Meningitis epidemics in Africa are most prevalent in the “meningitis belt” that stretches across sub-Saharan Africa. About 26 countries and 450 million people live in this area.
According to the World Health Organization (WHO) Weekly Meningitis Bulletin for West Africa, through Apr. 30, a cumulative total of 13,423 suspected cases of meningitis have been notified with 1,127 deaths (CFR 8.4%).
The Democratic Republic of the Congo (DRC) has reported the most cases and deaths with 3359 and 332, respectively. Nearly 10 percent of cases resulted in death.
Ghana, Burkina Faso, Togo and Niger follow in order, each with more than 1000 cases year to date.
Streptococcus pneumoniae (pneumococcal meningitis) is the type of bacterial meningitis predominant in the meningitis belt, followed by Neisseria meningitidis serotype W and Neisseria meningitidis serotype C.
According to WHO, Meningococcus is transmitted by aerosol or direct contact with respiratory secretions of patients or healthy human carriers. As a rule, endemic disease occurs primarily in children and adolescents, with highest attack rates in infants aged 3-12 months, whereas in epidemics older children and young adults may be more involved.
Nasopharyngeal carriage of meningococci is most common among adolescents and young adults, less so among young children and relatively rare in adult populations. Transient nasopharyngeal carriage rather than disease is the normal outcome of meningococcal colonization.
However, the rapid progression of meningococcal disease frequently results in death within 1-2 days after onset. 5-15% of children and young adults carry meningococci in the nose and throat, so chemoprophylaxis is of little value for the control of most endemic and epidemic disease. Immunization is the only rational approach to the control of meningococcal disease.