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Meningococcal meningitis in sub-Saharan Africa: the case for mass and routine vaccination with available

John B Robbins1, Rachel Schneerson, Emil C Gotschlich

  • 1National Institute of Child Health and Human Development, National Institutes for Health, Bethesda, MD 20892-2720, USA. robbinsjo@mail.nih.gov

Bulletin of the World Health Organization
|February 6, 2004
PubMed

Insights

Group A meningococcal meningitis causes significant illness in Africa. Universal vaccination with meningococcal polysaccharide vaccines could prevent both epidemic and endemic meningitis cases.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Public Health

Background:

  • Meningococcal meningitis, particularly group A, is a major health burden in sub-Saharan Africa.
  • Current treatments for meningococcal meningitis have high fatality and long-term neurological damage rates.
  • Existing epidemic containment strategies are insufficient, failing to address endemic cases.

Purpose of the Study:

  • To evaluate the potential of universal vaccination strategies for controlling group A meningococcal meningitis.
  • To assess the impact of current vaccination policies on epidemic and endemic disease.
  • To propose an improved vaccination schedule for comprehensive meningococcal disease prevention.

Main Methods:

  • Analysis of existing data on meningococcal meningitis epidemiology and vaccine effectiveness.
  • Review of World Health Organization (WHO) policies for epidemic containment.
  • Modeling the potential impact of universal polysaccharide vaccination schedules.

Main Results:

  • The group A meningococcal polysaccharide vaccine is safe, inexpensive, and effective at all ages.
  • Current WHO policies prevent only about 50% of epidemic cases and ignore endemic disease.
  • An estimated 50,000 endemic cases of meningitis occur annually.

Conclusions:

  • Universal vaccination with group A meningococcal polysaccharide vaccine, followed by a quadrivalent vaccine, could eliminate epidemic and endemic meningitis.
  • This strategy would also prepare for future conjugate vaccines.
  • Such a policy could have prevented recent group A and W135 meningitis epidemics.

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