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Alhazmi AH, Alameer KM, Abuageelah BM, Gharawi AY, Hakami EF, Zogel TA, Almalki AJ, Magrashi EG, Alharbi WA, Manni RM, Buayti AA, Alharbi AA, Dhayhi NS, Haddad M. Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study. Eur J Clin Microbiol Infect Dis 2024; 43:1383-1392. [PMID: 38683272 DOI: 10.1007/s10096-024-04835-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Bacterial meningitis poses significant medical challenges due to its acute inflammatory nature and potential for severe neurological complications, emphasizing the need for prompt diagnosis and treatment. Limited data exists on its epidemiology and antimicrobial resistance trends among hospitalized patients in Saudi Arabia. This study aimed to investigate these factors at a tertiary care hospital over six years. METHODS A retrospective analysis was conducted on cerebrospinal fluid samples results from 222 bacterial meningitis cases among hospitalized patients between 2018 and 2023. Demographic, clinical, microbiological data, and antibiotic susceptibility patterns were collected and analyzed. RESULTS Pseudomonas aeruginosa (43%) was the predominant pathogen isolated. Neonates (16%) and children (47%) were most affected population. Nosocomial meningitis accounted for 92% of cases, mainly in the intensive care settings (50.45%). Extended-spectrum beta-lactamase was the leading resistance pattern (12.2%). Seasonal variation was observed, with a peak incidence in October-November. CONCLUSION The study highlights the substantial burden of bacterial meningitis among hospitalized patients, especially among high-risk groups. Emerging antimicrobial resistance emphasizes the need for optimized surveillance and stewardship. Future prospective research employing molecular techniques across multiple centers in the country is warranted to enhance understanding and guide public health strategies in Saudi Arabia.
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Affiliation(s)
| | - Khalid M Alameer
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Bandar M Abuageelah
- Department of Medicine and Surgery, Batterjee Medical College, Aseer, 62451, Saudi Arabia
| | | | | | - Taif Ali Zogel
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | | | | | - Wafa Ali Alharbi
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | | | | | - Ahmad A Alharbi
- Faculty of Medicine, Jazan University, Jazan, 45142, Saudi Arabia
| | - Nabil S Dhayhi
- King Fahad Central Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Moayad Haddad
- King Fahad Central Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
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Khaleel HA, Alhilfi RA, Rawaf S, Atwan Z, Al-Alwany AA, Raheem M, Tabche C. Determining the bacterial and viral meningitis trend in Iraq from 2007 till 2023 using joinpoint regression. Heliyon 2024; 10:e30088. [PMID: 38707473 PMCID: PMC11066402 DOI: 10.1016/j.heliyon.2024.e30088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Background Acute meningitis is a disease with case fatality and disability rate that is dependent on the causative agent. Objective Determine the meningitis trend in Iraq from 2007 to 2023 using a joinpoint regression at national and sub-national levels and describe the epidemiology. Methods Joinpoint regression model was used on surveillance data from Jan 2007 until May 2023, to calculate annual and average annual percent changes to determine the trend. Meningitis total count was modelled by year of reporting and province using the log transformation and Poisson variance. Best-fit model was chosen based on the weighted BIC criteria as the final point. Results Bacterial meningitis was higher than viral meningitis from 2007 to 2018, then viral meningitis started to exceed till 2023. Meningococcal meningitis was lower than other bacterial and viral meningitis from 2007 to 2023. Most meningitis cases across the years were lower than 15 years, at almost 80 %, while 20 %-40 % were lower than one year. Across all years, 55 % of the cases were males; apart from 2019, 70 % were females. Conclusion In Iraq, viral meningitis has been the predominant type since 2018. Most meningitis patients were lower than 15-year-old males. The meningitis trend in Iraq was stable from 2007 till 2023.
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Affiliation(s)
| | | | - Salman Rawaf
- WHO Collaborating Centre, Department of Primary Care and Public Health, Imperial College London, UK
| | - Zeenah Atwan
- Virology, Faculty of Medicine, University of Basrah, Iraq
| | | | - Mays Raheem
- WHO Collaborating Centre, Department of Primary Care and Public Health, Imperial College London, UK
| | - Celine Tabche
- WHO Collaborating Centre, Department of Primary Care and Public Health, Imperial College London, UK
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Oduoye MO, Akanbi-Hakeem HB, Muzammil MA, Arama UO, Abbasi HQ, Farhan K, Fariha FNU, Modupeoluwa OO, Paul HW, Badarou ADE, Akilimali A. Meningitis in Niger Republic amidst COVID-19: current issues and novel recommendations. Ann Med Surg (Lond) 2024; 86:345-352. [PMID: 38222679 PMCID: PMC10783331 DOI: 10.1097/ms9.0000000000001511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/05/2023] [Indexed: 01/16/2024] Open
Abstract
Amidst coronavirus disease 2019 (COVID-19), there has been a misplaced priority on meningitis in the Niger Republic, thus refocusing resources and attention away from the continuing meningitis campaign in the Niger Republic. The over-strained state of public health resources and staff has also led to decreased surveillance, postponed diagnoses, and constrained immunization efforts in Niger Republic. This review aims to bridge the gaps regarding meningitis amid COVID-19 in Niger Republic and offer recommendations to government to mitigate meningitis in the country, with the hope of finding a permanent solution to this debilitating disease. The authors reviewed 45 past and present pieces of literature on meningitis and COVID-19 from 2013 to 2023 in well-renowned scientific databases such as PubMed, ResearchGate, Google Scholar, African Journals Online, Medline, and Embase. Since 2015, Niger Republic has experienced multiple meningitis epidemics that have resulted in 20, 789 cases and 1, 369 deaths [a case fatality rate (CFR) of 6.6%]. A total of 231 cases of meningitis were reported from 1 November 2021 to 31 January 2022. And recently, 559 cases of meningitis (of which 111 are laboratory confirmed), including 18 deaths (overall CFR 3.2%), occurred in the Zinder region, southeast of Niger Republic, from 1 November 2022 to 27 January 2023. Meningitis remains a public health concern in the world, especially in Niger Republic, which could lead to serious long-term complications. Therefore, adequate and novel measures and therapeutic actions should be implemented by the Niger Government to lessen the burden of the disease in the country.
