@article{fdi:010079048,
  title = {{U}nderstanding the spatio-temporal dynamics of meningitis epidemics outside the belt : the case of the {D}emocratic {R}epublic of {C}ongo ({DRC})},
  author = {{M}azamay, {S}. and {B}ompangue, {D}. and {G}u{\'e}gan, {J}ean-{F}ran{\c{c}}ois and {M}uyembe, {J}. {J}. and {R}aoul, {F}. and {B}routin, {H}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {B}acterial meningitis remains a major threat for the population of the meningitis belt. {B}etween 2004 and 2009, in the countries of this belt, more than 200,000 people were infected with a 10% mortality rate. {H}owever, for almost 20 years, important meningitis epidemics are also reported outside this belt. {R}esearch is still very poorly developed in this part of the word like in the {D}emocratic {R}epublic of {C}ongo ({DRC}), which experiences recurrent epidemics. {T}his article describes for the first time the spatio-temporal patterns of meningitis cases and epidemics in {DRC}, in order to provide new insights for surveillance and control measures. {M}ethods {B}ased on weekly suspected cases of meningitis (2000-2012), we used time-series analyses to explore the spatio-temporal dynamics of the disease. {W}e also used both geographic information systems and geostatistics to identify spatial clusters of cases. {B}oth using conventional statistics and the {C}leveland's algorithm for decomposition into general trend, seasonal and residuals, we searched for the existence of seasonality. {R}esults {W}e observed a low rate of biological confirmation of cases (11%) using soluble antigens search, culture and {PCR}. {T}he main strains found are {S}treptococcus pneumoniae, {H}aemophilus influenzae and {N}eisseria meningitidis ({A} and {C}) serogroups. {W}e identified 8 distinct spatial clusters, located in the northeastern and southeastern part of {DRC}, and in the capital city province, {K}inshasa. {A} low seasonal trend was observed with higher incidence and attack rate of meningitis during the dry season, with a high heterogeneity in seasonal patterns occurring across the different districts and regions of {DRC}. {C}onclusion {D}espite challenges related to completeness of data reporting, meningitis dynamics shows weak seasonality in {DRC}. {T}his tends to suggest that climatic, environmental factors might be less preponderant in shaping seasonal patterns in central {A}frica. {T}he characterization of 8 distinct clusters of meningitis could be used for a better sentinel meningitis surveillance and optimization of vaccine strategy in {DRC}. {I}mproving biological monitoring of suspected cases should be a priority for future eco-epidemiological studies to better understand the emergence and spread of meningitis pathogens, and the potential ecological, environmental drivers of this disease.},
  keywords = {{E}pidemics ; {E}co-epidemiology ; {S}patial clusters ; {S}easonality ; {REPUBLIQUE} {DEMOCRATIQUE} {DU} {CONGO}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {20},
  numero = {1},
  pages = {art. 291 [12 ]},
  year = {2020},
  DOI = {10.1186/s12879-020-04996-7},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079048},
}