# Etiology and Outcomes of Meningitis in Rural, Northern Uganda

> **NIH NIH R21** · UNIVERSITY OF ROCHESTER · 2022 · $189,768

## Abstract

Our long-term goal is to improve outcomes from meningitis in rural, northern Uganda, an area within the
meningitis belt of Africa, where there has been poor infrastructure related to the diagnosis and management of
meningitis. Each year, approximately five million people worldwide are affected by meningitis. According to the
WHO, the estimated number of annual deaths related to meningitis is 300,000, with infants and children at
greatest risk. A global health initiative to defeat meningitis by 2030 was developed by the WHO and partners.
The key goals are to: a) eliminate epidemics of bacterial meningitis (BM), b) reduce cases and deaths from
vaccine-preventable BM, and c) reduce disability and improve quality of life. In 2017, we developed a CM
diagnosis and treatment program (CM-DTP) at Lira Regional Referral Hospital (LRRH) in rural, northern
Uganda as a quality improvement initiative designed to improve the diagnosis and treatment of CM. This
ongoing program is a joint effort by collaborators on this application: University of Minnesota (UMN), the
Infectious Diseases Institute (IDI) at Makerere University, and Lira University/LRRH. Through the CM-DTP,
patients admitted to LRRH with signs and symptoms of meningitis undergo rapid HIV testing, HIV-positive
patients then undergo rapid cryptococcal antigen (CrAg) testing, and patients diagnosed with CM receive
standard of care antifungal treatment. Although this program was effective at improving the diagnosis and
treatment of CM, the program also pointed out major gaps in meningitis care related to the diagnosis and
treatment of meningitis due etiologies other than CM. Of 281 adult patients who presented with meningitis at
LRRH from 2017 to 2019, we diagnosed CM in 99 (35.2%), but the etiology of meningitis for the other 64.8% of
patients was unknown, due to lack of diagnostic capabilities. The specific aims are directed at improving
infrastructure for the diagnosis and treatment of meningitis by building microbiology laboratory capacity,
directing treatments at etiologies, and educating health care workers. Aim 1 is to identify the etiology of
meningitis in 400 patients at LRRH through expanded microbiology laboratory capacity developed through this
grant, aim 2 is to direct treatment of patients with meningitis based on etiology, and for each etiology, track
outcomes including death, cognitive impairment and neurological deficits, and aim 3 is to build human
resources capacity among health care workers to identify, diagnose, and treat meningitis at LRRH, Lira
University, and surrounding health facilities. This project will build microbiology laboratory and human
resources capacity for the diagnosis and treatment of meningitis in Lira and will provide vital information about
the burden, etiology, and outcomes of meningitis in a setting that is representative of many resource-limited
regions in rural SSA. Building capacity to diagnose different etiologies of meningitis at Lira University/LRRH will...

## Key facts

- **NIH application ID:** 10543219
- **Project number:** 1R21TW012439-01
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Paul R Bohjanen
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $189,768
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10543219

## Citation

> US National Institutes of Health, RePORTER application 10543219, Etiology and Outcomes of Meningitis in Rural, Northern Uganda (1R21TW012439-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10543219. Licensed CC0.

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