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Chen J, Jiao Z, Liang Z, Ma J, Xu M, Biswal S, Ramanathan M, Sun S, Zhang Z. Association between temperature variability and global meningitis incidence. ENVIRONMENT INTERNATIONAL 2023; 171:107649. [PMID: 36470121 DOI: 10.1016/j.envint.2022.107649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/23/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Meningitis can cause devastating epidemics and is susceptible to climate change. It is unclear how temperature variability, an indicator of climate change, is associated with meningitis incidence. METHODS We used global meningitis incidence data along with meteorological and demographic data over 1990-2019 to identify the association between temperature variability and meningitis. We also employed future (2020-2100) climate data to predict meningitis incidence under different emission levels (SSPs: Shared Socioeconomic Pathways). RESULTS We found that the mean temperature variability increased by almost 3 folds in the past 30 years. The largest changes occurred in Australasia, Tropical Latin America, and Central Sub-Saharan Africa. With a logarithmic unit increase in temperature variability, the overall global meningitis risk increases by 4.8 %. Australasia, Central Sub-Saharan Africa, and High-income North America are the most at-risk regions. Higher statistical differences were identified in males, children, and the elderly population. Compared to high-emission (SSP585) scenario, we predicted a median reduction of 85.8 % in meningitis incidence globally under the low-emission (SSP126) climate change scenario by 2100. CONCLUSION Our study provides evidence for temperature variability being in association with meningitis incidence, which suggests that global actions are urgently needed to address climate change and to prevent meningitis occurrence.
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Affiliation(s)
- Junjun Chen
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Zhihua Jiao
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zhisheng Liang
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Ming Xu
- Department of Global Health, Peking University School of Public Health, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Shyam Biswal
- Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, US
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Zhenyu Zhang
- Department of Global Health, Peking University School of Public Health, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.
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Mazamay S, Guégan JF, Diallo N, Bompangue D, Bokabo E, Muyembe JJ, Taty N, Vita TP, Broutin H. An overview of bacterial meningitis epidemics in Africa from 1928 to 2018 with a focus on epidemics "outside-the-belt". BMC Infect Dis 2021; 21:1027. [PMID: 34592937 PMCID: PMC8485505 DOI: 10.1186/s12879-021-06724-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bacterial meningitis occurs worldwide but Africa remains the most affected continent, especially in the "Meningitis belt" that extends from Senegal to Ethiopia. Three main bacteria are responsible for causing bacterial meningitis, i.e., N. meningitidis (Nm), S. pneumoniae and H. influenzae type b. Among Nm, serogroup A used to be responsible for up to 80 to 85% of meningococcal meningitis cases in Africa. Since 2000, other Nm serogroups including W, X and C have also been responsible for causing epidemics. This overview aims to describe the main patterns of meningitis disease cases and pathogens from 1928 to 2018 in Africa with a special focus on disease conditions “out-of-the-belt” area that is still usually unexplored. Based on basic spatio-temporal methods, and a 90-years database of reported suspected meningitis cases and death from the World Health Organization, we used both geographic information system and spatio-temporal statistics to identify the major localizations of meningitis epidemics over this period in Africa. Results Bacterial meningitis extends today outside its historical limits of the meningitis belt. Since the introduction of MenAfrivac vaccine in 2010, there has been a dramatic decrease in NmA cases while other pathogen species and Nm variants including NmW, NmC and Streptococcus pneumoniae have become more prevalent reflecting a greater diversity of bacterial strains causing meningitis epidemics in Africa today. Conclusion Bacterial meningitis remains a major public health problem in Africa today. Formerly concentrated in the region of the meningitis belt with Sub-Saharan and Sudanian environmental conditions, the disease extends now outside these historical limits to reach more forested regions in the central parts of the continent. With global environmental changes and massive vaccination targeting a unique serogroup, an epidemiological transition of bacterial meningitis is ongoing, requiring both a better consideration of the etiological nature of the responsible agents and of their proximal and distal determinants. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06724-1.
