Topic
Meningitis Vaccine Project
About: Meningitis Vaccine Project is a research topic. Over the lifetime, 44 publications have been published within this topic receiving 1614 citations.
Papers
TL;DR: In the medium term, the best prospect for the control of meningococcal meningitis in Africa lies in the recent development of polysaccharide-protein conjugate vaccines which, unlike poly Saccharide vaccines, are immunogenic in the very young, induce immunological memory and are likely to give long-lasting protection.
Abstract: This review covers the history of meningococcal meningitis in Africa since epidemics of the infection were first described around 100 years ago. It is possible that an epidemic strain of the meningococcus was introduced into West Africa from the Sudan by pilgrims returning from the Haj around the turn of the century. Since 1905 major epidemics of meningococcal meningitis have occurred in countries of the Sahel and sub-Sahel every few years, culminating in a massive epidemic in which nearly 200,000 cases were reported in 1996. Attempts to control epidemic meningococcal meningitis in Africa by vaccination with meningococcal polysaccharide vaccines have met with only modest success because epidemics can progress with great rapidity and vaccination is often started too late. This situation should be improved as a result of a recent initiative, the International Coordinating Group (ICG), which is contributing to better surveillance in countries at risk and ensuring that vaccine is available when needed. However, in the medium term, the best prospect for the control of meningococcal meningitis in Africa lies in the recent development of polysaccharide-protein conjugate vaccines which, unlike polysaccharide vaccines, are immunogenic in the very young, induce immunological memory and are likely to give long-lasting protection.
356 citations
TL;DR: The PsA-TT vaccine elicited a stronger response to group A antibody than the PsACWY vaccine, and had obvious immunologic memory after receiving a polysaccharide booster vaccine.
Abstract: Background Group A meningococci are the source of major epidemics of meningitis in Africa An affordable, highly immunogenic meningococcal A conjugate vaccine is needed Methods We conducted two studies in Africa to evaluate a new MenA conjugate vaccine (PsA-TT) In study A, 601 children, 12 to 23 months of age, were randomly assigned to receive PsA-TT, a quadrivalent polysaccharide reference vaccine (PsACWY), or a control vaccine (Haemophilus influenzae type b conjugate vaccine [Hib-TT]) Ten months later, these children underwent another round of randomization within each group to receive a full dose of PsA-TT, a one-fifth dose of PsACWY, or a full dose of Hib-TT, with 589 of the original participants receiving a booster dose In study B, 900 subjects between 2 and 29 years of age were randomly assigned to receive PsA-TT or PsACWY Safety and reactogenicity were evaluated, and immunogenicity was assessed by measuring the activity of group A serum bactericidal antibody (SBA) with rabbit complement and pe
178 citations
TL;DR: A vaccine introduction plan has been developed that includes introduction of the Men A conjugate vaccine into standard Expanded Programme on Immunization (EPI) schedules but also emphasizes mass vaccination of 1-29 years old to induce herd immunity, a strategy that has been shown to be highly effective when the meningococcal C (Men C) conjugates vaccine was introduced in several European countries.
174 citations
TL;DR: A meningococcal A conjugate vaccine (MenAfriVac) has been developed and tested in Phase II clinical trials in Africa and shown to be safe and to generate a sustained immunologic response with functional antibody 20 times higher than that seen with polysaccharide vaccine.
166 citations
TL;DR: A dramatic fall in NmA incidence after the introduction of PsA-TT is confirmed, confirming a global overview of the epidemiology of meningitis in the region, despite limitations in data quality and completeness.
Abstract: Countries in the African “meningitis belt,” an area in sub-Saharan Africa that stretches from Senegal in the west to Ethiopia in the east, are susceptible to intermittent devastating outbreaks of meningococcal meningitis, with attack rates as high as 1% of the population during major epidemics [1]. Most epidemics have been due to group A Neisseria meningitidis (NmA), and some have been due to groups C, W, and X (NmC, NmW, and NmX, respectively). In 2003, countries put in place an enhanced meningitis surveillance network with support of the World Health Organization (WHO) and the Meningitis Vaccine Project, a joint WHO/PATH initiative [2]. Standard operating procedures for surveillance implementation were developed and disseminated to participating countries; in short, data on suspected cases and deaths are recorded and transmitted weekly from health centers to the district medical officer, including zero reporting, and onward by radio, telephone, fax, or email to provincial and national levels [3]. When available, cerebrospinal fluid (CSF) specimens are sent to microbiology laboratories for the identification of the pathogen by rapid diagnostic test, polymerase chain reaction (PCR), latex agglutination test, or culture. Each country reports to the WHO Inter-country Support Team (WHO/IST) for West Africa each week in the meningitis season, and monthly the rest of the year.
An electronic application was developed by WHO for the compilation and analysis of the data. The system was implemented in 2005, with the database hosted in WHO/IST. Following initial variation in the format of data on cases and deaths provided by week and district, WHO/IST worked with reporting countries to standardize the format. Most participating countries are now providing data on the number of cases and deaths by district and week in an electronic format based on a standardized Microsoft Excel format or Microsoft Access. All files are automatically extracted and compiled in one database. Automated analysis and processing of the data are carried out using the open-source software package R [4]. The automated output for the bulletin includes tables, charts, maps, calculation of districts in epidemic and alert, with the addition of customized maps and an assessment of the current situation by WHO/IST [5].
Initially, in 2003, 8 countries (Benin, Burkina Faso, Chad, Ghana, Mali, Niger, Nigeria, and Togo) contributed to this enhanced surveillance network. Promoted by country capacity-building visits from the WHO/IST to other meningitis belt countries, the number of reporting countries increased to 13 in 2004. The phased introduction of the group A meningococcal conjugate vaccine (PsA-TT) by mass campaigns across the meningitis belt since 2010 [6] further drove country participation in enhanced surveillance. By 2013, 19 countries (Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Democratic Republic of Congo, Ethiopia, Ghana, Guinea, Cote d'Ivoire, Mali, Mauritania, Niger, Nigeria, Senegal, South Sudan, Sudan, The Gambia, and Togo) reported to this network. We describe the epidemiology of meningitis in countries that reported to the meningitis bulletins each year from 2004 to 2013, including the initial impact of PsA-TT on meningitis incidence.
119 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 1 |
| 2019 | 1 |
| 2018 | 1 |
| 2017 | 1 |
| 2016 | 1 |
| 2015 | 15 |