Socioepidemiological macro-determinants associated with the cumulative incidence of bacterial meningitis: A focus on the African Meningitis Belt

Abstract

BackgroundBacterial meningitis (BM) is a public health challenge as it is associated with high lethality and neurological sequelae. Worldwide, most cases are registered in the African Meningitis Belt (AMB). The role of particular socioepidemiological features is essential for understanding disease dynamics and optimizing policy-making.ObjectiveTo identify socioepidemiological macro-determinants that contribute to explaining the differences in BM incidence between AMB and the rest of Africa.MethodsCountry-level ecologic study based on the cumulative incidence estimates of the Global Burden of Disease study and reports of the MenAfriNet Consortium. Data about relevant socioepidemiological features were extracted from international sources. Multivariate regression models were implemented to define variables associated with the classification of African countries within the AMB and the incidence of BM worldwide.ResultsCumulative incidences at the AMB sub-regions were 111.93 (west), 87.23 (central), 65.10 (east), and 42.47 (north) per 100,000 population. A pattern of common origin with continuous exposition and seasonality of cases was observed. Socio-epidemiological determinants contributing to differentiating the AMB from the rest of Africa were household occupancy (OR 3.17 CI 95% 1.09–9.22, p = 0.034) and malaria incidence (OR 1.01 CI 95% 1.00–1.02, p = 0.016). BM cumulative incidence worldwide was additionally associated with temperature and gross national income per capita.ConclusionSocioeconomic and climate conditions are macro-determinants associated with BM cumulative incidence. Multilevel designs are required to confirm these findings.

Evaluating the impact of Neisserria meningitidis pentavalent vaccine in the African meningitis belt: A modeling study

“…The high-risk populations in the AMB exhibit traits such as laboriously populated regions, insufficient healthcare infrastructure, and restricted availability of immunization programs [32,33].…”

“…These populations are at a higher risk of meningococcal meningitis transmission due to their proximity to schools, refugee camps, and metropolitan areas. Besides, socioeconomic gaps make it difficult for them to receive healthcare and manage the disease [32]. Incorporating high-and-low risk populations into the model allows for a more comprehensive assessment of the impact of various vaccination strategies and control tailored to vulnerable communities, enhancing the model's utility in guiding effective intervention strategies and public health policies.…”