African meningitis belt

Last updated
The meningitis belt, showing the distribution of meningococcal meningitis in Africa Meningococcal Meningitis Range.svg
The meningitis belt, showing the distribution of meningococcal meningitis in Africa

The African meningitis belt is a region in sub-Saharan Africa where the rate of incidence of meningitis is very high. It extends from Senegal to Ethiopia, and the primary cause of meningitis in the belt is Neisseria meningitidis .

Contents

The belt was first proposed by Léon Lapeyssonnie of the World Health Organization (WHO) in 1963. Lapeyssonnie noticed that the disease occurred in areas receiving 300–1,100 mm of mean annual rainfall, which is the case in sub-Saharan Africa. [1] The intercontinental spread of meningitis has also been traced to South Asia, brought by those making the Hajj, a pilgrimage to Saudi Arabia, in 1987, leading to epidemics in Nepal, Saudi Arabia, and Chad. [2]

Regions

It consists of part of or all of (from West to East), the Gambia, Senegal, Guinea-Bissau, Guinea, Mali, Burkina Faso, Ghana, Niger, Nigeria, Cameroon, Chad, Central African Republic, Sudan, South Sudan, Uganda, Kenya, Ethiopia, Eritrea. Many other countries in Africa experience outbreaks as well, but they are less frequent and less interepidemic. The "belt" has an estimated 300 million people in its total area. This region is not only prone to meningitis, [3] but also very prone to epidemics such as malaria.

The most affected countries in the region are Burkina Faso, Chad, Ethiopia, and Niger. Burkina Faso, Ethiopia, and Niger were accountable for 65% of all cases in Africa. In major epidemics, the attack rate range is 100 to 800 people per 100,000. However, communities can have attack rates as high as 1000 per 100,000. During these epidemics, young children have the highest attack rates. [4] More than 90,000 cases were reported in the belt in 2009, in comparison, less than 800 cases were reported in the United States [5] in 2011.

Epidemiology

Neisseria meningitidis is found in other parts of the world as well, but the highest rates occur in the “meningitis belt.” Meningococcal disease is persistently high in this region. Large epidemics occur every 5–12 years, typically during the dry season (December–June). Incidence of the disease declines from May to June in the more humid weather. [6] Other factors contributing to the sustained transmission of meningococcal disease include dust, other respiratory viruses that co-circulate, as well as close social contact. [7]

Historically, 90% of outbreaks in the meningitis belt were primarily due to Neisseria meningitidis serogroup A (NmA). [8] However, a monovalent serogroup A meningococcal conjugate vaccine (MenAfriVac) was introduced in the region in 2010. Since then, meningococcal outbreaks in the meningitis belt have primarily been due to serogroups C and W. A few serogroup X outbreaks have also been reported. [9]

In the African meningitis belt, the WHO defines a meningococcal epidemic as at least 100 cases per 100,000 inhabitants in a year. [10] At its peak, the incidence of meningococcal disease has reached rates of up to 1,000 cases per 100,000 inhabitants, such as during the epidemics of 1996 and 2000–2001. [11] In the belt, fatality from NmA disease has been estimated at 10–15%, although higher rates have been seen in some settings. [12] Around 10–20% of survivors of meningococcal meningitis are left with permanent neuropsychological conditions such as hearing loss, vision loss, epilepsy, or other neurological disorders. Young children are particularly vulnerable due to immaturity in their immune systems, which contributes to the disproportionate burden of the disease in Africa due to its young population. [13]

Meningitis vaccine

The Meningitis Vaccine Project was conceived in 2001 as an effort to stop the spread of meningitis in this region. [14]

Related Research Articles

<span class="mw-page-title-main">Waterhouse–Friderichsen syndrome</span> Adrenal gland failure from internal bleeding, often due to infection

Waterhouse–Friderichsen syndrome (WFS) is defined as adrenal gland failure due to bleeding into the adrenal glands, commonly caused by severe bacterial infection. Typically, it is caused by Neisseria meningitidis.