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Affiliation(s)
- Serge Mazamay
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo. .,MIVEGEC, Université de Montpellier, IRD, CNRS, 911 avenue Agropolis, BP 64501, 34394, Montpellier Cedex 5, France.
| | - Jean-François Guégan
- MIVEGEC, Université de Montpellier, IRD, CNRS, 911 avenue Agropolis, BP 64501, 34394, Montpellier Cedex 5, France.,ASTRE, INRAE, Cirad, Université de Montpellier, Campus international de Baillarguet, 34398, Montpellier Cedex 5, France
| | - Neby Diallo
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Didier Bompangue
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo.,Chrono-Environnement, UMR CNRS 6249 Université de Franche-Comté, Besançon, France
| | - Eric Bokabo
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Jacques Muyembe
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Nadège Taty
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Tonton Paul Vita
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Hélène Broutin
- MIVEGEC, Université de Montpellier, IRD, CNRS, 911 avenue Agropolis, BP 64501, 34394, Montpellier Cedex 5, France.,Département de Parasitologie-Mycologie, Faculté de Médecine, Université Cheikh Anta Diop (UCAD), Dakar, Sénégal.,Centre de Recherche en Ecologie et Evolution de la Santé (CREES), Montpellier, France
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Zunt JR, Kassebaum NJ, Blake N, Glennie L, Wright C, Nichols E, Abd-Allah F, Abdela J, Abdelalim A, Adamu AA, Adib MG, Ahmadi A, Ahmed MB, Aichour AN, Aichour I, Aichour MTE, Akseer N, Al-Raddadi RM, Alahdab F, Alene KA, Aljunid SM, AlMazroa MA, Altirkawi K, Alvis-Guzman N, Animut MD, Anjomshoa M, Ansha MG, Asghar RJ, Avokpaho EFGA, Awasthi A, Badali H, Barac A, Bärnighausen TW, Bassat Q, Bedi N, Belachew AB, Bhattacharyya K, Bhutta ZA, Bijani A, Butt ZA, Carvalho F, Castañeda-Orjuela CA, Chitheer A, Choi JYJ, Christopher DJ, Dang AK, Daryani A, Demoz GT, Djalalinia S, Do HP, Dubey M, Dubljanin E, Duken EE, El Sayed Zaki M, Elyazar IRF, Fakhim H, Fernandes E, Fischer F, Fukumoto T, Ganji M, Gebre AK, Gebremeskel A, Gessner BD, Gopalani SV, Guo Y, Gupta R, Hailu GB, Haj-Mirzaian A, Hamidi S, Hay SI, Henok A, Irvani SSN, Jha RP, JÜRISSON M, Kahsay A, Karami M, Karch A, Kasaeian A, Kassa GM, Kassa TDD, Kefale AT, Khader YS, Khalil IA, Khan EA, Khang YH, Khubchandani J, Kimokoti RW, Kisa A, Lami FH, Levi M, Li S, Loy CT, Majdan M, Majeed A, Mantovani LG, Martins-Melo FR, Mcalinden C, Mehta V, Melese A, Memish ZA, Mengistu DT, Mengistu G, Mestrovic T, Mezgebe HB, Miazgowski B, Milosevic B, Mokdad AH, Monasta L, Moradi G, Moraga P, Mousavi SM, Mueller UO, Murthy S, Mustafa G, Naghavi M, Naheed A, Naik G, Newton CRJ, Nirayo YL, Nixon MR, Ofori-Asenso R, Ogbo FA, Olagunju AT, Olagunju TO, Olusanya BO, Ortiz JR, Owolabi MO, Patel S, Pinilla-Monsalve GD, Postma MJ, Qorbani M, Rafiei A, Rahimi-Movaghar V, Reiner RC, Renzaho AM, Rezai MS, Roba KT, Ronfani L, Roshandel G, Rostami A, Safari H, Safari S, Safiri S, Sagar R, Samy AM, Santric Milicevic MM, Sartorius B, Sarvi S, Sawhney M, Saxena S, Shafieesabet A, Shaikh MA, Sharif M, Shigematsu M, Si S, Skiadaresi E, Smith M, Somayaji R, Sufiyan MB, Tawye NY, Temsah MH, Tortajada-Girbés M, Tran BX, Tran KB, Ukwaja KN, Ullah I, Vujcic IS, Wagnew FS, Waheed Y, Weldegwergs KG, Winkler AS, Wiysonge CS, Wiyeh AB, Wyper GM, Yimer EM, Yonemoto N, Zaidi Z, Zenebe ZM, Feigin VL, Vos T, Murray CJL. Global, regional, and national burden of meningitis, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2018; 17:1061-1082. [PMID: 30507391 PMCID: PMC6234314 DOI: 10.1016/s1474-4422(18)30387-9] [Citation(s) in RCA: 217] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/24/2018] [Accepted: 