Meningitis Progress Tracker

Tracking progress towards defeating meningitis - visualising the story of meningitis for the first time

Meningitis is a globally important disease, especially for children under five. Many of the major bacterial pathogens that cause meningitis also cause sepsis. They can occur together or separately and can be very difficult to distinguish.

A.
According to the United Nations 2017 Levels and Trends in Child Mortality Report, meningitis and neonatal sepsis (sepsis in new-born babies) are together the second biggest infectious killer of children aged under 5 globally. However, progress in tackling meningitis lags behind that of other infectious diseases, according to an analysis published in the scientific journal The Lancet Neurology

Achieving the Sustainable Development Goal to end preventable deaths of new-borns and children under five years of age will not be possible without a concerted effort to defeat meningitis. Access to accurate data that tell the full story of meningitis will help national governments and inter-governmental institutions, such as the agencies of the United Nations, to create informed health strategies and monitor their success.

Currently, we know that data on the global meningitis burden are hard to interpret. This is due in part to there being multiple causes, and because the data come from many different sources. With the Meningitis Progress Tracker, we will be able to track national and global progress toward defeating the disease. For the first time, we bring ‘the story of meningitis’ together into one place.
A.
Meningitis and neonatal sepsis kill more children than malaria, measles and TB combined. Across all ages there were almost 500,000 estimated deaths in 2017.
 
Meningitis and neonatal sepsis are rarely listed as health priorities in major global health strategies and frameworks. This absence influences the priority that countries place on addressing the disease, budgets they allocate to it, and the wider funding available to them for this work. As a result, progress towards defeating meningitis has been slow. According to one estimate, between 1990 and 2017, meningitis deaths in children under 5 fell by just 53% compared to 87% for measles, 93% for tetanus and 70% for diarrhoea.

To accelerate progress, the World Health Organization (WHO) set up a technical taskforce to co-ordinate the development of a global roadmap to defeat meningitis by 2030. As a member of the taskforce, we investigated the global and regional burden of meningitis for the WHO Baseline Analysis, to show the extent of the problem and decide how to address it. We highlighted major differences between modelled estimates and deficiencies in data underlying these estimates in low and middle income countries.
 
Following this, we developed the prototype Meningitis Progress Tracker (MPT 1.0), a tool which, for the first time, brings together data from diverse sources on meningitis cases and deaths, prevention, surveillance, treatment and impact on quality of life all in one place, aligned with the five pillars of the WHO Defeating Meningitis by 2030 global roadmap.

As the tool chosen by WHO and the taskforce to monitor Roadmap progress, the tracker will play a vital role in focussing interventions where they are needed to combat 6 million cases and nearly 500,000 deaths due to meningitis and neonatal sepsis per year, and so contribute to the Sustainable Development Goal vision to leave no one behind.
A.
Watch the tutorial videos below to find out how to use the Meningitis Progress Tracker and answer three of our most commonly asked questions.

What is the impact of meningitis in different countries?



How many cases of meningitis are there where I live?



How can I find support groups for meningitis where I live?

A.
The prototype, MPT 1.0, launched on World Meningitis day 2019 has proven to be a valuable tool, attracting over 33,000 views, with users from 73 countries including epidemiologists, academics, global health specialists, patient groups, public health officials and funders.
 
This newly released interim version, MPT 2.0 now includes available estimates of cases, incidence, deaths and mortality in all ages, for meningitis and neonatal sepsis and for the major bacterial causes: the meningococcus, pneumococcus and Haemophilus influenza type B (Hib). It presents a global overview as well as regional and country breakdowns.  In addition to data on pneumococcal and Hib vaccines, it now shows meningococcal vaccine schedules around the world, including detailed information on the control of meningococcal A in the African meningitis belt. It features real surveillance data from the African meningitis belt, and animations showing seasonal changes and evolving epidemics.   A new country profiles page has been developed in prototype to enable countries to monitor their progress against the Roadmap. Users can interact with the site to create the visualisations most relevant to them.

Over the coming year we will continue developing the tracker, adding new features and routinely updating global estimates and vaccine data as available. We aim to include estimates of Group B Streptococcus (GBS) - an important neonatal cause of meningitis and sepsis, incorporate more real surveillance data from around the world, and add new indicators of progress on diagnosis, treatment and aftercare for meningitis.

As a single accessible source of the most comprehensive, up-to-date meningitis data, the tracker will not only enable progress against the Roadmap to be tracked, but also facilitate scrutiny to enable ministries of health and global health agencies to address problems and focus effort where it is needed most, empower civil society to advocate for improvement, and provide a teaching tool for academics training the current generation of public health doctors and epidemiologists.

This version of the Meningitis Progress Tracker has been made possible through tremendous support and technical skill from the developers Keytree, a generous grant of software licenses and training from the Tableau Foundation, and grants from Pfizer, Sanofi Pasteur and GSK.



What would you like to see in MPT 3.0? Give us your feedback.

We need your help to develop the next phase of the Meningitis Progress Tracker. How can we improve it? What is missing that we should include? Please submit your comments on the ‘feedback’ page of the tracker itself (above).

Further reading

A.

The following provides further reading on the number of people affected by meningitis:

Liu, L., et al., Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet, 2016. 388(10063): p. 3027-3035.

Collaborators, G.B.D.M., Global, regional, and national burden of meningitis, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2018. 17(12): p. 1061-1082.

