1921
Volume 80, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

The epidemiology of serogroup X meningococcal meningitis in Africa is unknown. During a serogroup X meningococcus outbreak in Kenya, case finding involved record review at health facilities and interviews with health workers and community leaders in West Pokot district. An age- and location-matched case-control study for risk factors was done. From December 2005 to April 2006, 82 suspect cases of meningitis were reported; the epidemic threshold was surpassed within two administrative divisions. Most (58%) cases were 5–24 years old; the case-fatality ratio was 21%. Serogroup X meningococcus was the most common serogroup – 5 (63%) of eight isolates serogrouped. Living in the same compound as another case, preceding upper respiratory tract infection and cooking outside the house were significant risk factors for disease. Serogroup X meningococcus caused an outbreak with similar epidemiology and risk factors as other serogroups. Serogroup-specific laboratory-based surveillance for meningococcus in Africa to detect serogroup X disease should be enhanced.

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References

  1. World Health Organization, 1998. Control of Epidemic Meningococcal Disease. WHO Practical Guidelines. Second edition. Geneva, Switzerland; WHO.
  2. Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL, Lefkowitz L, Perkins BA, 1997. Bacterial meningitis in the United States in 1995. N Engl J Med 337 : 970–976. [Google Scholar]
  3. Molesworth AM, Thomson MC, Connor SJ, Cresswell MP, Morse AP, Shears P, Hart CA, Cuevas LE, 2002. Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa. Trans R Soc Trop Med Hyg 96 : 242–249. [Google Scholar]
  4. Reido FX, Plikaytis BD, Broome CV, 1995. Epidemiology and prevention of meningococcal disease. Pediatr Infect Dis J 14 : 643–657. [Google Scholar]
  5. Broome CV, Rugh MA, Yada AA, Giat L, Giat H, Zeltner JM, Sanborn WR, Fraser DW, 1979. Epidemic group C meningococcal meningitis in Upper Volta, 1979. Bull World Health Organ 61 : 325–330. [Google Scholar]
  6. WHO, 2002. Meningococcal disease, serogroup W135, Burkina Faso, preliminary report, 2002. Wkly Epidemiol Rec 77 : 152–155. [Google Scholar]
  7. Lingappa JR, Al-Rabeah AM, Hajjeh R, Mustafa T, Fatani A, Al-Bassam T, Badukhan A, Turkistani A, Makki S, Al-Hamdan N, Al-Jeffri M, Al Mazrou Y, Perkins BA, Popovic T, Mayer LW, Rosenstein NE, 2003. Serogroup W-135 meningococcal disease during the Hajj, 2000. Emerg Infect Dis 9 : 665–671. [Google Scholar]
  8. Gagneux SP, Hodgson A, Smith TA, Wirth T, Ehrhard I, Morelli G, Genton B, Binka FN, Achtman M, Pluschke G, 2002. Prospective study of serogroup X Neisseria meningitidis outbreak in Northern Ghana. J Infect Dis 185 : 618–626. [Google Scholar]
  9. Gagneux S, Wirth T, Hodgson A, Ehrhard I, Morelli G, Kriz P, Genton B, Smith T, Binka F, Pluschke G, Achtman M, 2002. Clonal groupings in serogroup X Neisseria meningitidis. Emerg Infect Dis 8 : 462–466. [Google Scholar]
  10. Djibo S, Nicolas P, Alonso JM, Djibo A, Couret D, Riou JY, Chippaux JP, 2003. Outbreaks of serogroup X meningococcal meningitis in Niger 1995–2000. Trop Med Int Health 8 : 1118–1123. [Google Scholar]
  11. Boisier P, Nicolas P, Djibo S, Taha MK, Jeanne I, Maïnassara HB, Tenebray B, Kairo KK, Giorgini D, Chanteau S, 2007. Meningococcal meningitis: unprecedented incidence of sero-group X-related cases in 2006 in Niger. Clin Infect Dis 44 : 657–663. [Google Scholar]
  12. WHO, 2006. Meningococcal disease, Uganda – update. Wkly Epidemiol Rec 81 : 62. [Google Scholar]
  13. Lewis R, 2006. Meningococcal meningitis serogroup X: a new player in Ugandan epidemiology. WHO Health Action in Crisis 1 : 6. [Google Scholar]
  14. Materu S, Cox HS, Isaakidis P, Baruani B, Ogaro T, Caugant DA, 2007. Serogroup X in meningococcal disease, Western Kenya. Emerg Infect Dis J 13 : 944–945. [Google Scholar]
  15. WHO, 2000. Detecting meningococcal meningitis epidemics in highly-endemic African countries. WHO recommendations. Wkly Epidemiol Rec 38 : 306–312. [Google Scholar]
  16. Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB, 2001. Simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae in suspected cases of meningitis and septicemia using real-time PCR. J Clin Microbiol 39 : 1553–1558. [Google Scholar]
