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Spatial dynamics of meningococcal meningitis in Niger: observed patterns in comparison with measles

  • N. BHARTI (a1), H. BROUTIN (a2) (a3), R. F. GRAIS (a4), M. J. FERRARI (a5), A. DJIBO (a6), A. J. TATEM (a7) (a3) and B. T. GRENFELL (a1) (a3)...

Throughout the African meningitis belt, meningococcal meningitis outbreaks occur only during the dry season. Measles in Niger exhibits similar seasonality, where increased population density during the dry season probably escalates measles transmission. Because meningococcal meningitis and measles are both directly transmitted, we propose that host aggregation also impacts the transmission of meningococcal meningitis. Although climate affects broad meningococcal meningitis seasonality, we focus on the less examined role of human density at a finer spatial scale. By analysing spatial patterns of suspected cases of meningococcal meningitis, we show fewer absences of suspected cases in districts along primary roads, similar to measles fadeouts in the same Nigerien metapopulation. We further show that, following periods during no suspected cases, districts with high reappearance rates of meningococcal meningitis also have high measles reintroduction rates. Despite many biological and epidemiological differences, similar seasonal and spatial patterns emerge from the dynamics of both diseases. This analysis enhances our understanding of spatial patterns and disease transmission and suggests hotspots for infection and potential target areas for meningococcal meningitis surveillance and intervention.

Corresponding author
*Author for correspondence: Dr N. Bharti, Department of Ecology and Evolutionary Biology and Center for Health and Wellbeing, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton NJ, USA. (Email:
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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Type Description Title
Supplementary Materials

Bharti Supplementary Figure 3
Supplementary Figure S3: Niamey: Fadeouts for meningococcal meningitis and measles

 Word (1.5 MB)
1.5 MB
Supplementary Materials

Bharti Supplementary Text 2
Supplementary Text S2: Identifying high risk districts using alert and epidemic thresholds

 Word (275 KB)
275 KB
Supplementary Materials

Bharti Supplementary Text 1
Supplementary Text S1: Assessing rates of reported cases

 Word (77 KB)
77 KB
Supplementary Materials

Bharti Supplementary Figure 1
Supplementary Figure S1: Fadeouts and Interepidemic periods (adapted from [1])

 Word (2.7 MB)
2.7 MB
Supplementary Materials

Bharti Supplementary Figure 2
Supplementary Figure S2: Reported cases of meningococcal meningitis in Niger

 Word (11.6 MB)
11.6 MB


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