Department of Ecology and Evolutionary Biology, Woodrow Wilson School of Public and International Affairs, Princeton University, NJ, USA.
Epidemiol Infect. 2012 Aug;140(8):1356-65. doi: 10.1017/S0950268811002032. Epub 2011 Oct 5.
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.
在整个非洲脑膜炎带，脑膜炎球菌性脑膜炎疫情仅在旱季发生。尼日尔的麻疹也表现出类似的季节性，旱季期间人口密度增加可能会加剧麻疹传播。由于脑膜炎球菌性脑膜炎和麻疹都是直接传播的，因此我们提出宿主聚集也会影响脑膜炎球菌性脑膜炎的传播。虽然气候会影响脑膜炎球菌性脑膜炎的广泛季节性，但我们更关注在更精细的空间尺度上人类密度所扮演的较少被研究的角色。通过分析疑似脑膜炎球菌性脑膜炎病例的空间模式，我们发现沿主要道路的地区疑似病例较少，这与同一尼日尔人群中的麻疹消退相似。我们进一步表明，在没有疑似病例的时期之后，脑膜炎球菌性脑膜炎重新出现率高的地区，麻疹再次出现的比例也很高。尽管存在许多生物学和流行病学差异，但这两种疾病的动态产生了相似的季节性和空间模式。这项分析提高了我们对空间模式和疾病传播的理解，并提示了感染的热点以及脑膜炎球菌性脑膜炎监测和干预的潜在目标区域。