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Affiliation(s)
- Malik Olatunde Oduoye
- Ahmadu Bello University, Zaria, Kaduna State
- Department of Research, Medical Research Circle, Bukavu
| | | | | | | | | | - Kanza Farhan
- Medical College, Jinnah Sindh Medical University, Karachi
| | | | | | - Houessou W. Paul
- Faculty of Health Sciences of Andre Salifou Zinder University, Niger Republic
| | - Achiraf-deen E. Badarou
- Department of General Medicine, FSS-Cotonou, Association of Medical Students of Cotonou, Cotonou, Littoral, Benin
| | - Aymar Akilimali
- Department of Research, Medical Research Circle, Bukavu
- Faculty of Medicine, University of Goma, Goma, Democratic Republic of Congo
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Wunrow HY, Bender RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, Gray AP, Ikuta KS, Sharara F, Wool EE, Aali A, Abd-Elsalam S, Abdollahi A, Abdul Aziz JM, Abidi H, Aboagye RG, Abolhassani H, Abu-Gharbieh E, Adamu LH, Adane TD, Addo IY, Adegboye OA, Adekiya TA, Adnan M, Adnani QES, Afzal S, Aghamiri S, Aghdam ZB, Agodi A, Ahinkorah BO, Ahmad A, Ahmad S, Ahmadzade M, Ahmed A, Ahmed A, Ahmed JQ, Ahmed MS, Akinosoglou K, Aklilu A, Akonde M, Alahdab F, AL-Ahdal TMA, Alanezi FM, Albelbeisi AH, Alemayehu TBB, Alene KA, Al-Eyadhy A, Al-Gheethi AAS, Ali A, Ali BA, Ali L, Ali SS, Alimohamadi Y, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Alvis-Guzman N, Al-Worafi YM, Aly H, Ameyaw EK, Ancuceanu R, Ansar A, Ansari G, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Artamonov AA, Arulappan J, Aruleba RT, Asaduzzaman M, Atalell KA, Athari SS, Atlaw D, Atout MMW, Attia S, Awoke T, Ayalew MK, Ayana TM, Ayele AD, Azadnajafabad S, Azizian K, Badar M, Badiye AD, Baghcheghi N, Bagheri M, Bagherieh S, Bahadory S, Baig AA, Barac A, Barati S, Bardhan M, Basharat Z, Bashiri A, Basnyat B, Bassat Q, Basu S, Bayileyegn NS, Bedi N, Behnoush AH, Bekel AA, Belete MA, Bello OO, Bhagavathula AS, Bhandari D, Bhardwaj P, Bhaskar S, Bhat AN, Bijani A, Bineshfar N, Boloor A, Bouaoud S, Buonsenso D, Burkart K, Cámera LA, Castañeda-Orjuela CA, Cernigliaro A, Charan J, Chattu VK, Ching PR, Chopra H, Choudhari SG, Christopher DJ, Chu DT, Couto RAS, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Das S, Dash NR, Dashti M, De la Hoz FP, Debela SA, Dejen D, Dejene H, Demeke D, Demeke FM, Demessa BH, Demetriades AK, Demissie S, Dereje D, Dervišević E, Desai HD, Dessie AM, Desta F, Dhama K, Djalalinia S, Do TC, Dodangeh M, Dodangeh M, Dominguez RMV, Dongarwar D, Dsouza HL, Durojaiye OC, Dziedzic AM, Ekat MH, Ekholuenetale M, Ekundayo TC, El Sayed Zaki M, El-Abid H, Elhadi M, El-Hajj VG, El-Huneidi W, El-Sakka AA, Esayas HL, Fagbamigbe AF, Falahi S, Fares J, Fatehizadeh A, Fatima SAF, Feasey NA, Fekadu G, Fetensa G, Feyissa D, Fischer F, Foroutan B, Gaal PA, Gadanya MA, Gaipov A, Ganesan B, Gebrehiwot M, Gebrekidan KG, Gebremeskel TG, Gedef GM, Gela YY, Gerema U, Gessner BD, Getachew ME, Ghadiri K, Ghaffari K, Ghamari SH, Ghanbari R, Ghazy RMM, Ghozali G, Gizaw ABAB, Glushkova EV, Goldust M, Golechha M, Guadie HA, Guled RA, Gupta M, Gupta S, Gupta VB, Gupta VK, Gupta VK, Hadi NR, Haj-Mirzaian A, Haller S, Hamidi S, Haque S, Harapan H, Hasaballah AI, Hasan I, Hasani H, Hasanian M, Hassankhani H, Hassen MB, Hayat K, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Hezam K, Holla R, Horita N, Hossain MM, Hosseini MS, Hosseinzadeh M, Hostiuc S, Hussain S, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Iregbu KC, Ismail NE, Iwu CCD, Jaja C, Jakovljevic M, Jamshidi E, Javadi Mamaghani A, Javidnia J, Jokar M, Jomehzadeh N, Joseph N, Joshua CE, Jozwiak JJ, Kabir Z, Kalankesh LR, Kalhor R, Kamal VK, Kandel H, Karaye IM, Karch A, Karimi H, Kaur H, Kaur N, Keykhaei M, Khajuria H, Khalaji A, Khan A, Khan IA, Khan M, Khan T, Khatab K, Khatatbeh MM, Khayat Kashani HR, Khubchandani J, Kim MS, Kisa A, Kisa S, Kompani F, Koohestani HR, Kothari N, Krishan K, Krishnamoorthy Y, Kulimbet M, Kumar