10/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Acute meningitis has a high case-fatality rate and survivors can have severe lifelong disability. We aimed to provide a comprehensive assessment of the levels and trends of global meningitis burden that could help to guide introduction, continuation, and ongoing development of vaccines and treatment programmes. METHODS The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study estimated meningitis burden due to one of four types of cause: pneumococcal, meningococcal, Haemophilus influenzae type b, and a residual category of other causes. Cause-specific mortality estimates were generated via cause of death ensemble modelling of vital registration and verbal autopsy data that were subject to standardised data processing algorithms. Deaths were multiplied by the GBD standard life expectancy at age of death to estimate years of life lost, the mortality component of disability-adjusted life-years (DALYs). A systematic analysis of relevant publications and hospital and claims data was used to estimate meningitis incidence via a Bayesian meta-regression tool. Meningitis deaths and cases were split between causes with meta-regressions of aetiological proportions of mortality and incidence, respectively. Probabilities of long-term impairment by cause of meningitis were applied to survivors and used to estimate years of life lived with disability (YLDs). We assessed the relationship between burden metrics and Socio-demographic Index (SDI), a composite measure of development based on fertility, income, and education. FINDINGS Global meningitis deaths decreased by 21·0% from 1990 to 2016, from 403 012 (95% uncertainty interval [UI] 319 426-458 514) to 318 400 (265 218-408 705). Incident cases globally increased from 2·50 million (95% UI 2·19-2·91) in 1990 to 2·82 million (2·46-3·31) in 2016. Meningitis mortality and incidence were closely related to SDI. The highest mortality rates and incidence rates were found in the peri-Sahelian countries that comprise the African meningitis belt, with six of the ten countries with the largest number of cases and deaths being located within this region. Haemophilus influenzae type b was the most common cause of incident meningitis in 1990, at 780 070 cases (95% UI 613 585-978 219) globally, but decreased the most (-49·1%) to become the least common cause in 2016, with 397 297 cases (291 076-533 662). Meningococcus was the leading cause of meningitis mortality in 1990 (192 833 deaths [95% UI 153 358-221 503] globally), whereas other meningitis was the leading cause for both deaths (136 423 [112 682-178 022]) and incident cases (1·25 million [1·06-1·49]) in 2016. Pneumococcus caused the largest number of YLDs (634 458 [444 787-839 749]) in 2016, owing to its more severe long-term effects on survivors. Globally in 2016, 1·48 million (1·04-1·96) YLDs were due to meningitis compared with 21·87 million (18·20-28·28) DALYs, indicating that the contribution of mortality to meningitis burden is far greater than the contribution of disabling outcomes. INTERPRETATION Meningitis burden remains high and progress lags substantially behind that of other vaccine-preventable diseases. Particular attention should be given to developing vaccines with broader coverage against the causes of meningitis, making these vaccines affordable in the most affected countries, improving vaccine uptake, improving access to low-cost diagnostics and therapeutics, and improving support for disabled survivors. Substantial uncertainty remains around pathogenic causes and risk factors for meningitis. Ongoing, active cause-specific surveillance of meningitis is crucial to continue and to improve monitoring of meningitis burdens and trends throughout the world. FUNDING Bill & Melinda Gates Foundation.
