@article{fdi:010083166,
  title = {{A}n overview of bacterial meningitis epidemics in {A}frica from 1928 to 2018 with a focus on epidemics "outside-the-belt"},
  author = {{M}azamay, {S}. and {G}u{\'e}gan, {J}ean-{F}ran{\c{c}}ois and {D}iallo, {N}. and {B}ompangue, {D}. and {B}okabo, {E}. and {M}uyembe, {J}. {J}. and {T}aty, {N}. and {V}ita, {T}. {P}. and {B}routin, {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {B}acterial meningitis occurs worldwide but {A}frica remains the most affected continent, especially in the "{M}eningitis belt" that extends from {S}enegal to {E}thiopia. {T}hree main bacteria are responsible for causing bacterial meningitis, i.e., {N}. meningitidis ({N}m), {S}. pneumoniae and {H}. influenzae type b. {A}mong {N}m, serogroup {A} used to be responsible for up to 80 to 85% of meningococcal meningitis cases in {A}frica. {S}ince 2000, other {N}m serogroups including {W}, {X} and {C} have also been responsible for causing epidemics. {T}his overview aims to describe the main patterns of meningitis disease cases and pathogens from 1928 to 2018 in {A}frica with a special focus on disease conditions "out-of-the-belt" area that is still usually unexplored. {B}ased on basic spatio-temporal methods, and a 90-years database of reported suspected meningitis cases and death from the {W}orld {H}ealth {O}rganization, we used both geographic information system and spatio-temporal statistics to identify the major localizations of meningitis epidemics over this period in {A}frica. {R}esults {B}acterial meningitis extends today outside its historical limits of the meningitis belt. {S}ince the introduction of {M}en{A}frivac vaccine in 2010, there has been a dramatic decrease in {N}m{A} cases while other pathogen species and {N}m variants including {N}m{W}, {N}m{C} and {S}treptococcus pneumoniae have become more prevalent reflecting a greater diversity of bacterial strains causing meningitis epidemics in {A}frica today. {C}onclusion {B}acterial meningitis remains a major public health problem in {A}frica today. {F}ormerly concentrated in the region of the meningitis belt with {S}ub-{S}aharan and {S}udanian environmental conditions, the disease extends now outside these historical limits to reach more forested regions in the central parts of the continent. {W}ith 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.},
  keywords = {{M}eningitis ; {E}pidemics ; {E}pidemiology ; {P}athogens ; {T}ime-series ; {S}patial analysis ; {I}n- and outside the meningitis belt ; {AFRIQUE}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {21},
  numero = {1},
  pages = {1027 [13 ]},
  year = {2021},
  DOI = {10.1186/s12879-021-06724-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083166},
}