Sáfadi Marco Aurélio Palazzi, Cintra Otávio Augusto Leite
Department of Pediatrics, Santa Casa de São Paulo School of Medicine, São Paulo, Brazil.
Neurol Res. 2010 Apr;32(3):263-71. doi: 10.1179/016164110X12644252260754.
Meningococcal disease continues to be a serious public health concern, being associated with high morbidity and mortality rates in many countries from Latin America. In addition to discussing recent changes in the epidemiology of meningococcal disease in the region, we also analyse the development and potential impact of new vaccines on the prevention of meningococcal disease.
MEDLINE, SciELO, LILACS and websites of the national Ministries of Health databases were searched using the terms meningococcal disease, meningococcal epidemiology, Neisseria meningitidis, meningococcal vaccines and the name of Latin America countries, from 1998 to 2008, with emphasis on review articles, clinical trials and epidemiological studies.
Epidemiology of meningococcal disease in Latin America is characterized by marked differences from country to country. The overall incidence of meningococcal disease per year varied from less than 0.1 cases per 100,000 inhabitants in countries like Mexico to two cases per 100,000 inhabitants in Brazil. The highest age-specific incidence of meningococcal disease occurred in infants less than 1 year of age. Serogroups B and C were responsible for the majority of cases reported, but the emergence of serogroups W135 and Y was reported in some countries. Serogroup A disease is now rare in Latin America.
Although a few countries have established meningitis surveillance programs, the information is not uniform, and the quality of the reported data is poor in the majority of the region. The availability of new effective meningococcal conjugate vaccines and promising protein-based vaccine candidates against meningococcus B highlights the importance of a better understanding of the true burden of meningococcal disease in Latin America and also the need for cost-effectiveness studies before incorporating the new meningococcal vaccines to national immunization programs.
脑膜炎球菌病仍是一个严重的公共卫生问题，在许多拉丁美洲国家，其发病率和死亡率都很高。除了讨论该地区脑膜炎球菌病流行病学的近期变化外，我们还分析了新疫苗在预防脑膜炎球菌病方面的研发情况及其潜在影响。
使用“脑膜炎球菌病”“脑膜炎球菌流行病学”“脑膜炎奈瑟菌”“脑膜炎球菌疫苗”以及拉丁美洲国家名称等检索词，检索1998年至2008年期间的MEDLINE、SciELO、LILACS以及各国卫生部网站数据库，重点检索综述文章、临床试验和流行病学研究。
拉丁美洲脑膜炎球菌病的流行病学特征是各国之间存在显著差异。脑膜炎球菌病的年总发病率从墨西哥等国每10万居民不足0.1例到巴西每10万居民2例不等。脑膜炎球菌病特定年龄发病率最高的是1岁以下婴儿。报告的大多数病例由B群和C群引起，但在一些国家报告了W135群和Y群的出现。A群疾病目前在拉丁美洲很少见。
尽管一些国家已建立脑膜炎监测项目，但信息并不统一，该地区大部分地区报告数据的质量较差。新型有效的脑膜炎球菌结合疫苗以及有前景的针对B群脑膜炎球菌的基于蛋白质的候选疫苗的出现，凸显了更好地了解拉丁美洲脑膜炎球菌病真实负担的重要性，以及在将新型脑膜炎球菌疫苗纳入国家免疫规划之前进行成本效益研究的必要性。