M, Kumaran SD, Kuttikkattu A, Kwarteng A, Laksono T, Landires I, Laryea DO, Lawal BK, Le TTT, Ledda C, Lee SW, Lee S, Lema GK, Levi M, Lim SS, Liu X, Lopes G, Lutzky Saute R, Machado Teixeira PH, Mahmoodpoor A, Mahmoud MA, Malakan Rad E, Malhotra K, Malik AA, Martinez-Guerra BA, Martorell M, Mathur V, Mayeli M, Medina JRC, Melese A, Memish ZA, Mentis AFA, Merza MA, Mestrovic T, Michalek IM, Minh LHN, Mirahmadi A, Mirmosayyeb O, Misganaw A, Misra AK, Moghadasi J, Mohamed NS, Mohammad Y, Mohammadi E, Mohammed S, Mojarrad Sani M, Mojiri-forushani H, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Mossialos E, Mostafavi E, Motaghinejad M, Mousavi Khaneghah A, Mubarik S, Muccioli L, Muhammad JS, Mulita F, Mulugeta T, Murillo-Zamora E, Mustafa G, Muthupandian S, Nagarajan AJ, Nainu F, Nair TS, Nargus S, Nassereldine H, Natto ZS, Nayak BP, Negoi I, Negoi RI, Nejadghaderi SA, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noroozi N, Nouraei H, Nuñez-Samudio V, Nuruzzaman KM, Nwatah VE, Nzoputam CI, Nzoputam OJ, Oancea B, Obaidur RM, Odetokun IA, Ogunsakin RE, Okonji OC, Olagunju AT, Olana LT, Olufadewa II, Oluwafemi YD, Oumer KS, Ouyahia A, P A M, Pakshir K, Palange PN, Pardhan S, Parikh RR, Patel J, Patel UK, Patil S, Paudel U, Pawar S, Pensato U, Perdigão J, Pereira M, Peres MFP, Petcu IR, Pinheiro M, Piracha ZZ, Pokhrel N, Postma MJ, Prates EJS, Qattea I, Raghav PR, Rahbarnia L, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmanian V, Rahnavard N, Ramadan H, Ramasubramani P, Rani U, Rao IR, Rapaka D, Ratan ZA, Rawaf S, Redwan EMM, Reiner Jr RC, Rezaei N, Riad A, Ribeiro da Silva TM, Roberts T, Robles Aguilar G, Rodriguez JAB, Rosenthal VD, Saddik B, Sadeghian S, Saeed U, Safary A, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahu M, Sajedi SA, Saki M, Salahi S, Salahi S, Saleh MA, Sallam M, Samadzadeh S, Samy AM, Sanjeev RK, Satpathy M, Seylani A, Sha'aban A, Shafie M, Shah PA, Shahrokhi S, Shahzamani K, Shaikh MA, Sham S, Shannawaz M, Sheikh A, Shenoy SM, Shetty PH, Shin JI, Shokri F, Shorofi SA, Shrestha S, Sibhat MM, Siddig EE, Silva LMLR, Singh H, Singh JA, Singh P, Singh S, Sinto R, Skryabina AA, Socea B, Sokhan A, Solanki R, Solomon Y, Sood P, Soshnikov S, Stergachis A, Sufiyan MB, Suliankatchi Abdulkader R, Sultana A, T Y SS, Taheri E, Taki E, Tamuzi JJLL, Tan KK, Tat NY, Temsah MH, Terefa DR, Thangaraju P, Tibebu NS, Ticoalu JHV, Tillawi T, Tincho MB, Tleyjeh II, Toghroli R, Tovani-Palone MR, Tufa DG, Turner P, Ullah I, Umeokonkwo CD, Unnikrishnan B, Vahabi SM, Vaithinathan AG, Valizadeh R, Varthya SB, Vos T, Waheed Y, Walde MT, Wang C, Weerakoon KG, Wickramasinghe ND, Winkler AS, Woldemariam M, Worku NA, Wright C, Yada DY, Yaghoubi S, Yahya GATY, Yenew CYY, Yesiltepe M, Yi S, Yiğit V, You Y, Yusuf H, Zakham F, Zaman M, Zaman SB, Zare I, Zareshahrabadi Z, Zarrintan A, Zastrozhin MS, Zhang H, Zhang J, Zhang ZJ, Zheng P, Zoladl M, Zumla A, Hay SI, Murray CJL, Naghavi M, Kyu HH. Global, regional, and national burden of meningitis and its aetiologies, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:685-711. [PMID: 37479374 PMCID: PMC10356620 DOI: 10.1016/s1474-4422(23)00195-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. METHODS We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. FINDINGS In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000-277 000) and 2·51 million (2·11-2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400-145 000) and 1·28 million incident cases (0·947-1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6-8·4) per 100 000 population in 1990 to 3·3 (2·8-3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1-19·2]), followed by N meningitidis (13·6% [12·7-14·4]) and K pneumoniae (12·2% [10·2-14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5-81·8]), followed by N meningitidis (72·3% [64·4-78·5]) and viruses (58·2% [47·1-67·3]). INTERPRETATION Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. FUNDING Bill & Melinda Gates Foundation.
