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The dynamics of meningococcal disease and carriage in Northern Ghana in epidemic and non-epidemic years

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  • Swiss Tropical Institute, Basel, Switzerland, Navrongo Health Research Centre, Ministry of Health, Navrongo, Ghana
  • Researchers: Dr Abraham Hodgson, Dr Gerd Pluschke, Dr Thomas Smith
  • Project Number: 0103.0
  • Category: Surveillance
  • Duration: 2001-2004
  • Start Date: 01 January 2001
  • Type: Lay summary
  • View scientific version

The 'Meningitis Belt' in Sub-Saharan Africa suffers recurrent epidemic waves of meningococcal disease every 8-12 years, which account for almost half of the global cases of the disease.

Meningitis epidemics typically persist during dry seasons for up to three consecutive years. In the rainy seasons, harmless carriage of the bacteria increases as disease declines. This helps build immunity against prevalent strains, but over the years before the next epidemic, immunity gradually disappears.

In this study researchers aim to find out how this immunity is lost: could it be environmental factors? population migration? or changes in the bacteria? They will assess these factors, and study variation in meningococcal bacteria and other bacteria and viruses obtained from healthy carriers and from meningitis patients at local health centres. Patterns they find will show how different strains across continents are related to each other, and explain the emergence and global pattern of spread of new strains.

Knowledge gained will be crucial for preparing to meet the next epidemic, and provide an excellent base-line for trials of Group A meningococcal conjugate vaccines now in development.

Results from this study have been published in scientific journals as follows:

Leimkugel J, Forgor AA, Gagneux S, Pfluger V, Flierl C, Awine E, Naegeli M, Dangy JP, Smith T, Hodgson A, Pluschke G.
An outbreak of serotype 1 Streptococcus pneumoniae meningitis in northern Ghana with features that are characteristic of Neisseria meningitidis meningitis epidemics.
J Infect Dis 2005 Jul 15;192(2):192-9.
http://www.journals.uchicago.edu/JID/journal/issues/v192n2/33890/33890.web.pdf

Hodgson A, Smith T, Gagneaux S, Adjuik M, Pluschke G, Mensah NK, Binka F, Genton B.
Risk factors for meningococcal meningitis in northern Ghana
Trans R Soc Trop Med Hyg 2001 Sep-Oct;95(5):477-80.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?orig_db=PubMed&db=PubMed&cmd=Search&term=%22Transactions+of+the+Royal+Society+of+Tropical+Medicine+and+Hygiene%22%5BJour%5D+AND+95%5Bvolume%5D+AND+5%5Bissue%5D+AND+477%5Bpage%5D+AND+2001%5Bpdat%5D

Leimkugel J, Hodgson A, Forgor AA, Pfuger V, Dangy JP, Smith T, Achtman M, Gagneux S, Pluschke G.
Clonal Waves of Neisseria Colonisation and Disease in the African Meningitis Belt: Eight-Year Longitudinal Study in Northern Ghana
PLoS Med 2007 Mar 27;4(3):e101 [Epub ahead of print].
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1831736&blobtype=pdfs

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