Epidemiological Status of Bacterial Meningitis Disease Following the Introduction of the Meningococcal A Conjugate Vaccine in the African Meningitis Belt

Abstract

Bacterial meningitis disease is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (N. meningitidis A) was the predominant pathogen causing about 90 percent of meningitis epidemics in Africa. The meningococcal A conjugate vaccine (MACV) protecting against N. meningitidis A was introduced since 2010. The purpose of this quantitative study was to determine the magnitude and fatality of meningitis bacterial disease in Africa following the introduction of MACV from 2010 and 2017. An interrupted time series design and nonprobability sampling were used. Secondary data issued of meningitis enhanced surveillance were retrieved from World Health Organization database. The binomial negative regression and Pearson's Chi-Square tests were used. The study found that after the MACV introduction there was a 39% decline of incidence rate of meningitis suspected cases (IRR 0.61, 95% CI 0.48-0.79, p < .001) and 99% decline of the risk of N. meningitidis A (RR 0.01, 95% CI 0.08-0.013). There was a difference in the meningitis CFR before and after MACV introduction in 21 out of the 26 countries of African meningitis belt. After the introduction of MACV, there was a 46% decline in risk to report high CFR (>10%) after the MACV immunization (RR 0.547, 95% CI 0.40-0.74). There was a 49% decline of fatal meningitis (IRR 0.51, 95% CI 0.41-0.68, p < .001). After 2010, N. meningitidis A declined and S. Pneumoniae, N. meningitidis W135, N. meningitidis C, N. meningitidis X, and Hib became predominant. Between 2010 and 2017 N. meningitidis all serogroups concerned remained higher the other pathogens 15,885 (62.06%) Vs 25,596. The study showed that following the MACV introduction despite the dramatic reduction of N. meningitidis A, meningococcal meningitis bacterial disease remains a major public health problem.

The Bacterial Meningitis Epidemic in Banalia in the Democratic Republic of Congo in 2021

“…The country last reported a meningitis epidemic in 2009, in the city of Kisangani, with 214 meningitis suspected cases with a case fatality rate (CFR) of 8% [21,22]. In May 2016, MenAfriVac ® was introduced in four provinces, with over 18 million individuals aged 1-29 years vaccinated, 1.7 million of whom resided in Tshopo province [23,24]. In early July 2021, the Banalia health zone in the Tshopo province, located in the north-eastern DRC, notified several suspected cases and deaths due to meningitis through the alert system of the meningitis enhanced surveillance network of the African meningitis belt in which DRC was included.…”