MRCG Director said, “I am extremely pleased that we have been able to assist both the WHO and our Ghanaian colleagues in dealing with this devastating outbreak. It confirms MRCG’s ability to help, when needed, countries in the West African region confronted with similar threats. Such activities are part of our mission to improve health and save lives through research. This includes also training and capacity building of sister institutions in the region.”