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Zhang Y, Deng X, Jiang Y, Zhang J, Zhan L, Mei L, Lu H, Yao P, He H. The Epidemiology of Meningococcal Disease and Carriage, Genotypic Characteristics and Antibiotic Resistance of Neisseria meningitidis Isolates in Zhejiang Province, China, 2011–2021. Front Microbiol 2022; 12:801196. [PMID: 35140696 PMCID: PMC8819144 DOI: 10.3389/fmicb.2021.801196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/03/2021] [Indexed: 11/26/2022] Open
Abstract
Neisseria meningitidis (Nm) remains a worldwide leading cause of epidemic meningitis. During 2011–July 2021, 55 meningococcal disease (MD) cases were reported with a case fatality rate of 5.45% in Zhejiang Province, China. The median age was 7 years. The annual incidence was 0.0017–0.0183 per 100,000 population. The highest age-specific incidence was observed in the group younger than 1 year. Serogroup was identified in 30 laboratory-confirmed MD cases, and MenB was most predominant. MenB was mainly observed in two age groups: younger than 5 and older than 35 years. MenB incidence was significantly increasing from 0.0018 per 100,000 in 2013 to 0.0070 per 100,000 in 2019. During 2015–2020, 17 positive samples were detected from 2,827 throat swabs from healthy population, of which 70.59% was MenB. Twenty multilocus sequence typing sequence types (STs) containing eight newly assigned STs (ST15881–ST15888) were determined in all Nm isolates. Either in MD cases or in healthy population, MenB CC ST-4821 was the predominant ST. It was worth noting that two MenY CC ST-23 cases occurred in 2019 and 2021, respectively. MenY CC ST-23 MD cases increased gradually in China. Phylogeny results based on genome sequencing indicated that Chinese MenW CC ST-11 isolates were genetically linked and grouped together with Japanese isolates, separated from MenW CC ST-11 isolates from Saudi Arabia Hajj outbreak, Europe, South Africa, South America, North America, and Oceania. MenW CC ST-11 isolates from East Asia might have evolved locally. Antibiotic susceptibility tests revealed a relatively high resistance rate (22.86%) of Nm isolates to penicillin. This study provided valuable data for Chinese public health authorities to grasp the temporal epidemiological characteristics of MD and healthy carriage.
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Affiliation(s)
- Yunyi Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuan Deng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yan Jiang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junyan Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Li Zhan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lingling Mei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hangjing Lu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Pingping Yao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- *Correspondence: Pingping Yao,
| | - Hanqing He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Hanqing He,
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Joseph SK, M A A, Thomas S, Nair SC. Nanomedicine as a future therapeutic approach for treating meningitis. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.102968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Impact of MenAfriVac on Meningococcal A Meningitis in Cameroon: A Retrospective Study Using Case-by-Case-Based Surveillance Data from 2009 to 2015. J Trop Med 2021; 2021:4314892. [PMID: 34616456 PMCID: PMC8490062 DOI: 10.1155/2021/4314892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Meningococcal meningitis is a public health concern in Africa. Conjugated vaccine against serogroup A Neisseria meningitidis (MenAfriVac) was used in mass vaccination and was proved to have a good impact in the meningitis belt. There is a lack of information about the impact of this intervention in Cameroon after mass vaccination was undertaken. This study aimed at filling the gap in its unknown impact in Cameroon. A retrospective longitudinal study using biological monitoring data of case-by-case-based surveillance for meningitis was obtained from the National Reference Laboratories from 1 January 2009 to 20 September 2015. Immunization coverage data were obtained from Regional Public Health Delegations where immunizations took place. We compared the risks of vaccine serogroup occurrence before and after vaccinations and calculated the global impact using Halloran's formula. Annual cases of meningitis A decreased gradually from 92 in 2011 to 34 in 2012 and then to 1 case in 2013, and since 2014, no cases have been detected. The impact was estimated at 14.48% (p=0.41) in 2012 and then at 98.63% (p < 0.0001) after the end of vaccinations in 2013. This survey confirms the effectiveness of the MenAfriVac vaccine in Cameroon as expected by the WHO. The surveillance must be pursued and enhanced to monitor coming immunizations measures with multivalent conjugated vaccines for this changing threat.
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Kwambana-Adams BA, Cohen AL, Hampton L, Nhantumbo AA, Heyderman RS, Antonio M, Bita A, Mwenda JM. Toward Establishing Integrated, Comprehensive, and Sustainable Meningitis Surveillance in Africa to Better Inform Vaccination Strategies. J Infect Dis 2021; 224:S299-S306. [PMID: 34469559 PMCID: PMC8409533 DOI: 10.1093/infdis/jiab268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Large populations across sub-Saharan Africa remain at risk of devastating acute bacterial meningitis epidemics and endemic disease. Meningitis surveillance is a cornerstone of disease control, essential for describing temporal changes in disease epidemiology, the rapid detection of outbreaks, guiding vaccine introduction and monitoring vaccine impact. However, meningitis surveillance in most African countries is weak, undermined by parallel surveillance systems with little to no synergy and limited laboratory capacity. African countries need to implement comprehensive meningitis surveillance systems to adapt to the rapidly changing disease trends and vaccine landscapes. The World Health Organization and partners have developed a new investment case to restructure vaccine-preventable disease surveillance. With this new structure, countries will establish comprehensive and sustainable meningitis surveillance systems integrated with greater harmonization between population-based and sentinel surveillance systems. There will also be stronger linkage with existing surveillance systems for vaccine-preventable diseases, such as polio, measles, yellow fever, and rotavirus, as well as with other epidemic-prone diseases to leverage their infrastructure, transport systems, equipment, human resources and funding. The implementation of these concepts is currently being piloted in a few countries in sub-Saharan Africa with support from the World Health Organization and other partners. African countries need to take urgent action to improve synergies and coordination between different surveillance systems to set joint priorities that will inform action to control devastating acute bacterial meningitis effectively.
