Evaluation of response strategies against epidemics due to Neisseria meningitidis C in Niger

J. Grech, J. Robertson, J. Thomas, G. Cooper, M. Naunton, I. Mutambuze, T. Kelly

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To inform public health recommendations, we evaluated the effectiveness and efficiency of current and hypothetical surveillance and vaccine response strategies against Neisseria meningitidis C meningitis epidemics in 2015 in Niger. Methods: We analysed reports of suspected and confirmed cases of meningitis from the region of Dosso during 2014 and 2015. Based on a definition of epidemic signals, the effectiveness and efficiency of surveillance and vaccine response strategies were evaluated by calculating the number of potentially vaccine-preventable cases and number of vaccine doses needed per epidemic signal. Results: A total of 4763 weekly health area reports, collected in 90 health areas with 1282 suspected meningitis cases, were included. At a threshold of 10 per 100 000, the total number of estimated vaccine-preventable cases was 29 with district-level surveillance and vaccine response, 141 with health area-level surveillance and vaccination and 339 with health area-level surveillance and district-level vaccination. While being most effective, the latter strategy required the largest number of vaccine doses (1.8 million), similar to the strategy of surveillance and vaccination at district level (1.3 million), whereas the strategy of surveillance and vaccination at health area level would have required only 0.8 million doses. Thus, efficiency was lowest for district-level surveillance and highest for health area-level surveillance with district-level vaccination. Conclusion: In this analysis, we found that effectiveness and efficiency were higher at health area-level surveillance and district-level vaccination than for other strategies. Use of N. meningitidis C vaccines in a preventive strategy thus should be considered, in particular as most reactive vaccine response strategies in our analysis had little impact on disease burden.

Original languageEnglish
Pages (from-to)196-204
Number of pages9
JournalTropical Medicine and International Health
Volume22
Issue number2
DOIs
Publication statusPublished - 1 Feb 2017

Cite this

@article{0aa36d20d56e4f8d9dbf006a9d1460d3,
title = "Evaluation of response strategies against epidemics due to Neisseria meningitidis C in Niger",
abstract = "Objective: To inform public health recommendations, we evaluated the effectiveness and efficiency of current and hypothetical surveillance and vaccine response strategies against Neisseria meningitidis C meningitis epidemics in 2015 in Niger. Methods: We analysed reports of suspected and confirmed cases of meningitis from the region of Dosso during 2014 and 2015. Based on a definition of epidemic signals, the effectiveness and efficiency of surveillance and vaccine response strategies were evaluated by calculating the number of potentially vaccine-preventable cases and number of vaccine doses needed per epidemic signal. Results: A total of 4763 weekly health area reports, collected in 90 health areas with 1282 suspected meningitis cases, were included. At a threshold of 10 per 100 000, the total number of estimated vaccine-preventable cases was 29 with district-level surveillance and vaccine response, 141 with health area-level surveillance and vaccination and 339 with health area-level surveillance and district-level vaccination. While being most effective, the latter strategy required the largest number of vaccine doses (1.8 million), similar to the strategy of surveillance and vaccination at district level (1.3 million), whereas the strategy of surveillance and vaccination at health area level would have required only 0.8 million doses. Thus, efficiency was lowest for district-level surveillance and highest for health area-level surveillance with district-level vaccination. Conclusion: In this analysis, we found that effectiveness and efficiency were higher at health area-level surveillance and district-level vaccination than for other strategies. Use of N. meningitidis C vaccines in a preventive strategy thus should be considered, in particular as most reactive vaccine response strategies in our analysis had little impact on disease burden.",
keywords = "Niger, epidemics, meningitis, response strategies, surveillance",
author = "J. Grech and J. Robertson and J. Thomas and G. Cooper and M. Naunton and I. Mutambuze and T. Kelly",
year = "2017",
month = "2",
day = "1",
doi = "10.1111/tmi.12815",
language = "English",
volume = "22",
pages = "196--204",
journal = "Tropical and Geographical Medicine",
issn = "1360-2276",
publisher = "Wiley-Blackwell",
number = "2",

}

Evaluation of response strategies against epidemics due to Neisseria meningitidis C in Niger. / Grech, J.; Robertson, J.; Thomas, J.; Cooper, G.; Naunton, M.; Mutambuze, I.; Kelly, T.

