The outbreak is centred along the border with Ivory Coast, where 44 deaths had been reported by February 20, a day before the two countries announced a joint health programme to tackle the epidemic.

"Between January 1 and March 9, 2008, we have a total of 4,061 suspect cases of meningitis, including 441 deaths, a mortality rate of 10.85 percent," Ousmane Badolo, the ministry official in charge of epidemic disease surveillance told AFP.

Dr Badolo said that of 16 affected districts in Burkina Faso, the outbreak had reached epidemic levels in seven of them. The last official figures issued on March 2 reported 366 deaths out of 3,181 cases.

Over the border in Ivory Coast, the authorities last month said an epidemic in the Zanzans border region had a mortality rate of 15.4 percent.

Meningitis is very contagious and initial symptoms include a quickly rising temperature, violent headaches, vomiting and neck stiffness. It is declared an epidemic when there are at least 10 cases per 100,000 people.

Both countries are on a sub-Saharan "meningitis belt" that stretches from Senegal on the Atlantic coast to Ethiopia in the east. Burkina Faso has been worst affected, as it was last year.

In 2007, the United Nations said three-quarters of the more than 2,000 deaths from meningitis in nine countries were in Burkina Faso.

"The risk of an epidemic remains," Red Cross for West Africa coordinator Hans Ebbing warned in Dakar last month, pointing out that the "highest (number of) cases is often registered in the months of March and April."

The International Red Cross has launched vaccination campaigns and released 95,000 Swiss francs (almost 60,000 euros / 91,000 dollars) from its emergency fund to help the Burkinabe Red Cross.

The money is intended to help volunteer workers taking part in vaccination campaigns for people aged from two to 30 and efforts to raise public awareness of the risk of contagion.

At a meeting in February in the northeast Ivory Coast town of Bouna, Ivorian and Burkinabe authorities agreed to "formalise our exchanges and develop a joint strategy," Sylvestre Kiendrebeogo of Burkina Faso's health ministry said.

The neighbouring countries had worked separately, though their border is several hundred kilometres (miles) long, but infrastructure in Ivory Coast has been weakened since the north was taken by former rebels in 2002.

Health officials decided to synchronise their vaccination campaigns, share medical facilities including vaccines and vehicles and open health centres to people from both sides of the border, offering free care, they said in a joint statement.

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