Disease Burden from Group A Neisseria meningitidis Meningitis in Hyperendemic Countries of the African Meningitis Belt

Abstract

Neisseria meningitidis meningitis is a devastating illness characterized by the sudden onset of intense headache, high fever, nausea, vomiting, photophobia, and stiff neck. The disease has a high mortality rate and is associated with long-term neurological defects such as deafness and recurrent seizures. Epidemics of group A meningococcal meningitis continue to pose an important public health problem for sub-Saharan Africa. The last major epidemic occurred in 1996–1997, with more than 180,000 reported cases and 20,000 deaths. During 2006 and 2007 Burkina Faso suffered more than 45,000 cases of group A meningococcal meningitis. Using the population-based incidence and bacteriologic data from Niger to estimate disease burden in seven hyperendemic countries (Mali, Burkina Faso, Niger, Nigeria, Chad, Sudan, and Ethiopia), over a 10-year period, group A N. meningitidis is estimated to cause about 1.1 million cases of meningitis, 133,000 deaths, 317,000 disabilities, and 12 million disability-adjusted life years lost in the population 0- to 40-year-old cohorts. Over the last few years a major effort has been under way to control epidemic meningococcal disease in Africa through the development, testing, licensure, and introduction of new conjugate meningococcal vaccines. The Meningitis Vaccine Project, a partnership between PATH and the World Health Organization, is developing an affordable meningococcal A conjugate vaccine that will be introduced at public health scale in 2009. Wide-scale introduction of the meningococcal A conjugate vaccine is expected to eliminate these epidemics.