Skip to main content
×
Home
    • Aa
    • Aa

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)...
Abstract
SUMMARY

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.

Copyright
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: nbharti@princeton.edu)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. RF Grais , Unacceptably high mortality related to measles epidemics in Niger, Nigeria, and Chad. PLoS Medicine 2007; 4: 122129.

2. A Molesworth , Environmental risk and meningitis epidemics in Africa. Emerging Infectious Diseases 2003; 9: 12871293.

3. DJD Earn , A simple model for complex dynamical transitions in epidemics. Science 2000; 287: 667670.

4. ON Bjornstad , BF Finkenstadt , BT Grenfell . Dynamics of measles epidemics: Estimating scaling of transmission rates using a Time series SIR model. Ecological Monographs 2002; 72: 169184.

6. BT Grenfell , ON Bjornstad , J Kappey . Travelling waves and spatial hierarchies in measles epidemics. Nature 2001; 414: 716723.

8. MJ Ferrari , The dynamics of measles in sub-Saharan Africa. Nature 2008; 451: 679684.

10. N Stollenwerk , M Maiden , V Jansen . Diversity in pathogenicity can cause outbreaks of meningococcal disease. Proceedings of the National Academy of Science USA 2004; 101: 1022910234.

12. C Trotter , B Greenwood . Meningococcal carriage in the African meningitis belt. Lancet 2007; 7: 797803.

13. B Greenwood , Factors influencing susceptibility to meningococcal disease during an epidemic in The Gambia, West Africa. Journal of Infection 1987; 14: 167184.

14. C Trotter , NJ Gay , WJ Edmunds . Dynamic models of meningococcal carriage, disease, and the impact of serogroup C conjugate vaccination. American Journal of Epidemiology 2005; 162: 89–100.

15. I Blakebrough , The epidemiology of infections due to Neisseria meningitidis and Neisseria lactamica in a northern Nigerian community. Journal of Infectious Diseases 1982; 146: 626637.

16. P Boisier , Carriage of Neisseria meningitidis serogroup W135 ST-2881. Emerging Infectious Diseases 2006; 12: 14211423.

19. F de Chabalier , Meningitis seasonal pattern in Africa and detection of epidemics: a retrospective study in Niger, 1990–98. Transactions of the Royal Society of Tropical Medicine and Hygiene 2000; 94: 664668.

20. P Yaka , Relationships between climate and year-to-year variability in meningitis outbreaks: a case study in Burkina Faso and Niger. International Journal of Health Geographics 2008; 7: 34.

21. B Sultan , Climate drives the meningitis epidemics onset in West Africa. PLoS Medicine 2005; 2: 00430049.

25. ON Bjornstad , BT Grenfell . Hazards, spatial transmission and timing of outbreaks in epidemic metapopulations. Environmental and Ecological Statistics 2008; 15: 265277.

26. PEM Fine , JA Clarkson . Measles in England and Wales. 1. An analysis of factors underlying seasonal patterns. International Journal of Epidemiology 1982; 11: 5–14.

35. MJ Keeling , BT Grenfell . Disease extinction and community size: modeling the persistence of measles. Science 1997; 275: 6567.

38. PS Moore , Group A meningococcal carriage in travelers returning from Saudi Arabia. Journal of the American Medical Association 1988; 260: 26862689.

44. PS Moore , Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis. Journal of the American Medical Association 1990; 264: 12711275.

45. J Mueller , Association of respiratory tract infection symptoms and air humidity with meningococcal carriage in Burkina Faso. Tropical Medicine and International Health 2008; 13: 15431552.

46. B Hubert , Meningococcal disease and influenza-like symptoms: a new approach to an old question. Journal of Infectious Diseases 1992; 166: 542545.

47. C Viboud , JA Wladimir , L Simonsen . Influenza in tropical regions. PLoS Medicine 2006; 3: 468471.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
WORD
Supplementary Materials

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

 Word (1.5 MB)
1.5 MB
WORD
Supplementary Materials

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

 Word (275 KB)
275 KB
WORD
Supplementary Materials

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

 Word (77 KB)
77 KB
WORD
Supplementary Materials

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

 Word (2.7 MB)
2.7 MB
WORD
Supplementary Materials

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

 Word (11.6 MB)
11.6 MB

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 14 *
Loading metrics...

Abstract views

Total abstract views: 156 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th June 2017. This data will be updated every 24 hours.