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Munguambe AM, de Almeida AECC, Nhantumbo AA, Come CE, Zimba TF, Paulo Langa J, de Filippis I, Gudo ES. Characterization of strains of Neisseria meningitidis causing meningococcal meningitis in Mozambique, 2014: Implications for vaccination against meningococcal meningitis. PLoS One 2018; 13:e0197390. [PMID: 30089105 PMCID: PMC6082507 DOI: 10.1371/journal.pone.0197390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/01/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In sub Saharan Africa, the epidemiology, including the distribution of serogroups of strains of N. meningitidis is poorly investigated in countries outside "the meningitis belt". This study was conducted with the aim to determine the distribution of serogroups of strains of N. meningitidis causing meningococcal meningitis in children and adults in Mozambique. METHODS A total of 106 PCR confirmed Neisseria meningitidis Cerebrospinal Fluid (CSF) samples or isolates were obtained from the biobank of acute bacterial meningitis (ABM) surveillance being implemented by the National Institute of Health, at three central hospitals in Mozambique, from January to December 2014. Serogroups of N. meningitidis were determined using conventional PCR, targeting siaD gene for Neisseria meningitidis. Outer Membrane Proteins (OMP) Genotyping was performed by amplifying porA gene in nine samples. RESULTS Of the 106 PCR confirmed Neisseria meningitidis samples, the most frequent serotype was A (50.0%, 53/106), followed by W/Y (18.9%, 20/106), C (8.5%, 9/106), X (7.5%, 8/106) and B (0.9%, 1/106). We found non-groupable strains in a total of 15 (14.2%) samples. PorA genotypes from nine strains showed expected patterns with the exception of two serogroup C strains with P1.19,15,36 and P1.19-36,15 and one serogroup X with P1.19,15,36, variants frequently associated to serogroup B. CONCLUSION Our data shows that the number of cases of meningococcal meningitis routinely reported in central hospitals in Mozambique is significant and the most dominant serogroup is A. In conclusion, although serogroup A has almost been eliminated from the "meningitis belt", this serogroup remains a major concern in countries outside the belt such as Mozambique.
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Affiliation(s)
- Alcides Moniz Munguambe
- Microbiology Laboratory, National Institute of Health, Ministry of Health, Maputo, Mozambique
| | | | - Aquino Albino Nhantumbo
- Microbiology Laboratory, National Institute of Health, Ministry of Health, Maputo, Mozambique
| | | | | | - José Paulo Langa
- Microbiology Laboratory, National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Ivano de Filippis
- Laboratory of Reference Microorganisms, National Institute of Quality Control of Health (INCQS); Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Eduardo Samo Gudo
- National Institute of Health, Ministry of Health, Maputo, Mozambique
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Hagar Y, Hayden M, Wiedinmyer C, Dukic V. Comparison of Models Analyzing a Small Number of Observed Meningitis Cases in Navrongo, Ghana. JOURNAL OF AGRICULTURAL, BIOLOGICAL, AND ENVIRONMENTAL STATISTICS 2017; 22:76-104. [PMID: 38178919 PMCID: PMC10766423 DOI: 10.1007/s13253-016-0270-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/17/2016] [Indexed: 01/06/2024]
Abstract
The "meningitis belt" is a region in sub-Saharan Africa where annual outbreaks of meningitis occur, with epidemics observed cyclically. While we know that meningitis is heavily dependent on seasonal trends, the exact pathways for contracting the disease are not fully understood and warrant further investigation. Most previous approaches have used large sample inference to assess impacts of weather on meningitis rates. However, in the case of rare events, the validity of such assumptions is uncertain. This work examines the meningitis trends in the context of rare events, with the specific objective of quantifying the underlying seasonal patterns in meningitis rates. We compare three main classes of models: the Poisson generalized linear model, the Poisson generalized additive model, and a Bayesian hazard model extended to accommodate count data and a changing at-risk population. We compare the accuracy and robustness of the models through the bias, RMSE, and standard deviation of the estimators, and also provide a detailed case study of meningitis patterns for data collected in Navrongo, Ghana.
