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Meningococcal Meningitis Surveillance in the African Meningitis Belt, 2004-2013

Clément Lingani1, Cassi Bergeron-Caron2, James M Stuart3

  • 1Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 11, 2015
PubMed
Abstract

Insights

The enhanced meningitis surveillance system in Africa significantly reduced group A bacterial meningitis cases after the 2010 vaccine introduction. This system provides crucial epidemiological data for outbreak response and disease monitoring.

Area of Science:

  • Epidemiology
  • Infectious Disease Surveillance
  • Vaccinology

Background:

  • Enhanced meningitis surveillance network established in sub-Saharan Africa in 2003.
  • Network collects, disseminates, and utilizes district-level weekly meningitis incidence data.
  • 10 years of data analyzed, including introduction of the group A meningococcal conjugate vaccine, PsA-TT (MenAfriVac), in 2010.

Purpose of the Study:

  • Analyze 10 years of meningitis incidence and case fatality data from the enhanced surveillance network.
  • Evaluate the impact of the PsA-TT vaccine on meningitis epidemiology in the region.
  • Assess the utility of the surveillance system for outbreak response and epidemiological overview.

Main Methods:

  • Data extracted from surveillance bulletins and WHO database for 10 consistently reporting countries (2004-2013).
  • Data de-duplicated and reconciled.
  • Analysis focused on meningitis incidence and case fatality rates, particularly for Neisseria meningitidis serogroup A (NmA).

Main Results:

  • 341,562 suspected/confirmed cases reported over 10 years, with a peak in 2009 due to NmA meningitis.
  • Case fatality rate was lowest (5.9%) during the 2009 epidemic year.
  • NmA meningitis incidence rate decreased over 10-fold, from 0.27 to 0.02 per 100,000 between 2004-2010 and 2011-2013, respectively (P < .0001).

Conclusions:

  • The enhanced meningitis surveillance system effectively supports timely outbreak response.
  • The system provides a valuable global overview of meningitis epidemiology in the region, despite data limitations.
  • A dramatic reduction in NmA meningitis incidence was confirmed following the introduction of the PsA-TT vaccine.
Keywords:
Africameningitissurveillance

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