Ukoaka Bonaventure Michael, Okesanya Olalekan John, Daniel Faithful Miebaka, Affia Mmekom Obot, Emeruwa Victoria Ezinne
Department of Internal Medicine, Asokoro District Hospital, Abuja, Nigeria.
Community and Clinical Research Division, First On-Call Initiative, Port Harcourt, Nigeria.
Infez Med. 2024 Sep 1;32(3):323-329. doi: 10.53854/liim-3203-6. eCollection 2024.
The burden of meningitis poses great challenges for neurology and global health, manifesting with a range of symptoms from mild fever and headaches, to severe long term complications such as paralysis and cognitive impairment.. Unfortunately, those living in endemic regions, especially survivors, are often confronted with the harsh reality of reduced quality of life as measured by disability-adjusted life years. Meningitis is one of the leading causes of mortality and morbidity, especially in the meningitis belt of sub-Saharan Africa, with a recorded disease burden of over 2.5 million cases globally and children under five disproportionately impacted. This paper examines the global burden of meningitis, exploring its prevalence and impact across different regions. It further analyzes the evolution of vaccination strategies for meningitis prevention, emphasizing the recent development and introduction of the novel Men5CV meningococcal conjugate vaccine. Recurrent meningitis outbreaks across the meningitis belt have resulted in significant mortality over decades. A major turning point in the fight against the serogroup A epidemic was the development of the MenAfriVac vaccine, which resulted in declining cases. However, serogroups C, W, and X continue to pose problems. The novel pentavalent (Men5CV) vaccine has emerged as a remarkable advancement in the fight against meningitis, with its safety and effectiveness against a variety of serogroups, including the elusive serogroup X, demonstrated in clinical trials. Its pre-qualification by the World Health Organization (WHO), and subsequent recommendation for incorporation into routine immunization programs issued a new era with the potential for meningitis eradication. Nigeria now sets a benchmark for other nations in the meningitis zone, becoming the first country in the world to roll out the new Men5CV vaccines. Funding from organizations like Gavi, the Vaccine Alliance, highlights the importance of coordinated international efforts aligned with the WHO's roadmap for meningitis elimination by 2030. Stakeholder involvement, extensive immunization campaigns, and a strong healthcare infrastructure are all practical recommendations for public health integration.
脑膜炎的负担给神经病学和全球卫生带来了巨大挑战，其症状表现多样，从轻微发热和头痛到严重的长期并发症，如瘫痪和认知障碍。不幸的是，生活在流行地区的人们，尤其是幸存者，往往面临着生活质量下降的严峻现实，这可以通过伤残调整生命年衡量。脑膜炎是导致死亡和发病的主要原因之一，特别是在撒哈拉以南非洲的脑膜炎带，全球记录的疾病负担超过250万例，五岁以下儿童受到的影响尤为严重。本文研究了脑膜炎的全球负担，探讨了其在不同地区的流行情况和影响。它进一步分析了预防脑膜炎疫苗接种策略的演变，强调了新型五价脑膜炎球菌结合疫苗（Men5CV）的最新开发和引入。几十年来，脑膜炎带反复爆发的脑膜炎疫情导致了大量死亡。抗A群脑膜炎流行的一个重大转折点是开发了MenAfriVac疫苗，病例数因此下降。然而，C群、W群和X群仍然带来问题。新型五价（Men5CV）疫苗已成为抗击脑膜炎的一项重大进展，其针对包括难以捉摸的X群在内的多种血清群的安全性和有效性已在临床试验中得到证明。它获得了世界卫生组织（WHO）的预认证，随后被推荐纳入常规免疫计划，开启了一个有根除脑膜炎潜力的新时代。尼日利亚现在为脑膜炎带的其他国家树立了标杆，成为世界上第一个推出新型Men5CV疫苗的国家。像疫苗免疫全球联盟（Gavi）这样的组织提供的资金，凸显了与WHO到2030年消除脑膜炎路线图相一致的国际协调努力的重要性。利益相关者的参与、广泛的免疫运动和强大的医疗基础设施都是公共卫生整合的切实建议。
