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Declining Incidence of Invasive Meningococcal Disease in South Africa: 2003-2016

Susan Meiring1,2, Cheryl Cohen2,3, Linda de Gouveia3

  • 1Division of Public Health Surveillance and Response, National Institute for Communicable Diseases (NICD), a Division of the National Health Laboratory Service (NHLS), Johannesburg.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 24, 2018
PubMed
Abstract

Insights

Invasive meningococcal disease (IMD) significantly decreased in South Africa between 2003-2016, despite minimal vaccine use. Human immunodeficiency virus (HIV) infection increased IMD risk, particularly for serogroups W and Y.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health Surveillance

Background:

  • Invasive meningococcal disease (IMD) is a significant public health concern in South Africa.
  • Vaccine utilization for IMD is notably low in the region.

Purpose of the Study:

  • To describe the epidemiology of IMD in South Africa from 2003 to 2016.
  • To analyze trends, serogroup distribution, and risk factors associated with IMD.

Main Methods:

  • Utilized data from the national laboratory-based surveillance program, GERMS-SA (2003-2016).
  • Collected clinical data, including HIV status, from 26 sentinel hospital sites.
  • Performed space-time analyses to identify disease clusters.

Main Results:

  • Recorded 5249 IMD cases, with incidence declining from 0.97 to 0.23 cases per 100,000 population.
  • Serogroup W was predominant (49.5%), followed by B (23.3%) and Y (12.3%).
  • HIV coinfection was present in 36% of cases, with higher IMD risk (aRRR 2.5) and increased severity with serogroups W and Y.

Conclusions:

  • IMD incidence in South Africa decreased by 76% from 2003-2016, independent of widespread vaccination.
  • HIV infection is a significant risk factor for IMD, particularly for serogroups W and Y.
  • The study highlights the impact of HIV on IMD epidemiology in South Africa.
Keywords:
NeisseriaSouth Africaepidemiologyinvasive meningococcal diseasemeningococcus

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