In: Tropical Medicine and International Health, Vol. 22, No. 2, 01.02.2017, p. 196-204.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of response strategies against epidemics due to Neisseria meningitidis C in Niger

AU - Grech, J.

AU - Robertson, J.

AU - Thomas, J.

AU - Cooper, G.

AU - Naunton, M.

AU - Mutambuze, I.

AU - Kelly, T.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Objective: To inform public health recommendations, we evaluated the effectiveness and efficiency of current and hypothetical surveillance and vaccine response strategies against Neisseria meningitidis C meningitis epidemics in 2015 in Niger. Methods: We analysed reports of suspected and confirmed cases of meningitis from the region of Dosso during 2014 and 2015. Based on a definition of epidemic signals, the effectiveness and efficiency of surveillance and vaccine response strategies were evaluated by calculating the number of potentially vaccine-preventable cases and number of vaccine doses needed per epidemic signal. Results: A total of 4763 weekly health area reports, collected in 90 health areas with 1282 suspected meningitis cases, were included. At a threshold of 10 per 100 000, the total number of estimated vaccine-preventable cases was 29 with district-level surveillance and vaccine response, 141 with health area-level surveillance and vaccination and 339 with health area-level surveillance and district-level vaccination. While being most effective, the latter strategy required the largest number of vaccine doses (1.8 million), similar to the strategy of surveillance and vaccination at district level (1.3 million), whereas the strategy of surveillance and vaccination at health area level would have required only 0.8 million doses. Thus, efficiency was lowest for district-level surveillance and highest for health area-level surveillance with district-level vaccination. Conclusion: In this analysis, we found that effectiveness and efficiency were higher at health area-level surveillance and district-level vaccination than for other strategies. Use of N. meningitidis C vaccines in a preventive strategy thus should be considered, in particular as most reactive vaccine response strategies in our analysis had little impact on disease burden.

AB - Objective: To inform public health recommendations, we evaluated the effectiveness and efficiency of current and hypothetical surveillance and vaccine response strategies against Neisseria meningitidis C meningitis epidemics in 2015 in Niger. Methods: We analysed reports of suspected and confirmed cases of meningitis from the region of Dosso during 2014 and 2015. Based on a definition of epidemic signals, the effectiveness and efficiency of surveillance and vaccine response strategies were evaluated by calculating the number of potentially vaccine-preventable cases and number of vaccine doses needed per epidemic signal. Results: A total of 4763 weekly health area reports, collected in 90 health areas with 1282 suspected meningitis cases, were included. At a threshold of 10 per 100 000, the total number of estimated vaccine-preventable cases was 29 with district-level surveillance and vaccine response, 141 with health area-level surveillance and vaccination and 339 with health area-level surveillance and district-level vaccination. While being most effective, the latter strategy required the largest number of vaccine doses (1.8 million), similar to the strategy of surveillance and vaccination at district level (1.3 million), whereas the strategy of surveillance and vaccination at health area level would have required only 0.8 million doses. Thus, efficiency was lowest for district-level surveillance and highest for health area-level surveillance with district-level vaccination. Conclusion: In this analysis, we found that effectiveness and efficiency were higher at health area-level surveillance and district-level vaccination than for other strategies. Use of N. meningitidis C vaccines in a preventive strategy thus should be considered, in particular as most reactive vaccine response strategies in our analysis had little impact on disease burden.

KW - Niger

KW - epidemics

KW - meningitis

KW - response strategies

KW - surveillance

UR - http://www.scopus.com/inward/record.url?scp=85008264678&partnerID=8YFLogxK

UR - http://www.mendeley.com/research/training-curriculum-conducting-clinical-research-during-outbreaks

U2 - 10.1111/tmi.12815

DO - 10.1111/tmi.12815

M3 - Article

VL - 22

SP - 196

EP - 204

JO - Tropical and Geographical Medicine

JF - Tropical and Geographical Medicine

SN - 1360-2276

IS - 2

ER -