title: Detection of meningitis epidemics in Africa: a population-based analysis.
abstract: Portions of sub-Saharan Africa are subject to major epidemics of meningococcal meningitis that require early detection and rapid control. We evaluated the usefulness of weekly meningitis rates derived from active surveillance data in Burkina Faso for detecting a meningitis epidemic. By analysing the rates of disease in 40 x 40km2 areas within a study region of Burkina Faso, we found that a threshold of 15 cases/100,000/week averaged over 2 weeks was 72-93% sensitive and 92-100% specific in detecting epidemics exceeding 100 cases/100,000/year. During epidemic periods, the positive predictive value of this threshold approached 100% for detecting local epidemics. Additionally, meningitis incidence was proportional to village size, with villages greater than 8000 having the highest disease rates during a major group A meningococcal epidemic in 1983-1984. Despite the rudimentary nature of surveillance data available in many developing countries, these data can be used to detect the early emergence of meningitis epidemics. Additional studies are needed to determine the relevance of this approach for detecting epidemics.
authors.affiliation: Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: P S
authors.initials: PS
authors.lastname: Moore
authors.forename: B D
authors.initials: BD
authors.lastname: Plikaytis
authors.forename: G A
authors.initials: GA
authors.lastname: Bolan
authors.forename: M J
authors.initials: MJ
authors.lastname: Oxtoby
authors.forename: A
authors.initials: A
authors.lastname: Yada
authors.forename: A
authors.initials: A
authors.lastname: Zoubga
authors.forename: A L
authors.initials: AL
authors.lastname: Reingold
authors.forename: C V
authors.initials: CV
authors.lastname: Broome
mesh_terms: D002050:Burkina Faso / Q000453:epidemiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000517:prevention & control; D011156:Population Density; D011159:Population Surveillance; D012189:Retrospective Studies; D014611:Vaccination