28/11/18

Little progress made against meningitis over 25 years

Medson Boti talks with a child while on a home visit in his role as a palliative care clinician
Copyright: Panos

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  • Deaths from meningitis reduced by only 21 per cent over 25 years
  • Lack of routine meningitis vaccination is to blame
  • Coordinated efforts are needed to tackle the disease in Africa

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[NAIROBI] Despite increased reduction of deaths from vaccine-preventable diseases such as measles and tetanus over the past 25 years, meningitis deaths remain high, according to a new analysis.

With the introduction of initiatives such as the MenA vaccine campaign in 2010 to control meningitis, an inflammatory condition involving the membranes covering the brain and spinal cord, researchers expected reduction in cases of the disease.

But whereas measles, tetanus and diarrhoea due to rotavirus saw decreased deaths of 93 per cent, about 91 per cent and 58 per cent respectively between 1990 and 2016, which for meningitis was only 21 per cent, according to the study published in the 1 December 2018 issue of the Lancet Neurology.  

“Vaccination is the best way to prevent meningitis and despite major progress over the last 20 years, large epidemics continue to occur,” says Linda Glennie, a co-author of the study and director of research, evidence and policy at the Meningitis Research Foundation. “Nearly 18,000 cases of meningitis caused by meningococcal group C infection were reported in Niger and Nigeria in 2017, showing again that meningitis is very far from being defeated.”
 
Cases of meningitis increased from 2.5 million in 1990 to almost three million in 2016 globally, with Sub-Saharan Africa and India bearing the greatest burden.


Areas with frequent epidemics of meningococcal meningitis in Africa 

Sci-Dev - Meningitis map-01
Source: The Institute for Health Metrics and Evaluation

The Global Burden of Diseases, Injuries and Risk Factors study team used hospital and claims data to estimate the burden of meningitis.  The team also used statistical modelling used to generate deaths and incidence estimates where no data was available.
 
Because vaccines are not yet available for all causes of meningitis, other initiatives and programmes which can help fight the disease in Africa include a significant need for a reliable, simple, and cost-effective rapid test for meningitis, Glennie explains.  
 
“Reducing premature births, improving hygiene and sanitation in both hospitals and in the home for a newborn baby, and more general public health programmes to reduce smoking, over-crowding … would all have an impact on the fight against meningitis,” Glennie tells SciDev.Net
 

“Vaccination is the best way to prevent meningitis and despite major progress over the last 20 years, large epidemics continue to occur.”

Linda Glennie, Meningitis Research Foundation

Because meningitis can spread globally there is a need for a coordinated effort to defeat it. “We need faster progress, similar to that achieved with measles, tetanus, and diarrhoea due to rotavirus,” she adds.
 
According to Ombeva Malande, vaccinologist and director of the East Africa Centre for Vaccines and Immunization, there were increased meningitis deaths in Sub-Saharan Africa over the past 25 years because of lack of routine vaccination.  

African health care experts and policymakers, he says, need to care about meningitis urgently because while deadly and dangerous, it can be prevented with vaccines.

“The findings of this study are worrying, but are also helpful towards increasing surveillance, health education and mass or targeted vaccination,” Malande says.
 
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.