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Affiliation(s)
- Brenda Anna Kwambana-Adams
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, United Kingdom
- World Health Organization Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
| | - Adam L Cohen
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lee Hampton
- Gavi, The Vaccine Alliance, Global Health Campus, Geneva, Switzerland
| | - Aquino Albino Nhantumbo
- Laboratório Nacional de Referência de Microbiologia, Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Robert S Heyderman
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, United Kingdom
| | - Martin Antonio
- World Health Organization Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul, The Gambia
- Centre for Epidemic Preparedness and Response, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andre Bita
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Jason Mathiu Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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9
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Global Landscape Review of Serotype-Specific Invasive Pneumococcal Disease Surveillance among Countries Using PCV10/13: The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) Project. Microorganisms 2021; 9:microorganisms9040742. [PMID: 33918127 PMCID: PMC8066045 DOI: 10.3390/microorganisms9040742] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/27/2022] Open
Abstract
Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon.
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10
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Rezaei SJ, Mateen FJ. Encephalitis and meningitis in Western Africa: a scoping review of pathogens. Trop Med Int Health 2021; 26:388-396. [PMID: 33340211 DOI: 10.1111/tmi.13539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To give an overview of the recently reported literature on the aetiologies of meningitis and encephalitis in western sub-Saharan Africa. METHODS We conducted a scoping review following PRISMA guidance on published meningitis and encephalitis cases in the 16 countries of the United Nations-defined western sub-Saharan African region as identified in cohort studies, case series, and case reports, published 01/01/2000-08/01/2020, and available in four databases in August 2020 with an abstract in English, French or Italian. RESULTS There were 38 distinct pathogens identified from 91 cohort studies' data and 48 case reports or case series' data. In cohort-level data, the majority of cases were caused by Neisseria meningitidis (71.5%), Streptococcus pneumoniae (17.6%) and Haemophilus influenzae (7.3%). In case report- and case series-level data, 40.5% of patients were <18 years old, 28.6% were female, and 28.6% were known to be immunocompromised. The case fatality rate was 39.3%. The most commonly reported pathogens among immunocompetent patients were Salmonella species (13 cases) and Ebola virus (9 cases), and the most commonly reported pathogen among immunocompromised patients was Cryptococcus neoformans (18 cases). Most cohort cases (52.3%) derived from Niger followed by Burkina Faso (28.6%). Most cases from single reports or series were reported from Nigeria (21.4%), Mali (20.2%) and Burkina Faso (19.0%). CONCLUSIONS Given the small number of pathogens reported, our findings underscore the need to better screen, diagnose and monitor populations in western sub-Saharan Africa for additional CNS pathogens, including those posing significant outbreak risks.
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Affiliation(s)
- Shawheen J Rezaei
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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11
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von Gaudecker JR, Oduor C, Ofner S, Oyungu E, Said J, Buelow J. Pattern and frequency of neurological and neurosurgical care of adult inpatients and outpatients at a tertiary referral hospital in Kenya. eNeurologicalSci 2020; 21:100286. [PMID: 33204860 PMCID: PMC7649259 DOI: 10.1016/j.ensci.2020.100286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/15/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the patterns and burden of neurological and neurosurgical disorders at a national tertiary level referral hospital in western Kenya. METHODS We conducted a three-month period prevalence study. We recruited consecutive adult patients seeking neurological-neurosurgical care in both inpatient and outpatient settings at Moi Teaching and Referral Hospital. RESULTS 833 participants were included. The age range was between 19 year and 99 years (mean age = 45.3 years). The most common diagnoses among neurology inpatients were meningitis (12%), ischemic stroke (11.0%) and epilepsy/seizure (6.7%). Among neurology outpatients, epilepsy (35.1%) and ischemic stroke (18.8%) were the most common diagnoses. The most common neurosurgery inpatient diagnosis was hemorrhagic stroke (16.3%) and among outpatients, the most common diagnoses were traumatic brain injury (17.4%) and hemorrhagic stroke (16.3%). Overall, 471 (56.5%) patients underwent HIV testing, of which, 89 (18.9%) were HIV positive and 382 (81.1%) were HIV negative. Thirty-one inpatient deaths (male 58%), attributable to neurological and neurosurgical disorders, occurred during the study period. Meningitis was the most common cause of death. CONCLUSIONS The findings suggest that meningitis, stroke, epilepsy, and traumatic brain injury were the most common diagnosis. More resources and efforts should be directed towards prevention, diagnosis and management of these conditions in the region.