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Affiliation(s)
- Y Hagar
- Applied Mathematics, University of Colorado at Boulder, Boulder, Colorado, USA
| | - M Hayden
- National Center of Atmospheric Research (NCAR), Boulder, Colorado, USA
| | - C Wiedinmyer
- National Center of Atmospheric Research (NCAR), Boulder, Colorado, USA
| | - V Dukic
- Applied Mathematics, University of Colorado at Boulder, Boulder, Colorado, USA
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Larocca A, Moro Visconti R, Marconi M. Malaria diagnosis and mapping with m-Health and geographic information systems (GIS): evidence from Uganda. Malar J 2016; 15:520. [PMID: 27776516 PMCID: PMC5075756 DOI: 10.1186/s12936-016-1546-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 10/05/2016] [Indexed: 11/17/2022] Open
Abstract
Background Rural populations experience several barriers to accessing clinical facilities for malaria diagnosis. Increasing penetration of ICT and mobile-phones and subsequent m-Health applications can contribute overcoming such obstacles. Methods GIS is used to evaluate the feasibility of m-Health technologies as part of anti-malaria strategies. This study investigates where in Uganda: (1) malaria affects the largest number of people; (2) the application of m-Health protocol based on the mobile network has the highest potential impact. Results About 75% of the population affected by Plasmodium falciparum malaria have scarce access to healthcare facilities. The introduction of m-Health technologies should be based on the 2G protocol, as 3G mobile network coverage is still limited. The western border and the central-Southeast are the regions where m-Health could reach the largest percentage of the remote population. Six districts (Arua, Apac, Lira, Kamuli, Iganga, and Mubende) could have the largest benefit because they account for about 28% of the remote population affected by falciparum malaria with access to the 2G mobile network. Conclusions The application of m-Health technologies could improve access to medical services for distant populations. Affordable remote malaria diagnosis could help to decongest health facilities, reducing costs and contagion. The combination of m-Health and GIS could provide real-time and geo-localized data transmission, improving anti-malarial strategies in Uganda. Scalability to other countries and diseases looks promising.
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Affiliation(s)
| | | | - Michele Marconi
- Research and Consulting GIS, Natural Resources Management, Marine Ecology, Disaster Risk Reduction, Hue, Vietnam
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Cibrelus L, Lingani C, Fernandez K, Djingarey MH, Perea WA, Hugonnet S. Risk Assessment and Meningococcal A Conjugate Vaccine Introduction in Africa: The District Prioritization Tool. Clin Infect Dis 2016; 61 Suppl 5:S442-50. [PMID: 26553673 PMCID: PMC4639508 DOI: 10.1093/cid/civ671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A group A meningococcal (MenA) conjugate vaccine has progressively been introduced in the African meningitis belt since 2010. A country-wide risk assessment tool, the District Prioritization Tool (DPT), was developed to help national stakeholders combine existing data and local expertise to define priority geographical areas where mass vaccination campaigns should be conducted. METHODS DPT uses an Excel-supported offline tool that was made available to the countries proposed for immunization campaigns. It used quantitative-qualitative methods, relying predominantly on evidence-based risk scores complemented by expert opinion. RESULTS DPT was used by most of the countries that introduced the group A conjugate vaccine. Surveillance data enabled the computation of severity scores for meningitis at the district level (magnitude, intensity, and frequency). District data were scaled regionally to facilitate phasing decisions. DPT also assessed the country's potential to conduct efficient preventive immunization campaigns while paying close attention to the scope of the geographic extension of the campaigns. The tool generated meningitis district profiles that estimated the number of vaccine doses needed. In each assessment, local meningitis experts contributed their knowledge of local risk factors for meningitis epidemics to refine the final prioritization decisions. CONCLUSIONS DPT proved to be a useful and flexible tool that codified information and streamlined discussion among stakeholders while facilitating vaccine distribution decisions after 2011. DPT methodology may be tailored to prioritize vaccine interventions for other diseases.