<i>Neisseria</i> Genus of bacteria

Neisseria is a large genus of bacteria that colonize the mucosal surfaces of many animals. Of the 11 species that colonize humans, only two are pathogens, N. meningitidis and N. gonorrhoeae.

MeNZB was a vaccine against a specific strain of group B meningococcus, used to control an epidemic of meningococcal disease in New Zealand. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningococcal disease can cause meningitis and sepsis, resulting in brain damage, failure of various organs, severe skin and soft-tissue damage, and death.

<span class="mw-page-title-main">Conjugate vaccine</span> Type of vaccine

A conjugate vaccine is a type of subunit vaccine which combines a weak antigen with a strong antigen as a carrier so that the immune system has a stronger response to the weak antigen.

<i>Neisseria meningitidis</i> Species of bacterium that can cause meningitis

Neisseria meningitidis, often referred to as the meningococcus, is a Gram-negative bacterium that can cause meningitis and other forms of meningococcal disease such as meningococcemia, a life-threatening sepsis. The bacterium is referred to as a coccus because it is round, and more specifically a diplococcus because of its tendency to form pairs.

<span class="mw-page-title-main">Meningococcal disease</span> Often life-threatening bacterial infection

Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis. It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can also result in sepsis, which is an even more damaging and dangerous condition. Meningitis and meningococcemia are major causes of illness, death, and disability in both developed and under-developed countries.

<span class="mw-page-title-main">Gonorrhea</span> Sexually transmitted infection

Gonorrhoea or gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis. Many of those infected, however, have no symptoms. If untreated, gonorrhea can spread to joints or heart valves.

NmVac4-A/C/Y/W-135 is the commercial name of the polysaccharide vaccine against the bacterium that causes meningococcal meningitis. The product, by JN-International Medical Corporation, is designed and formulated to be used in developing countries for protecting populations during meningitis disease epidemics.

<span class="mw-page-title-main">Jeeri R. Reddy</span>

Jeeri Reddy an American biologist who became an entrepreneur, developing new generation preventive and therapeutic vaccines. He has been an active leader in the field of the biopharmaceutical industry, commercializing diagnostics and vaccines through JN-International Medical Corporation. He is the scientific director and president of the corporation that created the world's first serological rapid tests for Tuberculosis to facilitate acid-fast bacilli microscopy for the identification of smear-positive and negative cases. Prevention of mother-to-child transmission of HIV was achieved in South East Asia by the use of rapid tests developed by Reddy in 1999. Reddy through his Corporation donated $173,050 worth of Rapid Diagnostic Tests (RDTs) for malaria in Zambia and actively participated in the prevention of child deaths due to Malaria infections. Reddy was personally invited by the president, George W. Bush, and First Lady Laura Bush to the White House for Malaria Awareness Day sponsored by US President Malaria Initiative (PMI) on Wednesday, April 25, 2007.

<span class="mw-page-title-main">Meningitis</span> Inflammation of the membranes around the brain and spinal cord

Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasionally photophobia.

<span class="mw-page-title-main">Health in Niger</span>

Niger is a landlocked country located in West Africa and has Libya, Chad, Nigeria, Benin, Mali, Burkina Faso, and Algeria as its neighboring countries. Niger was French territory that got its independence in 1960 and its official language is French. Niger has an area of 1.267 million square kilometres, nevertheless, 80% of its land area spreads through the Sahara Desert.

Meningococcal vaccine refers to any vaccine used to prevent infection by Neisseria meningitidis. Different versions are effective against some or all of the following types of meningococcus: A, B, C, W-135, and Y. The vaccines are between 85 and 100% effective for at least two years. They result in a decrease in meningitis and sepsis among populations where they are widely used. They are given either by injection into a muscle or just under the skin.

