Institution: | 1.Department of Pediatrics and Child Health, Division of Women and Child Health,Aga Khan University,Karachi,Pakistan;2.Centers for Disease Control and Prevention,Atlanta,USA;3.Immunisation, Vaccines and Biologicals,World Health Organisation,Geneva,Switzerland;4.School of Medicine and Public Health,University of Newcastle,Callaghan,Australia;5.Health Protection,Hunter New England Area,Wallsend,Australia;6.Finnish National Institute for Health and Welfare (THL),Helsinki,Finland;7.International vaccination working group,Médécins Sans Frontières,Paris,France;8.Global Health, Rollins School of Public Health,Emory University,Atlanta,USA;9.Respiratory and Meningeal Pathogens Research Unit,University of Witwatersrand and Medical Research Council,Johannesburg,South Africa;10.Immunisation Department at the Health Protection Agency,Centre for Infections in Colindale,London,UK;11.Center for Vaccine Development,Ministry of Health,Bamako,Mali;12.School of Medicine,University of Maryland,Baltimore,USA;13.Institute for Communicable Disease Control and Prevention,Beijing,Republic of China;14.Winston-Salem,USA |
Abstract: | Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20 years in World Health Organization and European Centre for Disease Prevention and Control collections and published articles are included in this review, as well as direct communications with leading experts in the field. Countries were grouped into high-, moderate-, and low-incidence countries. The majority of countries in the high-incidence group are found in the African meningitis belt; many moderate-incidence countries are found in the European and African regions, and Australia, while low-incidence countries include many from Europe and the Americas. Priority countries for vaccine intervention are high- and moderate-incidence countries where vaccine-preventable serogroups predominate. Epidemiological data on burden of IMD are needed in countries where this is not known, particularly in South- East Asia and Eastern Mediterranean regions, so evidence-based decisions about the use of meningococcal vaccines can be made. |