Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis.
Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness o...
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ftdoajarticles:oai:doaj.org/article:fe4069a7d4ca485485a0784650cf39a9 2023-05-15T15:16:41+02:00 Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. Matt D T Hitchings Matthew E Coldiron Rebecca F Grais Marc Lipsitch 2019-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007077 https://doaj.org/article/fe4069a7d4ca485485a0784650cf39a9 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007077 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007077 https://doaj.org/article/fe4069a7d4ca485485a0784650cf39a9 PLoS Neglected Tropical Diseases, Vol 13, Iss 3, p e0007077 (2019) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2019 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007077 2022-12-31T11:28:52Z Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness of these campaigns. Targeted reactive antibiotic prophylaxis could be used to supplement reactive mass vaccination and further reduce the incidence of meningitis, and the potential effectiveness and efficiency of these strategies should be explored. Methods and findings Data from an outbreak of meningococcal meningitis in Niger, caused primarily by Neisseria meningitidis serogroup C, is used to estimate clustering of meningitis cases at the household and village level. In addition, reactive antibiotic prophylaxis and reactive vaccination strategies are simulated to estimate their potential effectiveness and efficiency, with a focus on the threshold and spatial unit used to declare an epidemic and initiate the intervention. There is village-level clustering of suspected meningitis cases after an epidemic has been declared in a health area. Risk of suspected meningitis among household contacts of a suspected meningitis case is no higher than among members of the same village. Village-wide antibiotic prophylaxis can target subsequent cases in villages: across of range of parameters pertaining to how the intervention is performed, up to 220/672 suspected cases during the season are potentially preventable. On the other hand, household prophylaxis targets very few cases. In general, the village-wide strategy is not very sensitive to the method used to declare an epidemic. Finally, village-wide antibiotic prophylaxis is potentially more efficient than mass vaccination of all individuals at the beginning of the season, and than the equivalent reactive vaccination strategy. Conclusions Village-wide antibiotic prophylaxis should be considered and tested further as a response against outbreaks of meningococcal meningitis in the ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 13 3 e0007077 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Matt D T Hitchings Matthew E Coldiron Rebecca F Grais Marc Lipsitch Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness of these campaigns. Targeted reactive antibiotic prophylaxis could be used to supplement reactive mass vaccination and further reduce the incidence of meningitis, and the potential effectiveness and efficiency of these strategies should be explored. Methods and findings Data from an outbreak of meningococcal meningitis in Niger, caused primarily by Neisseria meningitidis serogroup C, is used to estimate clustering of meningitis cases at the household and village level. In addition, reactive antibiotic prophylaxis and reactive vaccination strategies are simulated to estimate their potential effectiveness and efficiency, with a focus on the threshold and spatial unit used to declare an epidemic and initiate the intervention. There is village-level clustering of suspected meningitis cases after an epidemic has been declared in a health area. Risk of suspected meningitis among household contacts of a suspected meningitis case is no higher than among members of the same village. Village-wide antibiotic prophylaxis can target subsequent cases in villages: across of range of parameters pertaining to how the intervention is performed, up to 220/672 suspected cases during the season are potentially preventable. On the other hand, household prophylaxis targets very few cases. In general, the village-wide strategy is not very sensitive to the method used to declare an epidemic. Finally, village-wide antibiotic prophylaxis is potentially more efficient than mass vaccination of all individuals at the beginning of the season, and than the equivalent reactive vaccination strategy. Conclusions Village-wide antibiotic prophylaxis should be considered and tested further as a response against outbreaks of meningococcal meningitis in the ... |
format |
Article in Journal/Newspaper |
author |
Matt D T Hitchings Matthew E Coldiron Rebecca F Grais Marc Lipsitch |
author_facet |
Matt D T Hitchings Matthew E Coldiron Rebecca F Grais Marc Lipsitch |
author_sort |
Matt D T Hitchings |
title |
Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
title_short |
Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
title_full |
Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
title_fullStr |
Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
title_full_unstemmed |
Analysis of a meningococcal meningitis outbreak in Niger - potential effectiveness of reactive prophylaxis. |
title_sort |
analysis of a meningococcal meningitis outbreak in niger - potential effectiveness of reactive prophylaxis. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2019 |
url |
https://doi.org/10.1371/journal.pntd.0007077 https://doaj.org/article/fe4069a7d4ca485485a0784650cf39a9 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 13, Iss 3, p e0007077 (2019) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007077 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007077 https://doaj.org/article/fe4069a7d4ca485485a0784650cf39a9 |
op_doi |
https://doi.org/10.1371/journal.pntd.0007077 |
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PLOS Neglected Tropical Diseases |
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13 |
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3 |
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e0007077 |
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