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Sidikou F, Potts CC, Zaneidou M, Mbaeyi S, Kadadé G, Paye MF, Ousmane S, Issaka B, Chen A, Chang HY, Issifou D, Lingani C, Sakande S, Bienvenu B, Mahamane AE, Diallo AO, Moussa A, Seidou I, Abdou M, Sidiki A, Garba O, Haladou S, Testa J, Obama Nse R, Mainassara HB, Wang X. Epidemiology of Bacterial Meningitis in the Nine Years Since Meningococcal Serogroup A Conjugate Vaccine Introduction, Niger, 2010-2018. J Infect Dis 2019; 220:S206-S215. [PMID: 31671439 DOI: 10.1093/infdis/jiz296] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In 2010, Niger and other meningitis belt countries introduced a meningococcal serogroup A conjugate vaccine (MACV). We describe the epidemiology of bacterial meningitis in Niger from 2010 to 2018. METHODS Suspected and confirmed meningitis cases from January 1, 2010 to July 15, 2018 were obtained from national aggregate and laboratory surveillance. Cerebrospinal fluid specimens were analyzed by culture and/or polymerase chain reaction. Annual incidence was calculated as cases per 100 000 population. Selected isolates obtained during 2016-2017 were characterized by whole-genome sequencing. RESULTS Of the 21 142 suspected cases of meningitis, 5590 were confirmed: Neisseria meningitidis ([Nm] 85%), Streptococcus pneumoniae ([Sp] 13%), and Haemophilus influenzae ([Hi] 2%). No NmA cases occurred after 2011. Annual incidence per 100 000 population was more dynamic for Nm (0.06-7.71) than for Sp (0.18-0.70) and Hi (0.01-0.23). The predominant Nm serogroups varied over time (NmW in 2010-2011, NmC in 2015-2018, and both NmC and NmX in 2017-2018). Meningococcal meningitis incidence was highest in the regions of Niamey, Tillabery, Dosso, Tahoua, and Maradi. The NmW isolates were clonal complex (CC)11, NmX were CC181, and NmC were CC10217. CONCLUSIONS After MACV introduction, we observed an absence of NmA, the emergence and continuing burden of NmC, and an increase in NmX. Niger's dynamic Nm serogroup distribution highlights the need for strong surveillance programs to inform vaccine policy.
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Affiliation(s)
- Fati Sidikou
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Caelin C Potts
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maman Zaneidou
- Direction de la Surveillance et Riposte aux Epidémies, Ministry of Health, Niamey, Niger
| | - Sarah Mbaeyi
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Goumbi Kadadé
- Direction de la Surveillance et Riposte aux Epidémies, Ministry of Health, Niamey, Niger
| | - Marietou F Paye
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sani Ousmane
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Bassira Issaka
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Alexander Chen
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - How-Yi Chang
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Djibo Issifou
- Direction de la Surveillance et Riposte aux Epidémies, Ministry of Health, Niamey, Niger
| | - Clement Lingani
- World Health Organization-Intercountry Support Team, Ouagadougou, Burkina Faso
| | | | | | - Ali Elhadji Mahamane
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Alpha Oumar Diallo
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amadou Moussa
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Issaka Seidou
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Moussa Abdou
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Ali Sidiki
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Omar Garba
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Sani Haladou
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Jean Testa
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | | | - Halima Boubacar Mainassara
- Centre de Recherche Médicale et Sanitaire, Ministry of Public Health, Institut Pasteur International Network, Niamey, Niger
| | - Xin Wang
- Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
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