Abstract
Epidemics of bacterial meningitis have plagued the African continent for over a century creating public health emergencies with considerable morbidity and mortality. Although many bacteria can cause meningitis, most epidemics are due to a small number of meningococcal serogroups, especially groups A, C, X, Y and W135 with more than 90% of these epidemics due to group A Neisseria meningitidis. Current group A vaccines have serious shortcomings, although a new conjugate vaccine, likely to be licensed in the near future, is expected to greatly modify the epidemiology of the disease.
The distribution of the epidemics has a strong association with the environment and these associations have been used to develop models to predict their location and incidence with varying degrees of success.
Here we describe the characteristics of epidemic meningitis in Africa, its association with the environment, the approaches currently available for control and the advantages of the new vaccines. We also discuss the problems that may be faced with the advent of the vaccines and their large-scale implementation and how geographical information systems and climate and environmental information could play a role in informing vaccine strategies monitoring vaccine efficacy, and controlling epidemics in Africa.
Keywords
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References
Achtman, M., A. van der Ende, P. Zhu, I. S. Koroleva, B. Kusecek, G. Morelli, I. G. Schuurman, N. Brieske, K. Zurth, N. N. Kostyukova and A. E. Platonov (2001). Molecular epidemiology of serogroup a meningitis in Moscow, 1969 to 1997. Emerg Infect Dis 7(3): 420–477.
Adegbola, R. A., O. Secka, G. Lahai, N. Lloyd-Evans, A. Njie, S. Usen, C. Oluwalana, S. Obaro, M. Weber, T. Corrah, K. Mulholland, K. McAdam, B. Greenwood and P. J. Milligan (2005). Elimination of Haemophilus influenzae type b (Hib) disease from The Gambia after the introduction of routine immunisation with a Hib conjugate vaccine: a prospective study. Lancet 366(9480): 144–150.
Bhatia, S. L., K. B. Sharma and R. Natarajan (1968). An outbreak of meningococcal meningitis in Delhi. Ind J Med Res 56(3): 259–263.
Birmingham, M. E., R. F. Lewis, W. Perea, C.B.Nelson, A. Kabore and D. Tarantola (2003). Routine vaccination with polysaccharide meningococcal vaccines is an ineffective and possibly harmful strategy. Bull World Health Organ 81: 751–755.
Blakebrough, I. S., B. M. Greenwood, H. C. Whittle, A. K. Bradley and H. M. Gilles (1983). Failure of meningococcal vaccination to stop the transmission of meningococci in Nigerian schoolboys. Ann Trop Med Parasitol 77(2): 175–178.
Cheesbrough, J. S., A. P. Morse and S. D. Green (1995). Meningococcal meningitis and carriage in western Zaire: a hypoendemic zone related to climate? Epidemiol Infect 114(1): 75–92.
Cochi, S. L., L. E. Markowitz, D. D. Joshi, R. C. Owens, Jr., D. H. Stenhouse, D. N. Regmi, R. P. Shrestha, I. Lacharya, M. Manandhar, V. L. Gurubacharya, et al. (1987). Control of epidemic group A meningococcal meningitis in Nepal. Int J Epidemiol 16(1): 91–97.
Correia, J. B. and C. A. Hart (2004). Meningococcal disease. Clin Evid (12): 1164–1181.
Cuevas, L. E. and C. A. Hart (1993). Chemoprophylaxis of bacterial meningitis. J Antimicrob Chemother 31(Suppl B): 79–91.
Cuevas, L. E., I. Jeanne, A. Molesworth, M. Bell, E. C. Savory, S. J. Connor and M. C. Thomson (2007). Risk mapping and early warning systems for the control of meningitis in Africa. Vaccine 25S: A12–A17.
De Wals, P., L. Hertoghe, I. Borlee-Grimee, S. De Maeyer-Cleempoel, G. Reginster-Haneuse, A. Dachy, A. Bouckaert and M. F. Lechat (1981). Meningococcal disease in Belgium. Secondary attack rate among household, day-care nursery and pre-elementary school contacts. J Infect 3(Suppl 1): 53–61.
Emele, F. E., C. N. Ahanotu and C. E. Anyiwo (1999). Nasopharyngeal carriage of meningococcus and meningococcal meningitis in Sokoto, Nigeria. Acta Paediatr 88(3): 265–269.