  17. Mothershed EA, Sacchi CT, Whitney AM, Barnett GA, Ajello GW, Schmink S, Mayer LW, Phelan M, Taylor TH Jr, Bernhardt SA, Rosenstein NE, Popovic T, 2004. Use of real-time PCR to resolve slide agglutination discrepancies in serogroup identification of Neisseria meningitidis. J Clin Microbiol 42 : 320–328. [Google Scholar]
  18. Jolley KA, Chan MS, Maiden MCJ, 2004. mlstdbNet: distributed multi-locus sequence typing (MLST) databases. BMC Bioinformatics 5 : 286. [Google Scholar]
  19. Etienne J, Sperber G, Adamou A, Picq JJ, 1990. Epidemiologic notes: meningococcal meningitis of serogroup X in Niamey (Niger). Med Trop (Mars) 50 : 227–229. [Google Scholar]
  20. Campagne G, Schuchat A, Djibo S, Ousséini A, Cissé L, Chippaux JP, 1999. Epidemiology of bacterial meningitis in Niamey, Niger, 1981–96. Bull World Health Organ 77 : 499–508. [Google Scholar]
  21. Leimkugel J, Hodgson A, Adams Forger A, et al. Clonal waves of Neisseria colonization and disease in the African meningitis belt: eight year longitudinal study in Northern Ghana. Plos Med 2007; 4: 0535–0544. [Google Scholar]
  22. Raghunathan PL, Jones JD, Tiendrebéogo SR, Sanou I, Sangaré L, Kouanda S, Dabal M, Lingani C, Elie CM, Johnson S, Ari M, Martinez J, Chatt J, Sidibe K, Schmink S, Mayer LW, Kondé MK, Djingarey MH, Popovic T, Plikaytis BD, Carlone GM, Rosenstein N, Soriano-Gabarró M, 2006. Predictors of immunity alter a major serogroup W-135 meningococcal disease epidemic, Burkina Faso, 2002. J Infect Dis 193 : 607–616. [Google Scholar]
  23. Kellerman SE, McCombs K, Ray M, Baughman W, Reeves MW, Popovic T, Rosenstein NE, Farley MM, Blake P, Stephens DS; Georgia Emerging Infections Program, 2002. Genotype-specific carriage of Neisseria meningitidis in Georgia counties with hyper- and hyposporadic rates of meningococcal disease. J Infect Dis 186 : 40–48. [Google Scholar]
  24. Traoré Y, Njanpop-Lafourcade BM, Adjogble KL, Lourd M, Yaro S, Nacro B, Drabo A, Parent du Châtelet I, Mueller JE, Taha MK, Borrow R, Nicolas P, Alonso JM, Gessner BD, 2006. The rise and fall of epidemic Neisseria meningitidis serogroup W135 meningitis in Burkina Faso, 2002–2005. Clin Infect Dis 43 : 817–822. [Google Scholar]
  25. Hodgson A, Smith T, Gagneux S, Adjuik M, Pluschke G, Mensah NK, Binka F, Genton B, 2001. Risk factors for meningococcal meningitis in Northern Ghana. Trans R Soc Trop Med Hyg 95 : 477–480. [Google Scholar]
  26. Moore PS, Hierholzer J, DeWitt W, Gouan K, Djoré D, Lippeveld T, Plikaytis B, Broome CV, 1990. Respiratory viruses and Mycoplasma as cofactors for epidemic group A meningococcal meningitis. JAMA 263 : 1271–1275. [Google Scholar]
  27. Stanwell-Smith RE, Stuart JM, Hughes AO, Robinson P, Griffin MB, Cartwright K, 1994. Smoking, the environment and meningococcal disease: a case-control study. Epidemiol Infect 112 : 315–328. [Google Scholar]
  28. Pinner RW, Onyango F, Perkins BA, Mirza NB, Ngacha DM, Reeves M, DeWitt W, Njeru E, Agata NN, Broome CV, 1992. Epidemic meningococcal meningitis in Nairobi, Kenya 1989. J Infect Dis 166 : 359–364. [Google Scholar]
  29. Greenwood BM, Bradley AK, Cleland PG, Haggie MH, Hassan-King M, Lewis LS, Macfarlane JT, Taqi A, Whittle HC, Bradley-Moore AM, Ansari Q, 1979. An epidemic of meningococcal infection at Zaria, Northern Nigeria, General epidemiological features. Trans R Soc Trop Med Hyg 73 : 557–562. [Google Scholar]
  30. de Souza AL, Sztajnbok J, Salgado MM, Romano CC, Alkmin MG, Duarte AJ, Seguro AC, 2007. Severe myalgia of the lower extremities as the first clinical feature of meningococcal pur-pura fulminans. Am J Trop Med Hyg 77 : 723–726. [Google Scholar]
  31. WHO, 2007. Improved meningitis vaccine for Africa could signal eventual end to deadly scourge. Wkly Epidemiol Rec 24 : 222–224. [Google Scholar]
  32. Singleton RJ, Hennessy TW, Bulkow LR, Hammitt LL, Zulz T, Hurlburt DA, Butler JC, Rudolph K, Parkinson A, 2007. Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. JAMA 297 : 1784–1792. [Google Scholar]
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  • Received : 04 Sep 2008
  • Accepted : 26 Nov 2008

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