Badur Selim, Al Dabbagh Mona A, Shibl Atef M, Farahat Fayssal M, Öztürk Serdar, Saha Debasish, Khalaf Mansour
EM, Vaccines Scientific Affairs and Public Health, GSK, Büyükdere Caddesi No:173, 1, Levent Plaza B Blok, 34394, Istanbul, Turkey.
Division of Infectious Diseases, Department of Pediatrics, King Abdulaziz Medical City, King Abdullah International Medical Research Centre, King Saud Bin Abdulaziz University for Health Sciences, Jidda, Saudi Arabia.
Infect Dis Ther. 2021 Dec;10(4):2035-2049. doi: 10.1007/s40121-021-00467-x. Epub 2021 Aug 14.
Reducing invasive meningococcal disease (IMD) through MenACWY immunization is a critical healthcare strategy in the Kingdom of Saudi Arabia (KSA). Robust IMD surveillance is essential to help assess the need for additional immunization initiatives in target populations. This is particularly important in KSA, where mass gatherings accompanying Hajj/Umrah pilgrimages have been associated with IMD outbreaks within the local KSA population, and subsequent intercontinental spread via returning pilgrims. This narrative review of the published literature describes the changing epidemiology of IMD in KSA to provide a perspective on the impact of current immunization strategies and potential gaps. As recent published surveillance data are lacking, we also evaluated publicly reported data from the KSA Ministry of Health (MoH) for 2012-2019 to inform more recent IMD trends. Between 1995 and 2011, national surveillance data indicate that 1103 IMD cases were reported in KSA: 60% in 2000-2001, involving two (mainly MenW) outbreaks involving KSA citizens/residents and pilgrims focused in Mecca and Medina. Across 2002-2011, 184 cases of IMD were reported, with a higher proportion occurring in KSA citizens/residents, and with less focus within pilgrimage centers than apparent in previous years. Our analysis of MoH data found that, between 2012 and 2019, 44 IMD cases were reported, all in KSA citizens/residents, and chiefly in children or infants. No pilgrimage-associated outbreaks have occurred since 2001. Serogroup data were available for 62.5% of all cases for 2002-2011; MenW (40.0%), MenA (35.7%), and MenB (16.5%). Serogroup data for 2012-2019 remain incompletely reported, and the existing surveillance system could be improved, as some element of underestimation/underreporting of IMD may exist. While existing MenACWY immunization strategies for KSA citizens/residents and visiting pilgrims have been successful in reducing IMD due to specific serogroups, disease due to MenB remains a potential risk, and additional immunization strategies should be considered.
通过接种ACWY脑膜炎球菌结合疫苗来减少侵袭性脑膜炎球菌病（IMD）是沙特阿拉伯王国（KSA）一项关键的医疗保健策略。强大的IMD监测对于评估目标人群中额外免疫接种计划的必要性至关重要。这在沙特阿拉伯尤为重要，因为朝觐/副朝朝圣期间的大规模集会与沙特当地人群中的IMD疫情相关，随后还会通过返乡朝圣者在洲际传播。本叙述性文献综述描述了沙特阿拉伯IMD流行病学的变化，以提供对当前免疫策略影响及潜在差距的观点。由于缺乏近期已发表的监测数据，我们还评估了沙特阿拉伯卫生部（MoH）2012 - 2019年公开报告的数据，以了解近期IMD趋势。1995年至2011年期间，国家监测数据显示沙特阿拉伯报告了1103例IMD病例：2000 - 2001年占60%，涉及两起（主要是W群）疫情，涉及沙特公民/居民和集中在麦加和麦地那的朝圣者。在2002 - 2011年期间，报告了184例IMD病例，沙特公民/居民中的病例比例更高，且朝圣中心内的关注度低于前几年。我们对卫生部数据的分析发现，2012年至2019年期间，报告了44例IMD病例，均为沙特公民/居民，主要是儿童或婴儿。自2001年以来未发生与朝圣相关的疫情。2002 - 2011年所有病例中有62.5%可获得血清群数据；W群（40.0%）、A群（35.7%）和B群（16.5%）。2012 - 2019年的血清群数据报告仍不完整，现有监测系统可能有待改进，因为可能存在IMD的某些低估/漏报情况。虽然针对沙特公民/居民和来访朝圣者的现有ACWY脑膜炎球菌结合疫苗免疫策略已成功减少了特定血清群导致的IMD，但B群导致的疾病仍然是一个潜在风险，应考虑额外的免疫策略。
