In the household-level prophylaxis arm, each time a case is notified, a study nurse will visit the case’s household within 24 hours. A household is defined as a group of people living in the same building or group of adjacent buildings and under the authority of a single head of household. In the case of polygamy, all wives (and their children) of a male head of household will be considered to be members of a single household, provided that they live in the same building or group of adjacent buildings. In the case of multiple heads of household living in one compound of houses, only persons living under the authority of the head of household of the declared meningitis case will be considered a household member and therefore invited to take ciprofloxacin. The nurse will offer ciprofloxacin to all persons currently living in the household and present at the time of the visit, and supervise intake if they accept. (Household members who have accompanied the notified patient will be offered ciprofloxacin at the HC.) Return visits will be arranged for absent household members. In villages randomized to this arm, prophylaxis of a reported case-patient’s household will occur with each subsequent case notified from that village.