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Affiliation(s)
- Laurence Cibrelus
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - Clément Lingani
- Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Katya Fernandez
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - Mamoudou H Djingarey
- Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - William A Perea
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - Stéphane Hugonnet
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
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Codjoe SNA, Nabie VA. Climate change and cerebrospinal meningitis in the Ghanaian meningitis belt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6923-39. [PMID: 25003550 PMCID: PMC4113853 DOI: 10.3390/ijerph110706923] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 06/19/2014] [Accepted: 06/24/2014] [Indexed: 11/16/2022]
Abstract
Cerebrospinal meningitis (CSM) is one of the infectious diseases likely to be affected by climate change. Although there are a few studies on the climate change-CSM nexus, none has considered perceptions of community members. However, understanding public perception in relation to a phenomenon is very significant for the design of effective communication and mitigation strategies as well as coping and adaptation strategies. This paper uses focus group discussions (FGDs) to fill this knowledge lacuna. Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to CSM infections during FGDs, majority of participants rightly linked CSM infections to dry, very hot and dusty conditions experienced during the dry season. Finally, community members use a suite of adaptation options to curb future CSM epidemics.
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Affiliation(s)
- Samuel Nii Ardey Codjoe
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana.
| | - Vivian Adams Nabie
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana.
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Dukić V, Hayden M, Hopson T, Monaghan A, Adams Forgor A, Akweongo P, Hodgson A, Wiedinmyer C, Yoksas T, Pandya R, Thomson MC, Trzaska S. The Role of Weather in Meningitis Outbreaks in Navrongo, Ghana: A Generalized Additive Modeling Approach. JOURNAL OF AGRICULTURAL, BIOLOGICAL, AND ENVIRONMENTAL STATISTICS 2012; 17:442-460. [PMID: 38179552 PMCID: PMC10766424 DOI: 10.1007/s13253-012-0095-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Bacterial (meningococcal) meningitis is a devastating infectious disease with outbreaks occurring annually during the dry season in locations within the 'Meningitis Belt', a region in sub-Saharan Africa stretching from Ethiopia to Senegal. Meningococcal meningitis occurs from December to May in the Sahel with large epidemics every 5-10 years and attack rates of up to 1000 infections per 100,000 people. High temperatures coupled with low humidity may favor the conversion of carriage to disease as the meningococcal bacteria in the nose and throat are better able to cross the mucosal membranes into the blood stream. Similarly, respiratory diseases such as influenza and pneumonia might weaken the immune defenses and add to the mucosa damage. Although the transmission dynamics are poorly understood, outbreaks regularly end with the onset of the rainy season and may begin anew with the following dry season. In this paper, we employ a generalized additive modeling approach to assess the association between number of reported meningitis cases and a set of weather variables (relative humidity, rain, wind, sunshine, maximum and minimum temperature). The association is adjusted for air quality (dust, carbon monoxide), as well as varying degrees of unobserved time-varying confounding processes that co-vary with both the disease incidence and weather. We present the analysis of monthly reported meningitis counts in Navrongo, Ghana, from 1998-2008.
