Meningococcal immunisation in Ghana [letter]

In the article by Christopher Woods and colleagues the WHO’s threshold-based meningitis control strategy was considered as the best strategy in circumventing the meningitis epidemic in Ghana as compared to their mass vaccination strategy. However the author acknowledges that both strategies have drawbacks as proved by the relatively low percentage of cases prevented. Concern has also been raised that the cost of a death averted by vaccination is 15 times higher than that which is averted by treatment. This implies that when a surveillance strategy is used the service providers can be confronted with a difficult choice between vaccination and treatment. And because there is no scientific evidence that proves which strategy is more practical it would be detrimental to discourage additional efforts to improve responses to such a public health problem especially when those efforts prove cost-effective.