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Review
. 2018 May 4;14(5):1107-1115.
doi: 10.1080/21645515.2017.1412020. Epub 2018 Jan 16.

Vaccine prevention of meningococcal disease in Africa: Major advances, remaining challenges

Mustapha M Mustapha  1 , Lee H Harrison  1
Affiliations
Review

Vaccine prevention of meningococcal disease in Africa: Major advances, remaining challenges

Mustapha M Mustapha et al. Hum Vaccin Immunother. .

Abstract

Africa historically has had the highest incidence of meningococcal disease with high endemic rates and periodic epidemics. The meningitis belt, a region of sub-Saharan Africa extending from Senegal to Ethiopia, has experienced large, devastating epidemics. However, dramatic shifts in the epidemiology of meningococcal disease have occurred recently. For instance, meningococcal capsular group A (NmA) epidemics in the meningitis belt have essentially been eliminated by use of conjugate vaccine. However, NmW epidemics have emerged and spread across the continent since 2000; NmX epidemics have occurred sporadically, and NmC recently emerged in Nigeria and Niger. Outside the meningitis belt, NmB predominates in North Africa, while NmW followed by NmB predominate in South Africa. Improved surveillance is necessary to address the challenges of this changing epidemiologic picture. A low-cost, multivalent conjugate vaccine covering NmA and the emergent and prevalent meningococcal capsular groups C, W, and X in the meningitis belt is a pressing need.

Keywords: African meningitis belt; MenAfriVac; Meningococcal; Neisseria meningitidis; conjugate vaccine.

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Figures

Figure 1.
Figure 1.
The meningitis belt of Africa. Map highlights 26 countries that make up the meningitis belt color coded by group A protein conjugate vaccine (MenAfriVac) roll out year. Reproduced with permission from www.path.org/menafrivac/meningitis-belt.php.
Figure 2.
Figure 2.
Reduction in incidence of all meningitis cases in Chad following introduction of MenAfriVac in 2011–2012. Reproduced from Gamougam et al.
Figure 3.
Figure 3.
Total number of suspected meningitis cases (panel A) and capsular group distribution of confimed IMD cases (panel B) in the meningitis belt, 2006 to June 2017. Based on publically available data from the World Health Organization (www.who.int/csr/disease/meningococcal/epidemiological/en/). Data for 2006–2016 represent totals for 52 weeks (January to December) while data for 2017 are totals for first 26 weeks of the year when a vast majority of cases occur.
See this image and copyright information in PMC

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