Abstract
BackgroundBacterial 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.ResultsBacterial 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.ConclusionBacterial 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.
Highlights
Bacterial meningitis affects all countries of the world but primarily Africa especially the "Meningitis belt" that extends from Senegal near the Atlantic coast to Ethiopia and Somalia on the seashores of the Red Sea and the Indian Ocean [1]
We show that an interplay of different geographical and environmental variables as latitude, longitude and socio-economic drivers are important to consider in the epidemiology of bacterial meningitis epidemics in Demo‐ cratic Republic of Congo (DRC) which is considered outside the meningitis belt [34]
In this study based on a 90-year time-series of suspected meningitis cases and death reported in the 53 different states in Africa by the World Health Organization (WHO), we provide a first descriptive analysis of continent-wide meningitis epidemics in order to characterize the existence of spatio-temporal patterns of transmission over this period
Summary
Bacterial meningitis affects all countries of the world but primarily Africa especially the "Meningitis belt" that extends from Senegal near the Atlantic coast to Ethiopia and Somalia on the seashores of the Red Sea and the Indian Ocean [1]. Research studies carried out at the interface between epidemiology and climatology since the mid-XXth century have demonstrated the existence of a strong seasonal pattern of epidemics, which occurs during the dry season [10,11,12,13,14,15,16,17] i.e., from January to April During this period, the dry winds of the Harmattan blow in Western Africa, carriers of dust and sand particles, may irritate the mucous membranes of the upper respiratory tract for people living in these regions. Since 2000, other Nm serogroups includ‐ ing W, X and C have 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 “outof-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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
