Consensus recommendation for meningococcal disease prevention in children and adolescents in the Middle East region

Parental Knowledge Toward Meningococcal Disease and Vaccination in Makkah Region, Saudi Arabia: A Cross-Sectional Study

Background Invasive meningococcal disease (IMD) is a bacterial infection caused by Neisseria meningitidis, which primarily affects the meninges, with a high incidence in young children. The most effective technique for preventing IMD is vaccination, which has been available for over 40 years through meningococcal polysaccharide capsule-containing vaccines. This study aims to assess the parental knowledge of meningococcal disease and vaccination in the Makkah region of Saudi Arabia. Methodology A cross-sectional study was conducted between September and December 2023 among 597 parents in the Makkah region using a validated online survey. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS). Results The study sample included 597 parents, of which 339 (56.8%) were female and 258 (43.2%) were male. Our research demonstrated that 388 (65%) participants had an insufficient understanding of IMD, while 209 (35%) had a sufficient understanding. There was a significant correlation between the knowledge score and the completion of the routine vaccination and whether vaccinating a child is essential for the protection of other members of society. Conclusions Based on our study, only around one-third of the participants demonstrated a sufficient level of knowledge regarding IMD and its vaccination. To provide a more accurate assessment of the Saudi population, additional research should be conducted in various regions and cities.

Meningococcal Disease and Immunization Activities in Hajj and Umrah Pilgrimage: a review

Invasive meningococcal disease (IMD) outbreaks associated with Hajj and Umrah pilgrimage events in the Kingdom of Saudi Arabia (KSA) are well recognized. Past outbreaks have been associated with substantial intercontinental spread of specific Neisseria meningitidis serogroups. The emergence of meningococcal serogroup W (MenW) was a global concern following the 2000/2001 Hajj outbreaks. Broader compulsory meningococcal serogroups A, C, W and Y (MenACWY) immunization strategies for pilgrims were introduced in response to these events and led to substantial declines in IMD cases associated with these mass gatherings. However, there remains potential for future outbreaks either within KSA during the Hajj or in local populations via pilgrim meningococcal transmission on their return. While the annual Hajj involves pilgrims from over 185 countries, two-thirds of these arrive from 13 countries, chiefly from across South-East Asia, the Middle East and North African (MENA) regions; for which we review the relevant epidemiology of IMD and meningococcal carriage. While disease surveillance is limited and data are often lacking, MenB is an important serogroup associated with IMD and carriage in a number of countries. Available literature suggests that most pilgrims receive polysaccharide MenACWY vaccines (which do not impact carriage and onward transmission) and incomplete compliance with visa/entry immunization regulations is reported. Existing preventative approaches for visiting pilgrims require continued oversight. More complete compliance and switching to the conjugated MenACWY vaccine can provide more robust and broader protection for pilgrims. Additional immunization options could also be considered.

Epidemiology of Meningitis in Oman-Implications for Future Surveillance

OBJECTIVES

This study aimed to understand the epidemiology of meningitis cases admitted to hospitals in Oman and to identify any changing microbial patterns from the introduction of the new vaccines.

METHODS

A retrospective analysis of all cases of meningitis reported through a national surveillance system. Meningitis is a notifiable disease.

RESULTS

Of a total of 581 cases of meningitis from the period between January 1, 2005 and December 31, 2013, 15% (88) were confirmed to be bacterial in origin and 7.2% (42/581) viral. In 50.9% (296) of patients with suspected pyogenic meningitis, no specific bacterial pathogen were identified, and in 26% of cases (151) a cerebrospinal fluid study could not be undertaken. Among 88 cases with confirmed bacterial pathogens the organisms identified were Streptococcus pneumoniae (65.9%), Neisseria meningitides (18.2%), Haemophilus influenzae (6.8%), and other organisms (9.1%). The peak incidence was in children <2 years of age (39.4%). It showed notable decline in H. influenzae cases as well as pneumococcal meningitis cases, possibly indicative of the successful immunization program.

CONCLUSION

A drop in H. Influenzae and pneumococcal meningitis cases was possibly the effect of the introduction of vaccines. It shows the need for improving diagnostic accuracy, laboratory capacities, and quality of surveillance reporting.

Challenges and opportunities for meningococcal vaccination in the developing world

Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.