Impact de la Vaccination Réactive sur l'Epidémie de Méningite de 2021 à Banalia
Impact of Reactive Vaccination on the 2021 Meningitis Epidemic in Banalia
DOI :
https://doi.org/10.5281/hra.v2i5.5580Mots-clés :
Meningococcal vaccine, CongoRésumé
ABSTRACT
Introduction. The Banalia health zone reported a meningitis epidemic in 2021 that evolved outside the epidemic season. The aim of our study was to report challenges and best practices in implementing outbreak response interventions and assess their effects on the epidemiological evolution of the bacterial meningitis epidemic in Banalia. Methods. This cross-sectional study was retrospectively conducted from July to December 2021 in Banalia Health, which comprises 20 health areas with 171,001 inhabitants. The standard case definition was used to identify cases. Care was provided to 2,651 in-patients, with 8% of them laboratory tested, and reactive vaccination was conducted. The Wilcoxon–Mann–Whitney test was used to assess the relationship between cases that occurred before and after reactive vaccination. Results. Overall, 2,662 suspected cases of meningitis with 205 deaths were reported. Individuals aged 30–39 years were the most affected (38.5%). Case fatality rate decreased from 70.4% at the beginning of the epidemic to 7.7% . Neisseria meningitidis W was the predominant pathogen isolated, accounting 82% of the confirmed cases, of which 92% of the strains belonged to the clonal complex 11. Reactive vaccination of individuals in Banalia aged 1–19 years with a meningococcal multivalent conjugate (ACWY) vaccine (Menactra®) coverage of 104.6% resulted in an 82% decline in suspected meningitis cases (IRR= 0.18; 95% IC, 0.02–0.80; p = 0.041). Conclusion. Despite late detection and response to the meningitis epidemic in Banalia, reactive vaccination contributed to the control of the epidemic.
RESUME
Introduction. The Banalia health zone reported a meningitis epidemic in 2021 that evolved outside the epidemic season. The aim of our study was to report challenges and best practices in implementing outbreak response interventions and assess their effects on the epidemiological evolution of the bacterial meningitis epidemic in Banalia. Methods. This cross-sectional study was retrospectively conducted from July to December 2021 in Banalia Health, w hich comprises 20 health areas with 171,001 inhabitants. The standard case definition was used to identify cases. Care was provided to 2,651 in-patients, with 8% of them laboratory tested, and reactive vaccination was conducted. The Wilcoxon–Mann–Whitney test was used to assess the relationship between cases that occurred before and after reactive vaccination. Results. Overall, 2,662 suspected cases of meningitis with 205 deaths were reported. Individuals aged 30–39 years were the most affected (38.5%). Case fatality rate decreased from 70.4% at the beginning of the epidemic to 7.7% . Neisseria meningitidis W was the predominant pathogen isolated, accounting 82% of the confirmed cases, of which 92% of the strains belonged to the clonal complex 11. Reactive vaccination of individuals in Banalia aged 1–19 years with a meningococcal multivalent conjugate (ACWY) vaccine (Menactra®) coverage of 104.6% resulted in an 82% decline in suspected meningitis cases (IRR= 0.18; 95% IC, 0.02–0.80; p = 0.041). Conclusion. Despite late detection and response to the meningitis epidemic in Banalia, reactive vaccination contributed to the control of the epidemic.
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