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Timely detection of bacterial meningitis epidemics at district level: a studyin three countries of the African Meningitis Belt

Agier, Lydiane ; Broutin, Hélène ; Bertherat, Eric ; Djingarey, Mamoudou H. ; Lingani, Clement ; Perea, William ; Hugonnet, Stéphane

In: Transactions of The Royal Society of Tropical Medicine and Hygiene, 2013, vol. 107, no. 1, p. 30-36

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    Titre
    • Timely detection of bacterial meningitis epidemics at district level: a studyin three countries of the African Meningitis Belt
    Auteur
    • Agier, Lydiane. Epidemic and Pandemic Alert and Response, World Health Organization, Geneva, Switzerland
    • Broutin, Hélène. Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
    • Bertherat, Eric. Epidemic and Pandemic Alert and Response, World Health Organization, Geneva, Switzerland
    • Djingarey, Mamoudou H.. Intercountry Support Team for West Africa, WHO, Ouagadougou, Burkina Faso
    • Lingani, Clement. Intercountry Support Team for West Africa, WHO, Ouagadougou, Burkina Faso
    • Perea, William. Epidemic and Pandemic Alert and Response, World Health Organization, Geneva, Switzerland
    • Hugonnet, Stéphane. Epidemic and Pandemic Alert and Response, World Health Organization, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Transactions of The Royal Society of Tropical Medicine and Hygiene, 2013, vol. 107, no. 1, p. 30-36. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:302527
    Summary
    Background Bacterial meningitis is a major public health problem in the African ‘Meningitis Belt', where recurrent unpredictable epidemics occur. Despite the introduction in 2010 of the conjugate A vaccine, the reactive strategy remains important for responding to epidemics caused by other bacteria and in areas not yet vaccinated. Review of weekly numbers of suspected cases in Niger, Mali and Burkina Faso identified spatial disparities in the annual patterns of meningitis, which suggested a more local way of defining epidemics and initiating a timely vaccination campaign. Method We defined an epidemic district-year as an excess of cases compared to the incidence previously experienced in the given district. Groups of similar districts in terms of seasonal patterns were identified by cluster analysis. We investigated a cluster-specific criterion of early epidemic onset to anticipate epidemic district-years. Results These were encouraging, as epidemic district-years were fairly efficiently captured, with an average time gained of 2.5 weeks over the current strategy. Conclusion This early-onset criterion could help ensure timely implementation of vaccination campaigns without the need to modify the implemented surveillance system. The next step is to extend this study to other countries of the Meningitis Belt, and to explain the differences in seasonal patterns in the different clusters