Fati Sidikou1, Maman Zaneidou2, Ibrahim Alkassoum2, Stephanie Schwartz3, Bassira Issaka1, Ricardo Obama4, Clement Lingani5, Ashley Tate3, Flavien Ake6, Souleymane Sakande7, Sani Ousmane1, Jibir Zanguina1, Issaka Seidou1, Innocent Nzeyimana4, Didier Mounkoro8, Oubote Abodji8, Xin Wang3, Muhamed-Kheir Taha9, Jean Paul Moulia-Pelat1, Assimawe Pana4, Goumbi Kadade2, Olivier Ronveaux10, Ryan Novak3, Odile Ouwe Missi Oukem-Boyer1, Sarah Meyer11. 1. Centre de Recherche Médicale et Sanitaire (CERMES), Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger. 2. Direction de la Surveillance et Riposte aux Epidémies, Ministry of Health, Niamey, Niger. 3. Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. World Health Organization-Niger, Niamey, Niger. 5. World Health Organization Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso. 6. Davycas Consulting, Gounghin Petit-Paris, Ouagadougou, Burkina Faso. 7. Agence de Médecine Préventive-Ouagadougou, Ouagadougou, Burkina Faso. 8. Agence de Médecine Préventive-Togo, Dapaong, Togo. 9. Institut Pasteur, Paris, France. 10. World Health Organization, Geneva, Switzerland. 11. Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: SMeyer@cdc.gov.
Abstract
BACKGROUND: To combat Neisseria meningitidis serogroup A epidemics in the meningitis belt of sub-Saharan Africa, a meningococcal serogroup A conjugate vaccine (MACV) has been progressively rolled out since 2010. We report the first meningitis epidemic in Niger since the nationwide introduction of MACV. METHODS: We compiled and analysed nationwide case-based meningitis surveillance data in Niger. Cases were confirmed by culture or direct real-time PCR, or both, of cerebrospinal fluid specimens, and whole-genome sequencing was used to characterise isolates. Information on vaccination campaigns was collected by the Niger Ministry of Health and WHO. FINDINGS: From Jan 1 to June 30, 2015, 9367 suspected meningitis cases and 549 deaths were reported in Niger. Among 4301 cerebrospinal fluid specimens tested, 1603 (37·3%) were positive for a bacterial pathogen, including 1147 (71·5%) that were positive for N meningitidis serogroup C (NmC). Whole-genome sequencing of 77 NmC isolates revealed the strain to be ST-10217. Although vaccination campaigns were limited in scope because of a global vaccine shortage, 1·4 million people were vaccinated from March to June, 2015. INTERPRETATION: This epidemic represents the largest global NmC outbreak so far and shows the continued threat of N meningitidis in sub-Saharan Africa. The risk of further regional expansion of this novel clone highlights the need for continued strengthening of case-based surveillance. The availability of an affordable, multivalent conjugate vaccine may be important in future epidemic response. FUNDING: MenAfriNet consortium, a partnership between the US Centers for Disease Control and Prevention, WHO, and Agence de Médecine Preventive, through a grant from the Bill & Melinda Gates Foundation.
BACKGROUND: To combat Neisseria meningitidis serogroup A epidemics in the meningitis belt of sub-Saharan Africa, a meningococcal serogroup A conjugate vaccine (MACV) has been progressively rolled out since 2010. We report the first meningitis epidemic in Niger since the nationwide introduction of MACV. METHODS: We compiled and analysed nationwide case-based meningitis surveillance data in Niger. Cases were confirmed by culture or direct real-time PCR, or both, of cerebrospinal fluid specimens, and whole-genome sequencing was used to characterise isolates. Information on vaccination campaigns was collected by the Niger Ministry of Health and WHO. FINDINGS: From Jan 1 to June 30, 2015, 9367 suspected meningitis cases and 549 deaths were reported in Niger. Among 4301 cerebrospinal fluid specimens tested, 1603 (37·3%) were positive for a bacterial pathogen, including 1147 (71·5%) that were positive for N meningitidis serogroup C (NmC). Whole-genome sequencing of 77 NmC isolates revealed the strain to be ST-10217. Although vaccination campaigns were limited in scope because of a global vaccine shortage, 1·4 million people were vaccinated from March to June, 2015. INTERPRETATION: This epidemic represents the largest global NmC outbreak so far and shows the continued threat of N meningitidis in sub-Saharan Africa. The risk of further regional expansion of this novel clone highlights the need for continued strengthening of case-based surveillance. The availability of an affordable, multivalent conjugate vaccine may be important in future epidemic response. FUNDING: MenAfriNet consortium, a partnership between the US Centers for Disease Control and Prevention, WHO, and Agence de Médecine Preventive, through a grant from the Bill & Melinda Gates Foundation.
Authors: Abudulai Adams Forgor; Julia Leimkugel; Abraham Hodgson; Akalifa Bugri; Jean-Pierre Dangy; Sébastien Gagneux; Tom Smith; Gerd Pluschke Journal: Trop Med Int Health Date: 2005-12 Impact factor: 2.622
Authors: Clément Lingani; Cassi Bergeron-Caron; James M Stuart; Katya Fernandez; Mamoudou H Djingarey; Olivier Ronveaux; Johannes C Schnitzler; William A Perea Journal: Clin Infect Dis Date: 2015-11-15 Impact factor: 9.079
Authors: Henju Marjuki; Nadav Topaz; Lorraine D Rodriguez-Rivera; Edward Ramos; Caelin C Potts; Alexander Chen; Adam C Retchless; Gregory H Doho; Xin Wang Journal: J Clin Microbiol Date: 2019-02-27 Impact factor: 5.948
Authors: S M Niaz Arifin; Christoph Zimmer; Caroline Trotter; Anaïs Colombini; Fati Sidikou; F Marc LaForce; Ted Cohen; Reza Yaesoubi Journal: Med Decis Making Date: 2019-07-03 Impact factor: 2.583
Authors: Jaymin C Patel; Heidi M Soeters; Alpha Oumar Diallo; Brice W Bicaba; Goumbi Kadadé; Assétou Y Dembélé; Mahamat A Acyl; Christelle Nikiema; Clement Lingani; Cynthia Hatcher; Anna M Acosta; Jennifer D Thomas; Fabien Diomande; Stacey Martin; Thomas A Clark; Richard Mihigo; Rana A Hajjeh; Catherine H Zilber; Flavien Aké; Sarah A Mbaeyi; Xin Wang; Jennifer C Moisi; Olivier Ronveaux; Jason M Mwenda; Ryan T Novak Journal: J Infect Dis Date: 2019-10-31 Impact factor: 5.226