[Meningococcal meningitis epidemics in sub-Saharan Africa and the meningococcal A conjugate vaccine]
Unité du méningocoque, centre collaborateur OMS de référence et de recherche pour les méningocoques entre 1995 et 2011, Institut de recherche biomédicale des armées, institut de médecine tropicale du service de santé des armées, Marseille, France.Medecine et sante tropicales 11/2012; 22(3). DOI: 10.1684/mst.2012.0086
Group A meningococci are primarily responsible for the epidemic meningococcal diseases in the countries of the meningitis belt of sub-Saharan Africa. In 1995-1996 major epidemics (>200 000 cases) impeded effective management and ultimately resulted in many improvements. Since 2003, the Multi-Disease Center (MDSC) in Ouagadougou (Burkina Faso) and the WHO in Geneva have collected epidemiologic and laboratory data; new alert and epidemic thresholds are applied; and management has improved, with a single dose of ceftriaxone or of oily chloramphenicol now recommended. Trivalent ACW vaccine has been introduced against serogroup W135 epidemics. In 2010, preventive vaccination campaigns using the meningococcal conjugate vaccine MenAfriVac(®) began. Their use in all countries of the meningitis belt could eliminate serogroup A outbreaks in the region.
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ABSTRACT: We describe the main features of a meningitis outbreak caused by Neisseria meningitidis W135 which occurred in Burkina Faso from January to April 2012. Data were collected from the health districts. Meningitis cases were defined as suspected cases, probable or confirmed, according to clinical and laboratory criteria. The epidemic reached 13 health districts with a total of 5300 reported cases and 553 deaths (10.4%), mainly in the age group 5-14 years. The sex ratio was 1.3 for males. N. meningitidis W135 was reported in 49 of 63 (78%) districts and identified by latex test in 68% of cerebrospinal fluid. Three health districts have benefited from a reactive vaccination campaign with the tetravalent vaccine polysaccaridic (A, C, Y, W135). Patients were treated with ceftriaxone or ampicillin, in accordance with national guidelines. This study emphasized the necessity to strengthen the epidemiological surveillance and laboratory capacities, and make available the tetravalent conjugated vaccine in order to improve the response to meningitis outbreaks.
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