Impact of MenAfriVac in nine countries of the African meningitis belt, 2010–15: an analysis of surveillance data

Trotter, Caroline; Lingani, Clément; Fernandez, Katya C.; Cooper, Laura V; Bita, André; Tévi-Bénissan, Carol; Ronveaux, Olivier; Préziosi, Marie-Pierre; Stuart, James M.

doi:10.1016/s1473-3099(17)30301-8

Cited by 168 publications

(145 citation statements)

References 16 publications

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“…As reported previously, the prevalence of group A meningococcal carriage was reduced substantially following the introduction of MenAfriVac â in Burkina Faso and Chad, and the impact on this vaccine on carriage is likely to have contributed to profound reductions in group A disease observed across the belt since MenAfriVac â roll-out [33].…”

Section: Discussionsupporting

confidence: 59%

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Greenwood

Aseffa

Caugant

et al. 2018

Tropical Med Int Health

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Objective To review the findings of studies of pharyngeal carriage of Neisseria meningitidis and related species conducted in the African meningitis belt since a previous review published in 2007. Methods PubMed and Web of Science were searched in July 2018 using the terms ‘meningococcal OR Neisseria meningitidis OR lactamica AND carriage AND Africa’, with the search limited to papers published on or after 1st January 2007. We conducted a narrative review of these publications. Results One hundred and thirteen papers were identified using the search terms described above, 20 of which reported new data from surveys conducted in an African meningitis belt country. These papers described 40 surveys conducted before the introduction of the group A meningococcal conjugate vaccine (MenAfriVacR) during which 66 707 pharyngeal swabs were obtained. Carriage prevalence of N. meningitidis varied substantially by time and place, ranging from <1% to 24%. The mean pharyngeal carriage prevalence of N. meningitidis across all surveys was 4.5% [95% CI: 3.4%, 6.8%] and that of capsulated N. meningitidis was 2.8% [95% CI: 1.9%; 5.2%]. A study of households provided strong evidence for meningococcal transmission within and outside households. The introduction of MenAfriVac® led to marked reductions in carriage of the serogroup A meningococcus in Burkina Faso and Chad. Conclusions Recent studies employing standardised methods confirm the findings of older studies that carriage of N. meningitidis in the African meningitis belt is highly variable over time and place, but generally occurs with a lower prevalence and shorter duration than reported from industrialised countries.

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Section: Discussionsupporting

confidence: 59%

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Greenwood

Aseffa

Caugant

et al. 2018

Tropical Med Int Health

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“…41 As an example of these organizations working together, we point to the development, licensure and introduction of MenAfriVac, the vaccine for meningococcal A disease in Africa's meningitis belt that has reduced the incidence of suspected meningitis and epidemic risk, and its effect on confirmed group A meningococcal meningitis. 42,43 Understanding the FPHVP of NTD vaccines is a necessary step when building the business case primarily because it provides information on the need and the geograhic and population burden. It also assists in setting the appropriate target product profile, product development and regulatory strategy and ultimately proposes the advocacy, policy and public health activities needed to ensure demand, adoption, and implementation practices.…”

Section: Institute Of Allergy and Infectious Diseases (Nih-niaid) Andmentioning

confidence: 99%

“Running the Gauntlet”: Formidable challenges in advancing neglected tropical diseases vaccines from development through licensure, and a “Call to Action”

Bottazzi

Hotez

2019

Human Vaccines & Immunotherapeutics

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Translational science for new biotechnologies (e.g. drugs, vaccines, devices, or diagnostics) depend on the development of a robust ‘business case’. This is driven by complex scientific, technical, logistical, financial and operational elements to determine the feasibility and probability of traversing the “valleys of death” leading to licensure. The potential results in terms of profitability and financial realization, called ‘product value proposition’ play a crucial role in establishing incentives for investment during and after development. With this review, our goal is to summarize the challenges in taking vaccines against neglected tropical diseases (NTDs) from development through licensure and provide a perspective that these vaccines can have measurable public health and economic profitability and market success. Understanding these processes and its challenges would open the opportunity to accelerate and advance these essential NTD vaccines through the last mile towards licensure and for the delivery to afflicted populations in low- and middle-income countries.

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“…These vaccines are, however, expensive and not affordable for low-income countries. Therefore, a monovalent conjugate serogroup A vaccine was produced and successfully introduced in large-scale vaccination campaigns in countries of the so-called "meningitis belt" of sub-Saharan Africa (Diomandé et al, 2015;Trotter et al, 2017), a region stretching from the Gambia and Senegal to Ethiopia (Molesworth et al, 2002). Prior to the vaccination campaigns that started in 2010, the overall incidence of meningococcal meningitis in the region was substantially higher than anywhere else in the world, and included epidemics that occurred in the winter months between every five and twelve years (Trotter and Greenwood, 2007).…”

mentioning

confidence: 99%

“…Prior to the vaccination campaigns that started in 2010, the overall incidence of meningococcal meningitis in the region was substantially higher than anywhere else in the world, and included epidemics that occurred in the winter months between every five and twelve years (Trotter and Greenwood, 2007). Though the vaccine has been very effective at controlling meningitis epidemics caused by serogroup A, the main cause of IMD in the meningitis belt (Diomandé et al, 2015;Trotter et al, 2017), other serogroups (C, W, and X) have emerged or expanded in the region, reducing the initial impact of the vaccine. There is also concern that virulent strains circulating in the population might switch capsule or that less virulent strains not covered by the current vaccine might acquire virulence genes (Bårnes et al, 2017;Brynildsrud et al, 2019).…”

mentioning

confidence: 99%

The effect of recombination on the evolution of a population ofNeisseria meningitidis

MacAlasdair

Pesonen

Brynildsrud

et al. 2020

Preprint

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Neisseria meningitidis (the meningococcus) is a major human pathogen with a history of high invasive disease burden, particularly in sub-Saharan Africa. Our current understanding of the evolution of meningococcal genomes is limited by the rarity of large-scale genomic population studies and lack of indepth investigation of the genomic events associated with routine pathogen transmission. Here we fill this knowledge gap by a detailed analysis of 2,839 meningococcal genomes obtained through a carriage study of over 50,000 samples collected systematically in Burkina Faso, West Africa, before, during, and after the serogroup A vaccine rollout, 2009-2012. Our findings indicate that the meningococcal genome is highly dynamic, with recombination hotspots and frequent gene sharing across deeply separated lineages in a structured population. Furthermore, our findings illustrate the profound effect of population structure on genome flexibility, with some lineages in Burkina Faso being orders of magnitude more recombinant than others. We also examine the effect of selection on the population, in particular how it is correlated with recombination. We find that recombination principally acts to prevent the accumulation of deleterious mutations, although we do also find an example of recombination acting to speed the adaptation of a gene. In general, we show the importance of recombination in the evolution of a geographically expansive population with deep population structure in a short timescale. This has important consequences for our ability to both foresee the outcomes of vaccination programmes and, using surveillance data, predict when lineages of the meningococcus are likely to become a public health concern. meningicoccus | recombination | bacteria | evolution Correspondence: nm12@sanger.ac.uk

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Impact of MenAfriVac in nine countries of the African meningitis belt, 2010–15: an analysis of surveillance data

Abstract: World Health Organization.

Cited by 168 publications

References 16 publications

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

“Running the Gauntlet”: Formidable challenges in advancing neglected tropical diseases vaccines from development through licensure, and a “Call to Action”

The effect of recombination on the evolution of a population ofNeisseria meningitidis

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