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Affiliation(s)
| | | | - Susan Ofner
- Department of Biostatistics, Indiana University School of Medicine, United States of America
| | - Eren Oyungu
- Paeds Neurology, Moi University, Department of Medical Physiology, Eldoret, Kenya
| | - Jamil Said
- Moi University, Department of Human Anatomy, Eldoret, Kenya
| | - Janice Buelow
- Indiana University School of Nursing, Indianapolis, United States of America
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12
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Hurlburt NK, Guan J, Ong H, Yu H, Chen X, Fisher AJ. Structural characterization of a nonhydrolyzing UDP-GlcNAc 2-epimerase from Neisseria meningitidis serogroup A. Acta Crystallogr F Struct Biol Commun 2020; 76:557-567. [PMID: 33135674 PMCID: PMC7605110 DOI: 10.1107/s2053230x20013680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/13/2020] [Indexed: 11/10/2022] Open
Abstract
Bacterial nonhydrolyzing UDP-N-acetylglucosamine 2-epimerases catalyze the reversible interconversion of UDP-N-acetylglucosamine (UDP-GlcNAc) and UDP-N-acetylmannosamine (UDP-ManNAc). UDP-ManNAc is an important intermediate in the biosynthesis of certain cell-surface polysaccharides, including those in some pathogenic bacteria, such as Neisseria meningitidis and Streptococcus pneumoniae. Many of these epimerases are allosterically regulated by UDP-GlcNAc, which binds adjacent to the active site and is required to initiate UDP-ManNAc epimerization. Here, two crystal structures of UDP-N-acetylglucosamine 2-epimerase from Neisseria meningitidis serogroup A (NmSacA) are presented. One crystal structure is of the substrate-free enzyme, while the other structure contains UDP-GlcNAc substrate bound to the active site. Both structures form dimers as seen in similar epimerases, and substrate binding to the active site induces a large conformational change in which two Rossmann-like domains clamp down on the substrate. Unlike other epimerases, NmSacA does not require UDP-GlcNAc to instigate the epimerization of UDP-ManNAc, although UDP-GlcNAc was found to enhance the rate of epimerization. In spite of the conservation of residues involved in binding the allosteric UDP-GlcNAc observed in similar UDP-GlcNAc 2-epimerases, the structures presented here do not contain UDP-GlcNAc bound in the allosteric site. These structural results provide additional insight into the mechanism and regulation of this critical enzyme and improve the structural understanding of the ability of NmSacA to epimerize modified substrates.
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Affiliation(s)
| | - Jasper Guan
- Department of Chemistry, University of California, Davis, CA 95616, USA
| | - Hoonsan Ong
- Department of Chemistry, University of California, Davis, CA 95616, USA
| | - Hai Yu
- Department of Chemistry, University of California, Davis, CA 95616, USA
| | - Xi Chen
- Department of Chemistry, University of California, Davis, CA 95616, USA
| | - Andrew J. Fisher
- Department of Chemistry, University of California, Davis, CA 95616, USA
- Department of Molecular and Cellular Biology, University of California, Davis, CA 95616, USA
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13
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Patel JC, Soeters HM, Diallo AO, Bicaba BW, Kadadé G, Dembélé AY, Acyl MA, Nikiema C, Lingani C, Hatcher C, Acosta AM, Thomas JD, Diomande F, Martin S, Clark TA, Mihigo R, Hajjeh RA, Zilber CH, Aké F, Mbaeyi SA, Wang X, Moisi JC, Ronveaux O, Mwenda JM, Novak RT. MenAfriNet: A Network Supporting Case-Based Meningitis Surveillance and Vaccine Evaluation in the Meningitis Belt of Africa. J Infect Dis 2020; 220:S148-S154. [PMID: 31671453 DOI: 10.1093/infdis/jiz308] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Meningococcal meningitis remains a significant public health threat, especially in the African meningitis belt where Neisseria meningitidis serogroup A historically caused large-scale epidemics. With the rollout of a novel meningococcal serogroup A conjugate vaccine (MACV) in the belt, the World Health Organization recommended case-based meningitis surveillance to monitor MACV impact and meningitis epidemiology. In 2014, the MenAfriNet consortium was established to support strategic implementation of case-based meningitis surveillance in 5 key countries: Burkina Faso, Chad, Mali, Niger, and Togo. MenAfriNet aimed to develop a high-quality surveillance network using standardized laboratory and data collection protocols, develop sustainable systems for data management and analysis to monitor MACV impact, and leverage the surveillance platform to perform special studies. We describe the MenAfriNet consortium, its history, strategy, implementation, accomplishments, and challenges.
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Affiliation(s)
- Jaymin C Patel
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M Soeters
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alpha Oumar Diallo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Mahamat A Acyl
- Ministère de la Santé Publique du Tchad, N'Djamena, Tchad
| | | | - Clement Lingani
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Cynthia Hatcher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna M Acosta
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer D Thomas
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fabien Diomande
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stacey Martin
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas A Clark
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Richard Mihigo
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Rana A Hajjeh
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Flavien Aké
- Davycas International, Ouagadougou, Burkina Faso
| | - Sarah A Mbaeyi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xin Wang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer C Moisi
- Agence de Médecine Préventive, Paris, France, Geneva, Switzerland
| | | | - Jason M Mwenda
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ryan T Novak
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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14
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Fernandez K, Lingani C, Aderinola OM, Goumbi K, Bicaba B, Edea ZA, Glèlè C, Sarkodie B, Tamekloe A, Ngomba A, Djingarey M, Bwaka A, Perea W, Ronveaux O. Meningococcal Meningitis Outbreaks in the African Meningitis Belt After Meningococcal Serogroup A Conjugate Vaccine Introduction, 2011-2017. J Infect Dis 2019; 220:S225-S232. [PMID: 31671449 PMCID: PMC6822966 DOI: 10.1093/infdis/jiz355] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In 2010-2017, meningococcal serogroup A conjugate vaccine (MACV) was introduced in 21 African meningitis belt countries. Neisseria meningitidis A epidemics have been eliminated here; however, non-A serogroup epidemics continue. METHODS We reviewed epidemiological and laboratory World Health Organization data after MACV introduction in 20 countries. Information from the International Coordinating Group documented reactive vaccination. RESULTS In 2011-2017, 17 outbreaks were reported (31 786 suspected cases from 8 countries, 1-6 outbreaks/year). Outbreaks were of 18-14 542 cases in 113 districts (median 3 districts/outbreak). The most affected countries were Nigeria (17 375 cases) and Niger (9343 cases). Cumulative average attack rates per outbreak were 37-203 cases/100 000 population (median 112). Serogroup C accounted for 11 outbreaks and W for 6. The median proportion of laboratory confirmed cases was 20%. Reactive vaccination was conducted during 14 outbreaks (5.7 million people vaccinated, median response time 36 days). CONCLUSION Outbreaks due to non-A serogroup meningococci continue to be a significant burden in this region. Until an affordable multivalent conjugate vaccine becomes available, the need for timely reactive vaccination and an emergency vaccine stockpile remains high. Countries must continue to strengthen detection, confirmation, and timeliness of outbreak control measures.
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Affiliation(s)
| | - Clément Lingani
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | | | - Kadadé Goumbi
- Ministère de la Santé Publique du Niger, Niamey, Niger
| | - Brice Bicaba
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | | | | | | | - Armelle Ngomba
- Ministère de la Santé Publique du Cameroun, Yaoundé, Cameroon
| | - Mamoudou Djingarey
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ado Bwaka
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
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15
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Bwaka A, Bita A, Lingani C, Fernandez K, Durupt A, Mwenda JM, Mihigo R, Djingarey MH, Ronveaux O, Preziosi MP. Status of the Rollout of the Meningococcal Serogroup A Conjugate Vaccine in African Meningitis Belt Countries in 2018. J Infect Dis 2019; 220:S140-S147. [PMID: 31671448 PMCID: PMC6822965 DOI: 10.1093/infdis/jiz336] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND A novel meningococcal serogroup A conjugate vaccine (MACV [MenAfriVac]) was developed as part of efforts to prevent frequent meningitis outbreaks in the African meningitis belt. The MACV was first used widely and with great success, beginning in December 2010, during initial deployment in Burkina Faso, Mali, and Niger. Since then, MACV rollout has continued in other countries in the meningitis belt through mass preventive campaigns and, more recently, introduction into routine childhood immunization programs associated with extended catch-up vaccinations. METHODS We reviewed country reports on MACV campaigns and routine immunization data reported to the World Health Organization (WHO) Regional Office for Africa from 2010 to 2018, as well as country plans for MACV introduction into routine immunization programs. RESULTS By the end of 2018, 304 894 726 persons in 22 of 26 meningitis belt countries had received MACV through mass preventive campaigns targeting individuals aged 1-29 years. Eight of these countries have introduced MACV into their national routine immunization programs, including 7 with catch-up vaccinations for birth cohorts born after the initial rollout. The Central African Republic introduced MACV into its routine immunization program immediately after the mass 1- to 29-year-old vaccinations in 2017 so no catch-up was needed. CONCLUSIONS From 2010 to 2018, successful rollout of MACV has been recorded in 22 countries through mass preventive campaigns followed by introduction into routine immunization programs in 8 of these countries. Efforts continue to complete MACV introduction in the remaining meningitis belt countries to ensure long-term herd protection.
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Affiliation(s)
- Ado Bwaka
- World Health Organization (WHO) Inter-Country Support Team West Africa, Ouagadougou, Burkina Faso
| | - André Bita
- World Health Organization (WHO) Inter-Country Support Team West Africa, Ouagadougou, Burkina Faso
| | - Clément Lingani
- World Health Organization (WHO) Inter-Country Support Team West Africa, Ouagadougou, Burkina Faso
| | | | - Antoine Durupt
- WHO Initiative for Vaccine Research, Geneva, Switzerland
| | | | | | - Mamoudou H Djingarey
- WHO Infectious Hazard Management, Regional Office for Africa, Brazzaville, Congo
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16
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Novak RT, Moïsi JC, Tall H, Preziosi MP, Hadler SC, Messonnier NE, Mihigo R. Country Data for Action: The MenAfriNet Experience in Strengthening Meningitis Surveillance in Africa. J Infect Dis 2019; 220:S137-S139. [PMID: 31671440 DOI: 10.1093/infdis/jiz347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ryan T Novak
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Haoua Tall
- Agence de Médecine Préventive, Ouagadougou, Burkina Faso
| | | | - Stephen C Hadler
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nancy E Messonnier
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Richard Mihigo
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
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17
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Soeters HM, Diallo AO, Bicaba BW, Kadadé G, Dembélé AY, Acyl MA, Nikiema C, Sadji AY, Poy AN, Lingani C, Tall H, Sakandé S, Tarbangdo F, Aké F, Mbaeyi SA, Moïsi J, Paye MF, Sanogo YO, Vuong JT, Wang X, Ronveaux O, Novak RT. Bacterial Meningitis Epidemiology in Five Countries in the Meningitis Belt of Sub-Saharan Africa, 2015-2017. J Infect Dis 2019; 220:S165-S174. [PMID: 31671441 PMCID: PMC6853282 DOI: 10.1093/infdis/jiz358] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The MenAfriNet Consortium supports strategic implementation of case-based meningitis surveillance in key high-risk countries of the African meningitis belt: Burkina Faso, Chad, Mali, Niger, and Togo. We describe bacterial meningitis epidemiology in these 5 countries in 2015-2017. METHODS Case-based meningitis surveillance collects case-level demographic and clinical information and cerebrospinal fluid (CSF) laboratory results. Neisseria meningitidis, Streptococcus pneumoniae, or Haemophilus influenzae cases were confirmed and N. meningitidis/H. influenzae were serogrouped/serotyped by real-time polymerase chain reaction, culture, or latex agglutination. We calculated annual incidence in participating districts in each country in cases/100 000 population. RESULTS From 2015-2017, 18 262 suspected meningitis cases were reported; 92% had a CSF specimen available, of which 26% were confirmed as N. meningitidis (n = 2433; 56%), S. pneumoniae (n = 1758; 40%), or H. influenzae (n = 180; 4%). Average annual incidences for N. meningitidis, S. pneumoniae, and H. influenzae, respectively, were 7.5, 2.5, and 0.3. N. meningitidis incidence was 1.5 in Burkina Faso, 2.7 in Chad, 0.4 in Mali, 14.7 in Niger, and 12.5 in Togo. Several outbreaks occurred: NmC in Niger in 2015-2017, NmC in Mali in 2016, and NmW in Togo in 2016-2017. Of N. meningitidis cases, 53% were NmC, 30% NmW, and 13% NmX. Five NmA cases were reported (Burkina Faso, 2015). NmX increased from 0.6% of N. meningitidis cases in 2015 to 27% in 2017. CONCLUSIONS Although bacterial meningitis epidemiology varied widely by country, NmC and NmW caused several outbreaks, NmX increased although was not associated with outbreaks, and overall NmA incidence remained low. An effective low-cost multivalent meningococcal conjugate vaccine could help further control meningococcal meningitis in the region.
