Modelling meningococcal meningitis in the African meningitis belt

Abstract

SUMMARYMeningococcal meningitis is a major public health problem in a large area of sub-Saharan Africa known as the meningitis belt. Disease incidence increases every dry season, before dying out with the first rains of the year. Large epidemics, which can kill tens of thousands of people, occur frequently but unpredictably every 6-14 years. It has been suggested that these patterns may be attributable to complex interactions between the bacteria, human hosts and the environment. We used deterministic compartmental models to investigate how well simple model structures with seasonal forcing were able to qualitatively capture these patterns of disease. We showed that the complex and irregular timing of epidemics could be caused by the interaction of temporary immunity conferred by carriage of the bacteria together with seasonal changes in the transmissibility of infection. This suggests that population immunity is an important factor to include in models attempting to predict meningitis epidemics.

Bacterial Meningitis in Malawian Adults, Adolescents, and Children During the Era of Antiretroviral Scale-up and Haemophilus influenzae Type b Vaccination, 2000–2012

“…Meningitis is seasonal in many parts of the world [34]. A better understanding of these disease patterns and the potential climatic associations are important for public health planning and the interpretation of disease incidence.…”

“…A better understanding of these disease patterns and the potential climatic associations are important for public health planning and the interpretation of disease incidence. Malawi is geographically far from countries where epidemic meningitis primarily due to N. meningitidis, coincident with the hot, dry season has been described [34, 35]. In Malawi, pneumococcal and NTS meningitis were both seasonal over the last 10 years, peaking in the cold, dry and hot, wet seasons, respectively.…”

Seasonality of meningitis in Africa and climate forcing: aerosols stand out

“…Wavelet analyses were used here to explore the complexity of environmental and epidemiological signals before the modelling stage [31]. The current epidemiological [73] and forecasting [74] models for meningitis considered so far a theoretical seasonality of the meningitis transmission dynamics. We now suggest integrating dust data in these models to make them more realistic and usable in a public health perspective.…”

Spatio-Temporal Factors Associated with Meningococcal Meningitis Annual Incidence at the Health Centre Level in Niger, 2004–2010

“…Although difficult to collect retrospectively, these factors should be further investigated at the health centre level and at least properly accounted for in any modelling attempt. Mathematical models, still little developed on this topic [44], could also help us to better understand the role of carriage and immunity in the epidemic dynamics.…”