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Action Meningitis

Our work in Malawi

This crowded waiting room at a health centre in Malawi is typical of the problem Meningitis Research Foundation is tackling with Action Meningitis – a child in that room could be dying from bacterial meningitis and nobody would know.

More than half the babies and children who get meningitis in Malawi will die from the illness, while others are left with serious disabilities which the country is ill-equipped to support. Around 25% will have been misdiagnosed with malaria.

Our research in the second biggest city, Blantyre, showed there is a lack of awareness about the symptoms among health professionals and the public.

Our solution is Action Meningitis, a pilot project which focuses on the faster identification of sick children by using mobile phone technology (mHealth) and educating health care workers and the public to the dangers.

"Action Meningitis will shed light on the hidden diseases of meningitis and septicaemia in Africa, and has the potential to save many young lives as a result"

Professor Orin Levine, Executive Director, International Vaccines Access Centre

Why is this project important?

Action Meningitis is a pilot health project which raises awareness of meningitis among the public and health professionals and helps identify acute cases in clinics and hospitals.

Around 1,000 people globally die every day of meningitis. In Africa, deaths are especially high because, as the World Health Organization (WHO) has acknowledged, it is a neglected diseases. There are so many health issues on the continent, especially HIV/Aids, malnutrition, starvation and malaria, that other illnesses are easily missed.

Our research study into barriers to treatment in Blantyre, established around 25% of meningitis cases were misdiagnosed as malaria – which is why we are piloting Action Meningitis at five township clinics there.

One of the biggest barriers to early treatment in Malawi is getting people to medical help. We have just delivered “ambi-bikes” to 10 remote villages in the Blantyre region to help speed up the process.

Meet Kanny

This is Kanny who lost his hearing because of meningitis when he was six years old. His younger sister Zione, aged three, had been rushed to hospital with meningitis, but when his dad returned home he found Kanny very ill.

Kanny was taken to a health centre a 4km walk away and then to hospital where he was treated for 13 days. He is now deaf and has some learning problems. Zione was luckier; her main problem is she gets tired easily, but their 12 year old brother Yusuf died of meningitis before reaching hospital.

Support for disabled children is very poor in Malawi and Kanny is unable to go to school. He spends his days at home in his village with his mother and baby brothers and sister.

Chip diagnosis by traffic light

Chip is a special Action Meningitis character. He is a triage tool helping medical staff establish how quickly children need to be seen when they are feeling ill. He also features on posters in waiting rooms and on our ambi bikes so people in Malawi become familiar with the idea of being seen according to the priority of their case.

Triage has revolutionised emergency treatment of life-threatening illness in wealthy countries. A triage system using traffic lights, developed by WHO was piloted at Queen Elizabeth Central Hospital (QECH) in Blantyre and WHO now promotes this system for developing countries world-wide.

This system has already improved survival in children at QECH and so other hospitals in Malawi are now using it. We have shown that a triage system is sorely needed in primary care clinics where health workers are overwhelmed by people flooding into the clinic each morning, and children regularly die while waiting in the queue.

We have worked with our partners, the Malawi-Liverpool- Wellcome Trust, QECH and D-tree International to introduce the traffic light triage system into clinics using mobile phone technology to track referral to QECH.

Phone technology vital

Action Meningitis is using mobile phone technology (mHealth) to deliver the project, Health surveillance assistants patrol the queues at the medical centres, using a special programme on their mobile phones to identify sick children and track referrals.

Umoyo Mkukambirana

These are the words for Health Talk Radio in Malawi’s Chichewa language. This radio programme is spreading the word about meningitis to millions of people across Malawi.

Aimed at improving health awareness and knowledge, the programme is broadcast by the Malawi Broadcast Corporation and has already featured two sets of programming on meningitis funded by us.

Featuring medical professionals, the shows used phone-ins, discussions, real life experiences and even SMS to spread awareness of meningitis and knowledge of the symptoms.

Feedback from listening clubs and the data on SMS responses has been so positive we shall be doing more with Umoyo Mkukambirana in the year ahead.

Diagnosing across continents

Thousands of miles separate them but Edith Cheonga and Emma Harding share a story. They were misdiagnosed and treated very late.

Edith from Chunga village was two years old when she became sick. Her parents rushed her to the nearest health centre where they treated her for malaria instead of meningitis – even though a test showed she didn’t have malaria.

By day three Edith’s fontanelle was bulging and she was referred to hospital where she ended up having major surgery and staying 10 days. She is now blind, deaf and unable to sit upright.

Emma from Bracknell Surrey in the UK was misdiagnosed – over the telephone and face to face. One doctor said the 15 month old had an ear infection. Hospitalised for over three months with pneumococcal meningitis, she is now eight and thanks to medical intervention and support can see, hear with a cochlear implant and is more mobile.