The epidemiology of meningococcal disease in India.
OBJECTIVE
To undertake a review of the literature on the epidemiology of meningococcal disease in India, with a view to informing future control policies.


METHODS
We searched the PUBMED, EMBASE, Global Health, IMSEAR and MedIND databases for observational studies relating to the burden of endemic meningococcal disease in India, the occurrence and epidemiological characteristics of epidemics, and the prevalence of individual meningococcal serogroups.


RESULTS
The relatively few reports identified suggest that the incidence of endemic meningococcal disease in India is low, but that occasional epidemics of meningococcal disease have been recorded for at least 100 years. The larger epidemics have affected mainly the cities of northern India and have almost universally been caused by meningococci belonging to serogroup A. These epidemics have showed a few characteristics, including a marked seasonality, which are similar to those of epidemic meningococcal A disease in Africa.


CONCLUSIONS
New serogroup A-containing meningococcal conjugate vaccines are now being developed and reaching the market, including an affordable monovalent serogroup A vaccine manufactured in India, but intended primarily for use in Africa. These new tools may have a role in containing future Indian epidemics, but their usefulness is dependent on early identification of epidemics. This will require a functional disease surveillance system with adequate laboratory support throughout India.
The South Asian Cochrane Centre, Christian Medical College, Vellore, India. davesinkers@yahoo.com
David
D
Sinclair
Marie-Pierre
MP
Preziosi
T
T
Jacob John
Brian
B
Greenwood
D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000453:epidemiology; D002648:Child; D004196:Disease Outbreaks; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D009305:Nasopharynx / Q000382:microbiology; D038381:Neisseria meningitidis, Serogroup A / Q000302:isolation & purification; D012621:Seasons; D055815:Young Adult