Future Directions for Meningitis Surveillance and Vaccine Evaluation in the Meningitis Belt of Sub-Saharan Africa

Abstract

In sub-Saharan Africa, bacterial meningitis remains a significant public health problem, especially in the countries of the meningitis belt, where Neisseria meningitidis serogroup A historically caused large-scale epidemics. In 2014, MenAfriNet was established as a consortium of partners supporting strategic implementation of case-based meningitis surveillance to monitor meningitis epidemiology and impact of meningococcal serogroup A conjugate vaccine (MACV). MenAfriNet improved data quality through use of standardized tools, procedures, and laboratory diagnostics. MenAfriNet surveillance and study data provided evidence of ongoing MACV impact, characterized the burden of non-serogroup A meningococcal disease (including the emergence of a new epidemic clone of serogroup C), and documented the impact of pneumococcal conjugate vaccine. New vaccines and schedules have been proposed for future implementation to address the remaining burden of meningitis. To support the goals of “Defeating Meningitis by 2030,” MenAfriNet will continue to strengthen surveillance and support research and modeling to monitor the impact of these programs on meningitis burden in sub-Saharan Africa.

Status of the Rollout of the Meningococcal Serogroup A Conjugate Vaccine in African Meningitis Belt Countries in 2018

“…In 2018, the predominant bacterial meningitis pathogens reported from the meningitis belt were Streptococcus pneumoniae (33%), NmC (24%), NmX (23%), and NmW (5.6%) [30]. This shift in causes of meningitis etiology requires ongoing effective surveillance and laboratory confirmation [31], as well as improved vaccination strategies [26].…”

“…Strategies to eliminate meningitis epidemics include ensuring long-term protection against NmA disease through mass vaccination campaigns (herd protection) and routine immunization (long-term sustainability), enhancing outbreak response and control, strengthening surveillance and laboratory capacity, and promoting development and use of affordable multivalent conjugate vaccines. A global roadmap with the vision of defeating meningitis by 2030 [31] is being developed with the goal of eliminating bacterial meningitis epidemics, reducing cases and deaths from vaccine-preventable bacterial meningitis, reducing risk of disability, and improving quality of life after all cases of meningitis.…”

Malaria and meningitis under climate change: initial assessment of climate information service in Nigeria

“…It has been reported in the literature also that knowledge of climate variability over some time with records is T A B L E 3 The relationship and influence of climatic indices on the occurrence of malaria and meningitis in different ecological zones in the study area essential to understand the nature of some illnesses (Henne et al, 2018). While meningitis occurs in every part of the world, the highest rate is recorded in Sub-Saharan Africa (Besancenot et al, 1997;Mohammed et al, 2017;Novak et al, 2019;Greene et al, 2020). This area spreads from the Gambia to Ethiopia, known as the "meningitis belt."…”

The Epidemic Effect: On the Politics and Economic Burden of Infectious Disease

“…There has been a reduction in serogroup A cases in many countries since the introduction of the vaccine with the vaccine hailed as a success. Concerns have been raised about waning herd immunity over the next decade especially if the vaccine does not become part of routine childhood vaccinations; and an increase in serogroup C cases has been noted in other regions more recently prompting concerns about more epidemics from other serogroups of the bacterium (Karachaliou et al, 2015;Novak et al, 2019). There is currently no vaccine that prevents against all serogroups of Neisseria meningitidis (Yezli et al, 2016).…”