Agier L., Martiny N., Thiongane Oumy, Mueller J. E., Paireau J., Watkins E. R., Irving T. J., Koutangni T., Broutin H. (2017). Towards understanding the epidemiology of Neisseria meningitidis in the African meningitis belt : a multi-disciplinary overview. International Journal of Infectious Diseases, 54, p. 103-112. ISSN 1201-9712.
Titre du document
Towards understanding the epidemiology of Neisseria meningitidis in the African meningitis belt : a multi-disciplinary overview
Agier L., Martiny N., Thiongane Oumy, Mueller J. E., Paireau J., Watkins E. R., Irving T. J., Koutangni T., Broutin H.
Source
International Journal of Infectious Diseases, 2017,
54, p. 103-112 ISSN 1201-9712
Objectives: Neisseria meningitidis is the major cause of seasonal meningitis epidemics in the African meningitis belt. In the changing context of a reduction in incidence of serogroup A and an increase in incidence of serogroups W and C and of Streptococcus pneumoniae, a better understanding of the determinants driving the disease transmission dynamics remains crucial to improving bacterial meningitis control. Methods: The literature was searched to provide a multi-disciplinary overview of the determinants of meningitis transmission dynamics in the African meningitis belt. Results: Seasonal hyperendemicity is likely predominantly caused by increased invasion rates, sporadic localized epidemics by increased transmission rates, and larger pluri-annual epidemic waves by changing population immunity. Carriage likely involves competition for colonization and cross-immunity. The duration of immunity likely depends on the acquisition type. Major risk factors include dust and low humidity, and presumably human contact rates and co-infections; social studies highlighted environmental and dietary factors, with supernatural explanations. Conclusions: Efforts should focus on implementing multi-country, longitudinal seroprevalence and epidemiological studies, validating immune markers of protection, and improving surveillance, including more systematic molecular characterizations of the bacteria. Integrating climate and social factors into disease control strategies represents a high priority for optimizing the public health response and anticipating the geographic evolution of the African meningitis belt.
