Environmental risk and meningitis epidemics in Africa

Abstract

Epidemics of meningococcal meningitis occur in areas with particular environmental characteristics. We present evidence that the relationship between the environment and the location of these epidemics is quantifiable and propose a model based on environmental variables to identify regions at risk for meningitis epidemics. These findings, which have substantial implications for directing surveillance activities and health policy, provide a basis for monitoring the impact of climate variability and environmental change on epidemic occurrence in Africa.

Figure 1

Ecologic variation in the seasonal profile of absolute humidity. a) spatial variation in profile class; b) representative profile class.

Figure 2

Distribution of districts where epidemic meningococcal meningitis are likely to occur. a) observed distribution of meningitis epidemics (1841–1999). b) fitted model of observed meningitis epidemics based on environmental variables.

Figure 3

Receiver-operator characteristics curve for the model.