title: Epidemic meningitis due to Group A Neisseria meningitidis in the African meningitis belt: a persistent problem with an imminent solution.
abstract: Epidemic meningitis in Africa remains an important and unresolved public health problem. Bacteriologic and epidemiologic data collected over the past 30 years have consistently established the importance of Group A Neisseria meningitidis as the dominant etiologic agent. The meningococcal Group A capsule is the major virulence factor; it is a polysaccharide comprised of a repeating unit of partly O-acetylated alpha-1,6-linked N-acetylmannosamine phosphate. Meningitis epidemics occur annually during the dry season (January to May) and stop with the first rains. Until now, control of these meningitis epidemics has relied on a reactive vaccination strategy with polysaccharide vaccines that is logistically complicated and has not put an end to recurrent epidemics. A meningococcal A conjugate vaccine (MenAfriVac) has been developed and tested in Phase II clinical trials in Africa. The vaccine has been shown to be safe and to generate a sustained immunologic response with functional antibody 20 times higher than that seen with polysaccharide vaccine. Widespread use of such a vaccine is likely to generate herd immunity and to put an end to Group A meningococcal epidemics.
authors.affiliation: PATH, 13 Chemin du Levant, Ferney-Voltaire 01210, France. fmlaforce@path.org
authors.forename: F
authors.initials: F
authors.lastname: Marc LaForce
authors.forename: Neil
authors.initials: N
authors.lastname: Ravenscroft
authors.forename: Mamoudou
authors.initials: M
authors.lastname: Djingarey
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
mesh_terms: D000349:Africa / Q000453:epidemiology; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000276:immunology; D038381:Neisseria meningitidis, Serogroup A / Q000276:immunology / Q000302:isolation & purification*; D012621:Seasons; D018074:Vaccines, Conjugate / Q000276:immunology
chemical_list: D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate