A critical review of control strategies against meningococcal meningitis epidemics in sub-Saharan African countries.
The control strategy of meningitis epidemics in sub-Saharan countries, although reexamined regularly, is based on epidemiological, immunological and logistical considerations put forward at the end of the 1970s. It comprises organizing large-scale vaccinations in the event of a declared epidemic. The obvious failure of this strategy recommended by the World Health Organization (WHO) necessitates evaluation of the emergency vaccination criteria. Despite current controversy on the immunogenicity of the polysaccharide vaccine, its safety, effectiveness in the field and low cost could justify the reopening of a debate on its use in routine vaccination. Routine--or preventive--vaccination could significantly reduce the incidence of meningococcal meningitis and its severity. The conjugate vaccine, when available, will constitute an additional advantage in the prevention of meningococcal meningitis. A strategy combining both polysaccharide and conjugate vaccines according to the population targets and possibilities for funding remain to be defined.
Chippaux
J P
JP
Institute de Recherche pour le Developpement, Dakar, Senegal. chippaux@ird.sn
Debois
H
H
Saliou
P
P
D000293:Adolescent; D000328:Adult; D000349:Africa; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D019983:Guideline Adherence; D006291:Health Policy; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D012307:Risk Factors; D014944:World Health Organization
D022401:Meningococcal Vaccines