Slideshow: Researchers tackle meningitis in Africa’s Sahel

A trip to Ghana last February brought UCAR/NCAR researchers from different disciplines together to reduce meningitis in Africa’s Sahel region.

The UCAR Meningitis Weather Project was launched in 2009 by Raj Pandya (EO), Mary Hayden (RAL/ISP), Tom Yoksas (Unidata), and Tom Hopson (RAL), with a grant from and partnerships with Ghana’s Navrongo Health Research Centre and the University of Ghana’s School of Public Health. The goal is to provide long-term weather forecasts in the Sahel that will help reduce outbreaks of meningitis by enabling local health providers to target vaccination programs more effectively.

Meningitis, a potentially deadly disease, is an inflammation of the membranes covering the brain and spinal cord. Most cases are caused by a viral infection, but bacterial and fungal infections are also culprits, with the bacterial form the most dangerous. Meningitis outbreaks in the Sahel are associated with the dry season, when conditions are dusty. Experts hypothesize that dust and dryness may irritate membranes, making victims vulnerable to infection, or in other ways foster the spread of the bacteria. The exact mechanism is yet unclear. The region’s last major meningitis epidemic, in 1996, generated at least 200,000 cases of the disease and killed thousands.

Two people sitting on the ground with equipment.

Raj Pandya and Christine Wiedinmyer measure the flow rates of the sampling pumps before each sample. To see more photos, view slideshow.

Now the UCAR team is tackling not just weather-related aspects of meningitis but also the dust itself. Christine Wiedinmyer (NESL/ACD), who has been working with scientists at CU-Boulder to study microbes that can travel on dust, was listening to Mary Hayden (RAL/ISP) describe how climate variability in the Sahel may affect meningitis outbreaks when she found herself intrigued by the disease’s connection to air quality.

“There is a hypothesis that bacteria can travel on dust, and dust is more prevalent during dry conditions,” she says. “We can test this by measuring particles in the atmosphere and looking at airborne microbial populations to see if meningitis is on the dust.”

Air quality and indoor cooking

Christine was also interested in research showing that people exposed to large amounts of indoor pollution (from cooking over open flames) are up to nine times more likely to contract meningitis. Raj, Mary, and Tom Hopson were already headed to Ghana in February for a weeklong research trip, so Christine joined them for a quick look at how air quality and indoor cooking might connect to meningitis.

From a base at Navrongo, the team collaborated with Ghanaian researchers to study the disease’s local context, improve forecasts of annual rains with enough spatial resolution and lead time to optimize the allocation of vaccines, and carry out air quality research.

Christine brought an assortment of small, inexpensive instruments being developed at CU-Boulder for measuring air quality and airborne particles. She was able to make basic measurements of both background air quality and indoor air quality where cook stoves are used. It’s too early to make conclusions from the data, which is still being analyzed. But the team is currently working on a proposal to make a return trip to Ghana for a more thorough study that covers two dry seasons and also takes into account biomass burning in the area.

The team also brought along five cleaner-burning cook stoves developed by colleagues in CSU’s Department of Mechanical Engineering for locals to test out, to see if they could be a practical alternative to their current method of cooking over open flames inside their homes. Currently, women spend about six hours in the bush searching for wood for every three days’ worth of cooking.

Mary, who is trained as a medical anthropologist, recorded what people liked and didn’t like about the stoves and gauged their willingness to pay for them and whether any barriers to use exist. “People loved that the stoves would allow them to use far less fuel,” she says. “If we could reduce both fuel use and cooking time by half, that’s really a boon.”

The team’s proposed return trip to Navrongo would involve bringing 100–200 of the stoves and setting up a study to see if their use reduces indoor air pollution, negative health impacts, and incidents of meningitis.

Bringing weather models into the loop

Tom’s role on the project is to apply ensemble forecasts of weather variables that relate to meningitis occurrence into models of disease outbreak. The weather forecasts come from eight global forecasting centers and are supported by the World Meteorological Organization’s THORPEX-TIGGE program, which seeks to improve weather forecasts to benefit humanity.

In Ghana, Tom set up instruments and gathered weather data that will help with forecasts throughout the Sahel’s meningitis belt. He was especially focused on measuring relative humidity, as research has shown that this is the most significant weather variable for predicting meningitis outbreaks. Back at UCAR, he has been collaborating with Tom Yoksas to develop effective ways to visualize and communicate the relative humidity forecasts to vaccination decision makers.

“The people were very friendly,” Tom says. “I was impressed at how welcoming they were to having people come into their houses and set up instruments.”

Raj, who serves as principal investigator for the project, also helped set up instrumentation and conduct fieldwork.

“This project is very exciting because it initiates a long-term partnership between African and U.S. researchers and it matches UCAR’s expertise to a regional priority—public health,” he says. “More importantly, if we do this well, we could contribute to improved lives and livelihoods throughout the Sahel.”

View slideshow.