An analysis of bacteria recovered from cerebrospinal fluid over a 16-year period at a rural hospital in western Zaire showed that Neisseria meningitidis accounted for only five (2·2%) isolates. A survey of naso-pharyngeal colonisation with N. meningitidis in 378 healthy children was undertaken to distinguish whether this low frequency was due to lack of carriage or, by inference, lack of the co-factors necessary to permit invasive disease. N. meningitidis was recovered from only three (0·78%) of the children. All isolates were non-typable strains of low pathogenicity.
A review of studies examining the aetiology of bacterial meningitis and the geographical location of epidemics of meningococcal meningitis in and around Zaire reveals a ‘hypoendemic zone’, the limits of which correlate well with the area in which mean absolute humidity remains above 10 g m−3 of air throughout the year. Continuous high absolute humidity appears to reduce the transmission of meningococci.