<span class="mw-page-title-main">2009–2010 West African meningitis outbreak</span> 2009 meningitis epidemic in Africa

The 2009–2010 West African meningitis outbreak was an epidemic of bacterial meningitis which occurred in Burkina Faso, Mali, Niger, and Nigeria since January 2009, an annual risk in the African meningitis belt. A total of 13,516 people have been infected with meningitis, and 931 have died. Nigeria has been the most adversely affected, with over half of the total cases and deaths occurring in the nation. The WHO reported on 27 March 2009 that 1,100 had died and there were 25,000 suspected cases. It is the worst outbreak in the region since 1996, and a third of the world's emergency vaccine stockpile for the bacterial form has been consumed. The GAVI Alliance has been trying to secure more vaccines.

MenAfriVac is a vaccine developed for use in sub-Saharan Africa for children and adults between 9 months and 29 years of age against meningococcal bacterium Neisseria meningitidis group A. The vaccine costs less than US$0.50 per dose.

<span class="mw-page-title-main">Meningitis Vaccine Project</span>

The Meningitis Vaccine Project is an effort to eliminate the meningitis epidemic in Sub-Saharan Africa by developing a new meningococcal vaccine. The meningitis problem in that area is caused by a strain of meningitis called "meningitis A", which is present only in the African meningitis belt. In June 2010 various sources announced that they had developed MenAfriVac, which is an inexpensive, safe, and highly effective vaccine which is likely to stop the epidemic as quickly as anyone had ever hoped that it would.

<i>Neisseria flavescens</i> Species of bacterium

Neisseria flavescens was first isolated from cerebrospinal fluid in the midst of an epidemic meningitis outbreak in Chicago. These gram-negative, aerobic bacteria reside in the mucosal membranes of the upper respiratory tract, functioning as commensals. However, this species can also play a pathogenic role in immunocompromised and diabetic individuals. In rare cases, it has been linked to meningitis, pneumonia, empyema, endocarditis, and sepsis.

Sir Andrew John Pollard is the Ashall Professor of Infection & Immunity at the University of Oxford and a Fellow of St Cross College, Oxford. He is an Honorary Consultant Paediatrician at John Radcliffe Hospital and the Director of the Oxford Vaccine Group. He is the Chief Investigator on the University of Oxford COVID-19 Vaccine trials and has led research on vaccines for many life-threatening infectious diseases including typhoid fever, Neisseria meningitidis, Haemophilus influenzae type b, streptococcus pneumoniae, pertussis, influenza, rabies, and Ebola.

<span class="mw-page-title-main">Diana Martin (scientist)</span> New Zealand microbiologist (1942–2019)

Diana Rae Martin was a New Zealand microbiologist. She was a Fellow of the Royal Society Te Apārangi from 2000, and was made an Officer of the New Zealand Order of Merit for services to microbiology in 2008.

Dan M. Granoff is an infectious disease physician-scientist who was named the 2014 Maurice Hilleman/Merck Laureate by the American Society for Microbiology for outstanding contributions to vaccine discovery and development. Beginning in 2011, Granoff held the Clorox Foundation Endowed Chair and was director of the Center of Immunobiology and Vaccine Development at Children's Hospital Oakland Research Institute. His work increased understanding of basic mechanisms of human immunity to encapsulated bacteria, and furthered development of vaccines against Haemophilus influenzae type B (Hib) and Neisseria meningitidis.

Penbraya is a pentavalent conjugate vaccine developed by Pfizer for the prevention of invasive meningococcal disease in people 10 through 25 years of age. Invasive meningococcal disease, caused by the bacterium Neisseria meningitidis, can lead to serious conditions such as meningitis and septicemia. Penbraya is approved for use by the US Food and Drug Administration (FDA). Penbraya is the first pentavalent vaccine that provides coverage against the five most common serogroups causing meningococcal disease.

