Epidemiological Status of Bacterial Meningitis Disease Following the Introduction of the Meningococcal A Conjugate Vaccine in the African Meningitis Belt

Bacterial meningitis disease is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (Neisseria meningitidis A) was the predominant pathogen causing about 90 percent of meningitis epidemics in Africa. The meningococcal A conjugate vaccine (MACV) protecting against Neisseria meningitidis A was introduced since 2010. The purpose of this quantitative study was to determine the magnitude and fatality of meningitis bacterial disease in Africa following the introduction of MACV from 2010 and 2017. An interrupted time series design and nonprobability sampling were used. Secondary data issued of meningitis enhanced surveillance were retrieved from World Health Organization database. The binomial negative regression and Pearson’s Chi-Square tests were used. The study found that after the MACV introduction there was a 39% decline of incidence rate of meningitis suspected cases (IRR 0.61, 95% CI 0.48 – 0.79, p 10%) after the MACV immunization (RR 0.547, 95% CI 0.40 – 0.74). There was a 49% decline of fatal meningitis (IRR 0.51, 95% CI 0.41 – 0.68, p < .001). After 2010, Neisseria meningitidis A declined and S. Pneumoniae, Neisseria meningitidis W135, Neisseria meningitidis C, Neisseria meningitidis X, and Hib became predominant. Between 2010 and 2017 Neisseria meningitidis all serogroups concerned remained higher the other pathogens 15,885 (62.06%) Vs 25,596. The study showed that following the MACV introduction despite the dramatic reduction of Neisseria meningitidis A, meningococcal meningitis bacterial disease remains a major public health problem.