Wahl, B., et al., Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000-15. Lancet Glob Health, 2018. 6(7): p. e744-e757.

Seale, A.C., et al., Estimates of the Burden of Group B Streptococcal Disease Worldwide for Pregnant Women, Stillbirths, and Children. Clin Infect Dis, 2017. 65(suppl_2): p. S200-S219.

A.

The following provides further reading on preventing meningitis:

The VIEW-hub report on global vaccine introduction and implementation (2016-present) https://www.jhsph.edu/ivac/resources/view-hub-reports/

Gavi, the vaccine alliance progress reports https://www.gavi.org/results/gavi-progress-reports/

Mosser, J.F., et al., Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000-2016: a spatial and temporal modelling study. Lancet, 2019.

Establishing and strengthening immunisation in the second year of life.  Practices for vaccination beyond infancy”.  World Health Organization 2018. Strengthening immunisation beyond infancy is particularly relevant for meningitis vaccines because a 2+1 schedule for PCV is considered preferable to the 3+0 schedule adopted by many countries and routine vaccination with MenA has been recommended to be given between 9 to 18 months of age.  https://apps.who.int/iris/bitstream/handle/10665/260556/9789241513678-eng.pdf?ua=1|

World Health Organisation vaccine coverage information - https://www.who.int/immunization/monitoring_surveillance/routine/coverage/en/

The Global Meningococcal Initiative (GMI) promotes and shares world class research into best practice, prevention, diagnosis and treatment of meningococcal disease around the world - https://www.meningitis.org/partnership/global-meningitis-initiative
 

A.

The visualisations on the MPT use modelled estimates, but meningitis and pathogen specific surveillance systems also exist which serve the purpose of identifying outbreaks in higher risk areas and for monitoring vaccine efficacy.

The following provides further reading on meningitis surveillance and improving surveillance data:

Major meningitis efforts surveillance

WHO – Meningitis Weekly Bulletin - https://www.who.int/immunization/monitoring_surveillance/burden/laboratory/IBVPD/en/

MenAfrinet - http://www.menafrinet.org/en-us/

WHO Invasive Bacterial Vaccine Preventable Diseases Laboratory Network - https://www.who.int/immunization/monitoring_surveillance/burden/laboratory/IBVPD/en

Surveillance in the meningitis belt - Lingani, C., et al., Meningococcal Meningitis Surveillance in the African Meningitis Belt, 2004-2013. Clin Infect Dis, 2015. 61 Suppl 5: p. S410-5. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639499/

WHO Vaccine Preventable Diseases Surveillance Standards - https://www.who.int/immunization/monitoring_surveillance/burden/vpd/standards/en/

Improving death registration

How can we accelerate progress on civil registration and vital statistics - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872022/

Estimating meningitis deaths

In countries with no national death registration systems, death estimates are based largely on modelled data using verbal autopsy as the primary data source.  Verbal autopsy involves interviewing individuals close to the deceased as a way of identifying a cause of death.  This means that verbal autopsy cannot accurately distinguish between diseases which have similar symptoms and cannot identity which pathogen caused an infectious death.

The Child Health and Mortality Prevention Surveillance (CHAMPS) Network has been established in areas Sub-saharan Africa and South Asia where infant mortality is very high and there are no national death registration systems to better understand the causes of death of children under 5 in these regions.  - https://champshealth.org/

A.

The following provides further reading on meningitis diagnosis and treatment:

Information about the need for meningitis rapid diagnostic tests -  https://www.who.int/emergencies/diseases/meningitis/meningitis-diagnostics-use-cases.pdf?ua=1

This course provides a general introduction to Meningitis and is intended for incident managers and personnel working for the United Nations, international organizations and NGOs - https://openwho.org/courses/meningitis-introduction

WHO Pocketbook for treating common childhood illnesses - https://www.who.int/maternal_child_adolescent/documents/child_hospital_care/en/

WHO Managing Meningitis Epidemics in Africa - https://www.who.int/csr/resources/publications/HSE_GAR_ERI_2010_4/en/

Waite (2014) Systematic review of Rapid Diagnostic Tests for the diagnosis of meningitis in outbreak response in sub-Saharan Africa Report for WHO Meningitis guideline revision - https://www.who.int/csr/resources/publications/meningitis/PICO_2_report_1may14.pdf?ua=1

A.

The following provides further reading on the need to improve meningitis support and aftercare:

Edmond, K., et al., Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis, 2010. 10 (5): p. 317-28.

Report from the WHO regional office for Africa - “A heavy burden.  The indirect cost of illness in Africa

Share this
We take action that benefits people directly. including, training health professionals and providing support and information services.
Since the charity was founded in 1989, we have awarded 161 research grants. The total value of our investment in vital scientific research is over £19.1 million (€24.7 million).
We call for positive change as a united voice against meningitis and septicaemia, and a dedicated champion for those it affects.
Meningitis is a deadly and complicated disease - so is it actually possible to truly "defeat" it? Find out here.
Provide a lifeline for those in need
Provide a lifeline for those in need
£6/€7.20/$8 pays for a 30 minute call from a trained support officer.

They listen to the issues faced by someone struggling with the impact of meningitis, and provide detailed information and support.
Claire Wright
Evidence and policy manager (prevention)

Hello I'm Claire.

If you'd like to know more about this apect of MRF's work, please get in touch.

Tel: 0333 405 6259