References

  1. ↑ Lapeyssonnie, L. (November 1968). "[Comparative epidemiologic study of meningococcic cerebrospinal meningitis in temperate regions and in the meningitis belt in Africa. Attempt at synthesis]". Médecine Tropicale: Revue du Corps de Santé Colonial. 28 (6): 709–720. ISSN   0025-682X. PMID   5739513.
  2. ↑ Moore, P. S.; Reeves, M. W.; Schwartz, B.; Gellin, B. G.; Broome, C. V. (1989-07-29). "Intercontinental spread of an epidemic group A Neisseria meningitidis strain". Lancet. 2 (8657): 260–263. doi:10.1016/s0140-6736(89)90439-x. ISSN   0140-6736. PMID   2569063. S2CID   46601999.
  3. ↑ "Meningitis: Meningitis Belt". Archived from the original on 2008-05-19. Retrieved 2009-10-20.
  4. ↑ "Meningitis Vaccine Project: Epidemics in Africa". Archived from the original on 2014-04-29. Retrieved 2014-04-28.
  5. ↑ Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. (28 October 2015). Medical microbiology (8th ed.). Philadelphia, PA. ISBN   9780323299565. OCLC   914223501.{{cite book}}: CS1 maint: location missing publisher (link)
  6. ↑ Paireau, Juliette; Chen, Angelica; Broutin, Helene; Grenfell, Bryan; Basta, Nicole E (June 2016). "Seasonal dynamics of bacterial meningitis: a time-series analysis". The Lancet. Global Health. 4 (6): e370–e377. doi:10.1016/S2214-109X(16)30064-X. ISSN   2214-109X. PMC   5516123 . PMID   27198841.
  7. ↑ Mustapha, Mustapha M.; Harrison, Lee H. (2018-01-16). "Vaccine prevention of meningococcal disease in Africa: Major advances, remaining challenges". Human Vaccines & Immunotherapeutics. 14 (5): 1107–1115. doi:10.1080/21645515.2017.1412020. ISSN   2164-5515. PMC   5989898 . PMID   29211624.
  8. ↑ Lingani, Clément; Bergeron-Caron, Cassi; Stuart, James M.; Fernandez, Katya; Djingarey, Mamoudou H.; Ronveaux, Olivier; Schnitzler, Johannes C.; Perea, William A. (2015-11-15). "Meningococcal Meningitis Surveillance in the African Meningitis Belt, 2004-2013". Clinical Infectious Diseases. 61 (Suppl 5): S410–415. doi:10.1093/cid/civ597. ISSN   1537-6591. PMC   4639499 . PMID   26553668.
  9. ↑ "Meningococcal Disease - Chapter 4 - 2020 Yellow Book | Travelers' Health | CDC". wwwnc.cdc.gov. Retrieved 2020-11-18.
  10. ↑ World Health Organization. "Weekly epidemiological record" (PDF).
  11. ↑ Al-Tawfiq, Jaffar (2010). "Meningococcal Disease: The Organism, Clinical Presentation, and Worldwide Epidemiology". Journal of Travel Medicine. 7: 3–8. doi: 10.1111/j.1708-8305.2010.00448.x . PMID   20849427.
  12. ↑ Greenwood, B. M.; Bradley, A. K.; Smith, A. W.; Wall, R. A. (1987). "Mortality from meningococcal disease during an epidemic in The Gambia, West Africa". Transactions of the Royal Society of Tropical Medicine and Hygiene. 81 (4): 536–538. doi:10.1016/0035-9203(87)90397-x. ISSN   0035-9203. PMID   3445333.
  13. ↑ Ramakrishnan, Meenakshi; Ulland, Aaron J; Steinhardt, Laura C; Moïsi, Jennifer C; Were, Fred; Levine, Orin S (2009-09-14). "Sequelae due to bacterial meningitis among African children: a systematic literature review". BMC Medicine. 7: 47. doi: 10.1186/1741-7015-7-47 . ISSN   1741-7015. PMC   2759956 . PMID   19751516.
  14. ↑ Tiffay, Kathleen; Jodar, Luis; Kieny, Marie-Paule; Socquet, Muriel; LaForce, F. Marc (2015-11-09). "The Evolution of the Meningitis Vaccine Project". Clinical Infectious Diseases. 61 (suppl_5). Oxford University Press (OUP): S396–S403. doi:10.1093/cid/civ594. ISSN   1537-6591. PMC   4639496 . PMID   26553666.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.