Gagneux, S. P., A. Hodgson, T. A. Smith, T. Wirth, I. Ehrhard, G. Morelli, B. Genton, F. N. Binka, M. Achtman and G. Pluschke (2002). Prospective study of a serogroup X Neisseria meningitidis outbreak in northern Ghana. J Infect Dis 185(5): 618–626.
Greenwood, B. M., A. K. Bradley and P. G. Cleland (1979). An epidemic of meningococcal meningitis at Zaria, Northern Nigeria. Trans R Soc Trop Med Hyg 73: 557–573.
Hart, C. A. and L. E. Cuevas (1997). Meningococcal disease in Africa. Ann Trop Med Parasitol 91(7): 777–785.
Hassan-King, M. K., R. A. Wall and B. M. Greenwood (1988). Meningococcal carriage, meningococcal disease and vaccination. J Infect 16(1): 55–59.
Hu, X. (1990). Surveillance of epidemiological features for epidemic cerebrospinal meningitis in China during 1980s. Zhonghua Liu Xing Bing Xue Za Zhi 11(6): 321–324.
Jackou-Boulama, M., R. Michel, L. Ollivier, J. B. Meynard, P. Nicolas and J. P. Boutin (2005). Correlation between rainfall and meningococcal meningitis in Niger. Med Trop (Mars) 65(4): 329–333.
Lapeyssonnie, L. (1963). Cerebrospinal Meningitis in Africa. Bull World Health Organ 28(Suppl):1–114.
Luo, N., C. Perera, J. Holton, H. Ayles and A. Zumla (1998). Spread of Neisseria meningitidis group A clone III-I meningitis epidemic into Zambia. J Infect 36(2): 141–143.
MacLennan, J., S. Obaro, J. Deeks, D. Lake, C. Elie, G. Carlone, E. R. Moxon and B. Greenwood (2001). Immunologic memory 5 years after meningococcal A/C conjugate vaccination in infancy. J Infect Dis 183(1): 97–104.
Molesworth, A. M., L. E. Cuevas, S. J. Connor, A. P. Morse and M. C. Thomson (2003). Environmental risk and meningitis epidemics in Africa. Emerg Infect Dis 9(10): 1287–1293.
Molesworth, A. M., M. C. Thomson, S. J. Connor, M. P. Cresswell, A. P. Morse, P. Shears, C. A. Hart and L. E. Cuevas (2002). Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa. Trans R Soc Trop Med Hyg 96(3): 242–249.
Moore, P. S. (1992). Meningococcal meningitis in sub-Saharan Africa: a model for the epidemic process. Clin Infect Dis 14(2): 515–525.
Moore, P. S. and C. V. Broome (1994). Cerebrospinal meningitis epidemics. Sci Am 271(5): 38–45.
Moore, P. S., J. Hierholzer, W. De Witt, et al. (1990). Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis. JAMA 264: 1271–1275.
Moore, P. S., M. W. Reeves, B. Schwartz, B. G. Gellin and C. V. Broome (1989). Intercontinental spread of an epidemic group A Neisseria meningitidis strain. Lancet 2(8657): 260–263.
Omanga U, Nethihinyurwa M, S. D, et al. (1980). Aspectes étiologiques et évolutifs des méningites purulentes de l’enfant à Kinshasa: analyse de 471 cases. Méd d’Afrique Noire 27: 25–34.
Peltola, H. (2000). Emergency or routine vaccination against meningococcal disease in Africa? Lancet 355(9197): 3.
Ramsay, M. E., N. Andrews, E. B. Kaczmarski and E. Miller (2001). Efficacy of meningococcal serogroup C conjugate vaccine in teenagers and toddlers in England. Lancet 357(9251): 195–196.
Reingold, A. L., C. V. Broome, A. W. Hightower, G. W. Ajello, G. A. Bolan, C. Adamsbaum, E. E. Jones, C. Phillips, H. Tiendrebeogo and A. Yada (1985). Age-specific differences in duration of clinical protection after vaccination with meningococcal polysaccharide A vaccine. Lancet 2(8447): 114–118.
Riordan, F. A. I., O. Marzouk, A. P. J. Thomson, J. A. Sills and C. A. Hart (1995). Changing presentation of meningococcal disease. Eur J Pediatr 154: 472–474.