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Affiliation(s)
- Vanja Dukić
- Department of Applied Mathematics, University of Colorado, Boulder, CO, USA
| | - Mary Hayden
- National Center for Atmospheric Research, Boulder, CO, USA
| | - Tom Hopson
- National Center for Atmospheric Research, Boulder, CO, USA
| | | | | | | | | | | | - Tom Yoksas
- University Corporation for Atmospheric Research, Boulder, CO, USA
| | - Raj Pandya
- University Corporation for Atmospheric Research, Boulder, CO, USA
| | - Madeleine C Thomson
- The International Research Institute, Columbia University, New York City, NY, USA
| | - Sylwia Trzaska
- The International Research Institute, Columbia University, New York City, NY, USA
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Ibarz-Pavón AB, Morais L, Sigaúque B, Mandomando I, Bassat Q, Nhacolo A, Quintó L, Soriano-Gabarró M, Alonso PL, Roca A. Epidemiology, molecular characterization and antibiotic resistance of Neisseria meningitidis from patients ≤15 years in Manhiça, rural Mozambique. PLoS One 2011; 6:e19717. [PMID: 21695194 PMCID: PMC3112148 DOI: 10.1371/journal.pone.0019717] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 04/14/2011] [Indexed: 11/19/2022] Open
Abstract
Background The epidemiology of meningococcal disease in Mozambique and other African countries located outside the “meningitis belt” remains widely unknown. With the event of upcoming vaccines microbiological and epidemiological information is urgently needed. Methods Prospective surveillance for invasive bacterial infections was conducted at the Manhiça District hospital (rural Mozambique) among hospitalized children below 15 years of age. Available Neisseria meningitidis isolates were serogrouped and characterized by Multilocus Sequence Typing (MLST). Antibiotic resistance was also determined. Results Between 1998 and 2008, sixty-three cases of confirmed meningococcal disease (36 meningitis, 26 sepsis and 1 conjunctivitis) were identified among hospitalized children. The average incidence rate of meningococcal disease was 11.6/100,000 (8/100,000 for meningitis and 3.7/100,000 for meningococcemia, respectively). There was a significant rise on the number of meningococcal disease cases in 2005–2006 that was sustained till the end of the surveillance period. Serogroup was determined for 43 of the 63 meningococcal disease cases: 38 serogroup W-135, 3 serogroup A and 2 serogroup Y. ST-11 was the most predominant sequence type and strongly associated with serogroup W-135. Two of the three serogroup A isolates were ST-1, and both serogroup Y isolates were ST-175. N. meningitidis remained highly susceptible to all antibiotics used for treatment in the country, although the presence of isolates presenting intermediate resistance to penicillin advocates for continued surveillance. Conclusions Our data show a high rate of meningococcal disease in Manhiça, Mozambique, mainly caused by serogroup W-135 ST-11 strains, and advocates for the implementation of a vaccination strategy covering serogroup W-135 meningococci in the country.
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Affiliation(s)
- Ana Belén Ibarz-Pavón
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (ABI); (AR)
| | - Luis Morais
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Betuel Sigaúque
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- Instituto Nacional de Saúde, Ministerio de Saúde, Maputo, Mozambique
| | - Quique Bassat
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Ariel Nhacolo
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Llorenç Quintó
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
| | | | - Pedro L. Alonso
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
| | - Anna Roca
- Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique
- * E-mail: (ABI); (AR)
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Sinclair D, Preziosi MP, Jacob John T, Greenwood B. The epidemiology of meningococcal disease in India. Trop Med Int Health 2010; 15:1421-35. [PMID: 21054695 DOI: 10.1111/j.1365-3156.2010.02660.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To undertake a review of the literature on the epidemiology of meningococcal disease in India, with a view to informing future control policies. METHODS We searched the PUBMED, EMBASE, Global Health, IMSEAR and MedIND databases for observational studies relating to the burden of endemic meningococcal disease in India, the occurrence and epidemiological characteristics of epidemics, and the prevalence of individual meningococcal serogroups. RESULTS The relatively few reports identified suggest that the incidence of endemic meningococcal disease in India is low, but that occasional epidemics of meningococcal disease have been recorded for at least 100 years. The larger epidemics have affected mainly the cities of northern India and have almost universally been caused by meningococci belonging to serogroup A. These epidemics have showed a few characteristics, including a marked seasonality, which are similar to those of epidemic meningococcal A disease in Africa. CONCLUSIONS New serogroup A-containing meningococcal conjugate vaccines are now being developed and reaching the market, including an affordable monovalent serogroup A vaccine manufactured in India, but intended primarily for use in Africa. These new tools may have a role in containing future Indian epidemics, but their usefulness is dependent on early identification of epidemics. This will require a functional disease surveillance system with adequate laboratory support throughout India.
