Meningococcal meningitis epidemics in sub-Saharan Africa and the meningococcal A conjugate vaccine

Group A meningococci are primarily responsible for the epidemic meningococcal diseases in the countries of the meningitis belt of sub-Saharan Africa. In 1995-1996 major epidemics (>200 000 cases) impeded effective management and ultimately resulted in many improvements. Since 2003, the Multi-Disease Center (MDSC) in Ouagadougou (Burkina Faso) and the WHO in Geneva have collected epidemiologic and laboratory data; new alert and epidemic thresholds are applied; and management has improved, with a single dose of ceftriaxone or of oily chloramphenicol now recommended. Trivalent ACW vaccine has been introduced against serogroup W135 epidemics. In 2010, preventive vaccination campaigns using the meningococcal conjugate vaccine MenAfriVac (R) began. Their use in all countries of the meningitis belt could eliminate serogroup A outbreaks in the region.