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Affiliation(s)
- Heidi M. Soeters
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | - Alpha Oumar Diallo
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | - Brice W. Bicaba
- Ministère de la Santé du Burkina Faso, Ouagadougou, Burkina Faso
| | - Goumbi Kadadé
- Ministère de la Santé Publique du Niger, Niamey, Niger
| | | | | | | | - Adodo Yao Sadji
- Ministère de la Santé et de la Protection Sociale du Togo, Lomé, Togo
| | - Alain N. Poy
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Clement Lingani
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Haoua Tall
- Agence de Médicine Préventive, Ouagadougou, Burkina Faso
| | | | | | - Flavien Aké
- Davycas International, Ouagadougou, Burkina Faso
| | - Sarah A. Mbaeyi
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | | | - Marietou F. Paye
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | - Yibayiri Osee Sanogo
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | - Jeni T. Vuong
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | - Xin Wang
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
| | | | - Ryan T. Novak
- National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA
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18
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Mbaeyi SA, Lingani C, Diallo AO, Bicaba B, Ouédraogo-Traoré R, Acyl M, Gamougame K, Coulibaly O, Coulibaly S, Zaneidou M, Sidikou F, Nikiema C, Sadji AY, Aké F, Tarbangdo F, Sakande S, Tall H, Njanpop-Lafourcade BM, Moïsi J, N’diaye A, Bwaka A, Bita A, Fernandez K, Poy A, Soeters HM, Vuong J, Novak R, Ronveaux O. Improving Case-Based Meningitis Surveillance in 5 Countries in the Meningitis Belt of Sub-Saharan Africa, 2015–2017. J Infect Dis 2019; 220:S155-S164. [DOI: 10.1093/infdis/jiz303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The MenAfriNet consortium was established in 2014 to support implementation of case-based meningitis surveillance in 5 countries in the meningitis belt of sub-Saharan Africa: Burkina Faso, Chad, Mali, Niger, and Togo. Assessing surveillance performance is critical for interpretation of the collected data and implementation of future surveillance-strengthening initiatives.
Methods
Detailed epidemiologic and laboratory data were collected on suspected meningitis cases through case-based meningitis surveillance in participating districts in 5 countries. Performance of case-based surveillance was evaluated through sensitivity of case ascertainment in case-based versus aggregate meningitis surveillance and an analysis of surveillance indicators.
Results
From 2015 to 2017, 18 262 suspected meningitis cases were identified through case-based surveillance and 16 262 were identified through aggregate surveillance, for a case ascertainment sensitivity of 112.3%. Among suspected cases, 16 885 (92.5%) had a cerebrospinal fluid (CSF) specimen collected, 13 625 (80.7%) of which were received at a national reference laboratory. Among these, 13 439 (98.6%) underwent confirmatory testing, and, of those tested, 4371 (32.5%) were confirmed for a bacterial pathogen.
Conclusions
Overall strong performance for case ascertainment, CSF collection, and laboratory confirmation provide evidence for the quality of MenAfriNet case-based surveillance in evaluating epidemiologic trends and informing future vaccination strategies.
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Affiliation(s)
- Sarah A Mbaeyi
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Clement Lingani
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Alpha Oumar Diallo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brice Bicaba
- Ministère de la Santé du Burkina Faso, Ouagadougou
| | | | - Mahamat Acyl
- Ministère de la Santé Publique du Tchad, N’Djamena
| | | | - Oumou Coulibaly
- Ministère de la Santé et de l’Hygiène Publique du Mali, Bamako, Mali
| | | | | | | | | | - Adodo Yao Sadji
- Ministère de la Santé et de la Protection Sociale du Togo, Lomé
| | - Flavien Aké
- Davycas International, Ouagadougou, Burkina Faso
| | | | | | - Haoua Tall
- Agence de Médecine Préventive, Ouagadougou, Burkina Faso
| | | | | | - Aboubacar N’diaye
- World Health Organization, Intercountry Support Team for Central Africa, Libreville, Gabon
| | - Ado Bwaka
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Andre Bita
- World Health Organization, AFRO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | | | - Alain Poy
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Heidi M Soeters
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeni Vuong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan Novak
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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