Global epidemiology of invasive meningococcal disease.

Rabab Z Jafri,Samba Sow,Florence Fermon,Carol Tevi-Benissan,Mary Ramsay,David Durrheim,Juhani Eskola,Keith P Klugman,Zulfiqar A Bhutta,Jon Abramson,Asad Ali,Nancy E Messonnier,Shao Zhujun

doi:10.1186/1478-7954-11-17

Abstract

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20 years in World Health Organization and European Centre for Disease Prevention and Control collections and published articles are included in this review, as well as direct communications with leading experts in the field. Countries were grouped into high-, moderate-, and low-incidence countries. The majority of countries in the high-incidence group are found in the African meningitis belt; many moderate-incidence countries are found in the European and African regions, and Australia, while low-incidence countries include many from Europe and the Americas. Priority countries for vaccine intervention are high- and moderate-incidence countries where vaccine-preventable serogroups predominate. Epidemiological data on burden of IMD are needed in countries where this is not known, particularly in South- East Asia and Eastern Mediterranean regions, so evidence-based decisions about the use of meningococcal vaccines can be made.

Highlights

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can cause sepsis, pneumonia, and other localized infections
A vaccine against serogroup A has recently been introduced in the African meningitis belt, an area extending from Senegal in the west to Ethiopia in the east [4,5]
In many countries with invasive meningococcal disease (IMD) surveillance, extensive targeted vaccine development and increasing coverage has decreased the burden of disease

Summary

Introduction

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can cause sepsis, pneumonia, and other localized infections. To combat IMD, many industrialized countries have included different formulations of meningococcal vaccine in their routine immunization programs. A vaccine against serogroup A has recently been introduced in the African meningitis belt, an area extending from Senegal in the west to Ethiopia in the east [4,5]. Meningococcal vaccines remain underutilized globally, in resource-limited countries outside the African meningitis belt. To provide cost effective recommendations about the use of meningococcal vaccines, the country-specific burden of IMD must be established [6]. A comprehensive review of IMD incidence, including all countries with at least a basic surveillance infrastructure reporting IMD cases, was conducted. The review provides the most recently published attack rates, predominant serogroups, and at-risk groups from over 80 countries and organizes the data according to priority groups for vaccine intervention

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Conclusion