Robbins, J. B., R. Schneerson and E. C. Gotschlich (2000). A rebuttal: epidemic and endemic meningococcal meningitis in sub-Saharan Africa can be prevented now by routine immunization with group A meningococcal capsular polysaccharide vaccine. Pediatr Infect Dis J 19: 945–953.
Robbins, J. B., R. Schneerson, E. C. Gotschlich, I. Mohammed, A. Nasidi, J. P. Chippaux, L. Bernardino and M. A. Maiga (2003). Meningococcal meningitis in sub-Saharan Africa: the case for mass and routine vaccination with available polysaccharide vaccines. Bull World Health Organ 81(10): 745–750; discussion 751–755.
Salih, M. A., H. S. Ahmed, Z. A. Karrar, I. Kamil, K. A. Osman, H. Palmgren, Y. Hofvander and P. Olcen (1990). Features of a large epidemic of group A meningococcal meningitis in Khartoum, Sudan in 1988. Scand J Infect Dis 22(2): 161–170.
Savory, E. C., L. E. Cuevas, M. A. Yassin, C. A. Hart, A. M. Molesworth and M. C. Thomson (2006). Evaluation of the meningitis epidemics risk model in Africa. Epidemiol Infect 134(5): 1047–1051.
Scheld, W. M., U. Koedel, B. Nathan and H. W. Pfister (2002). Pathophysiology of bacterial meningitis: mechanism(s) of neuronal injury. J Infect Dis 186(Suppl 2): S225–S233.
Sidikou, F., S. Djibo, M. K. Taha, J. M. Alonso, A. Djibo, K. K. Kairo, S. Chanteau and P. Boisier (2003). Polymerase chain reaction assay and bacterial meningitis surveillance in remote areas, Niger. Emerg Infect Dis 9(11): 1486–1488.
Soriano-Gabarro, M., N. Rosenstein and F. M. LaForce (2004). Evaluation of serogroup A meningococcal vaccines in Africa: a demonstration project. J Health Popul Nutr 22(3): 275–285.
Stephens, D. S., B. Greenwood and P. Brandtzaeg (2007). Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet 369(9580): 2196–2210.
Stuart, J. M., K. A. Cartwright, P. M. Robinson and N. D. Noah (1989). Effect of smoking on meningococcal carriage. Lancet 2(8665): 723–725.
Sultan, B., K. Labadi, J. F. Guegan and S. Janicot (2005). Climate drives the meningitis epidemics onset in west Africa. PLoS Med 2(1): e6.
Thomson, M. C., S. J. Connor, U. D’Alessandro, B. Rowlingson, P. Diggle, M. Cresswell and B. Greenwood (1999). Predicting malaria infection in Gambian children from satellite data and bed net use surveys: the importance of spatial correlation in the interpretation of results. Am J Trop Med Hyg 61(1): 2–8.
Thomson, M. C., F. J. Doblas-Reyes, S. J. Mason, R. Hagedorn, S. J. Connor, T. Phindela, A. P. Morse and T. N. Palmer (2006a). Malaria early warnings based on seasonal climate forecasts from multi-model ensembles. Nature 439(7076): 576–579.
Thomson, M. C., A. M. Molesworth, M. H. Djingarey, K. R. Yameogo, F. Belanger and L. E. Cuevas (2006b). Potential of environmental models to predict meningitis epidemics in Africa. Trop Med Int Health 11(6): 781–788.
Whittle, H. C. and B. M. Greenwood (1976). Meningococcal meningitis in the northern savanna of Africa. Trop Doct 6(3): 99–104.
WHO (1998). Epidemic meningococcal disease. Fact sheet 105 (Geneva).
WHO (2000). Detecting meningococcal meningitis epidemics in highly-endemic African countries. Wkly Epidemiol Rec 75: 306–309.
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Cuevas, L.E., Hart, C.A., Thomson, M.C. (2008). Climate and Environmental Information and the Control of Epidemic Meningitis in Africa. In: Thomson, M.C., Garcia-Herrera, R., Beniston, M. (eds) Seasonal Forecasts, Climatic Change and Human Health. Advances in Global Change Research, vol 30. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-6877-5_5
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