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Affiliation(s)
- David Sinclair
- The South Asian Cochrane Centre, Christian Medical College, Vellore, India.
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13
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Palmgren H. Meningococcal disease and climate. Glob Health Action 2009; 2. [PMID: 20052424 PMCID: PMC2799239 DOI: 10.3402/gha.v2i0.2061] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 09/21/2009] [Accepted: 09/22/2009] [Indexed: 11/25/2022] Open
Affiliation(s)
- Helena Palmgren
- Department of Infectious Diseases, Umeå University, Umeå, Sweden
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14
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Thomson MC, Jeanne I, Djingarey M. Dust and epidemic meningitis in the Sahel: A public health and operational research perspective. ACTA ACUST UNITED AC 2009. [DOI: 10.1088/1755-1307/7/1/012017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yaka P, Sultan B, Broutin H, Janicot S, Philippon S, Fourquet N. Relationships between climate and year-to-year variability in meningitis outbreaks: a case study in Burkina Faso and Niger. Int J Health Geogr 2008; 7:34. [PMID: 18597686 PMCID: PMC2504476 DOI: 10.1186/1476-072x-7-34] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 07/02/2008] [Indexed: 11/28/2022] Open
Abstract
Background Every year, West Africa is afflicted with Meningococcal Meningitis (MCM) disease outbreaks. Although the seasonal and spatial patterns of disease cases have been shown to be linked to climate, the mechanisms responsible for these patterns are still not well identified. Results A statistical analysis of annual incidence of MCM and climatic variables has been performed to highlight the relationships between climate and MCM for two highly afflicted countries: Niger and Burkina Faso. We found that disease resurgence in Niger and in Burkina Faso is likely to be partly controlled by the winter climate through enhanced Harmattan winds. Statistical models based only on climate indexes work well in Niger showing that 25% of the disease variance from year-to-year in this country can be explained by the winter climate but fail to represent accurately the disease dynamics in Burkina Faso. Conclusion This study is an exploratory attempt to predict meningitis incidence by using only climate information. Although it points out significant statistical results it also stresses the difficulty of relating climate to interannual variability in meningitis outbreaks.
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Affiliation(s)
- Pascal Yaka
- ProdiG, UMR 8586, 2 rue Valette, 75005, Paris, France.
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Nelson CB, Birmingham M, Costa A, Daviaud J, Perea W, Kieny MP, Tarantola D. Preparedness for infectious threats: public-private partnership to develop an affordable vaccine for an emergent threat: the trivalent Neisseria meningitidis ACW135 polysaccharide vaccine. Am J Public Health 2007; 97 Suppl 1:S15-22. [PMID: 17413077 PMCID: PMC1854992 DOI: 10.2105/ajph.2005.075085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2006] [Indexed: 10/23/2022]
Abstract
With the emergence of epidemic Neisseria meningitidis W135 meningitis in Burkina Faso during early 2002, the public health community was faced with the challenge of providing access to an appropriate and affordable vaccine in time for the upcoming 2003 epidemic season. Recognizing the implications of the emergent threat, the World Health Organization developed a strategy, established a public-private partnership to provide the needed vaccine, and then ensured that a stockpile was available for future use. The trivalent N meningitidis ACW135 polysaccharide vaccine that resulted is now one of the primary tools for epidemic response in African meningitis belt countries. It will remain so for the foreseeable future and until appropriate and affordable conjugate vaccines become part of national immunization programs in the region.
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Affiliation(s)
- Christopher B Nelson
- Department of Immunizations, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
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