It was made by generic drug maker Serum Institute of India and cost 50 U.S. cents per injection. Beginning in Burkina Faso in 2010, it has been given to 215 million people across Benin, Cameroon, Chad, Ivory Coast, Ethiopia, Ghana, Mali, Niger, Mauritania, Nigeria, Senegal, Sudan, Togo and Gambia. The vaccination campaign has resulted in near-elimination of serogroup A meningitis from the participating countries. Treatment
Persons with confirmed N. meningitidis infection should be hospitalized immediately for treatment with antibiotics. Because meningococcal disease can disseminate very rapidly, a single dose of intramuscular antibiotic is often given at the earliest possible opportunity, even before hospitalization, if disease symptoms look suspicious enough. Third-generation cephalosporin antibiotics (i.e. cefotaxime, ceftriaxone) should be used to treat a suspected or culture-proven meningococcal infection before antibiotic susceptibility results are available. Clinical practice guidelines endorse empirical treatment in the event a lumbar puncture to collect cerebrospinal fluid (CSF) for laboratory testing cannot first be performed. Antibiotic treatment may affect the results of microbiology tests, but a diagnosis may be made on the basis of blood-cultures and clinical examination. Epidemiology
N. meningitidis is a major cause of illness, developmental impairment and death during childhood in industrialized countries and has been responsible for epidemics in Africa and in Asia. Every year, about 2,500 to 3,500 people become infected with N. meningitidis in the US, with a frequency of about 1 in 100,000. Children younger than 5 years are at greatest risk, followed by teenagers of high school age.
Amitriptyline/perphenazine (Duo-Vil, Etrafon, Triavil, Triptafen) is a formulation that contains the tricyclic antidepressant amitriptyline and the medium-potency typical (first-generation) antipsychotic, perphenazine. In the United States amitriptyline/perphenazine is marketed by Mylan Pharmaceuticals Inc. and Remedy Repack Inc.

Medical uses
In the United States amitriptyline/perphenazine is indicated for the treatment of patients with:
Moderate-severe anxiety and/or agitation and depression
Depression and anxiety in association with chronic physical disease
Schizophrenia with prominent depressive symptoms

Adverse effects
Common (>1% incidence) adverse effects include
Sedation
Hypertension — high blood pressure. Neurological impairments (such as extrapyramidal side effects which include dystonia, akathisia, parkinsonism, muscle rigidity, etc.) Anticholinergic side effects such as:- Blurred vision
- Constipation
- Dry mouth
- Nasal congestionIncreased appetite
Weight gain
Nausea
Dizziness
Headache
VomitingUnknown frequency adverse effects include
Diarrhoea
Alopecia — hair loss
Photophobia
Pigmentation
Eczema up to exfoliative dermatitis
Urticaria
Erythema
Itching
Photosensitivity (increased sensitivity of affected skin to sunlight)
Hypersalivation — excessive salivation. Hyperprolactinaemia — elevated blood prolactin levels. This may present with the following symptoms:- Galactorrhea — the release of milk that is not associated with pregnancy or breastfeeding
- Gynaecomastia — the development of breast tissue in males
- Disturbances in menstrual cycle
- Sexual dysfunctionPigmentation of the cornea and lens
Hyperglycaemia — elevated blood glucose (sugar) levels. Hypoglycaemia — low blood glucose (sugar) levels. Disturbed concentration
Excitement
Anxiety
Insomnia
Restlessness
Nightmares
Weakness
Fatigue
Diaphoresis — excessive/abnormal sweating.Uncommon/Rare adverse effects include
Tardive dyskinesia, an often irreversible adverse effect that usually results from chronic use antipsychotic medications, especially the high-potency first-generation antipsychotics. It is characterised by slow (hence tardive), involuntary, repetitive, purposeless muscle movements. Neuroleptic malignant syndrome, a potentially fatal complication of antipsychotic drug use. It is characterised by the following symptoms:- Muscle rigidity
- Tremors
- Mental status change (e.g. hallucinations, agitation, stupor, confusion, etc.)