Table 5.
Characteristics of meningococcal outbreaks/epidemics in Africa 1997–2020*
| Country (year of MenA-CV introduction [10]) | Outbreak years | Serogroup | Age group Primarily affected | No. of cases** | Cumulative attack rate per 100,000 population | CFR (%) | Vaccination intervention and outcome (when available) | Ref |
|---|---|---|---|---|---|---|---|---|
| Benin (2012) | 1998–2002 | A and C | – | 6287 | 20.4 to 619 by district | 2–15 | MenAC-PS | [139] |
| 2012 |
81% W 15% X |
0–14 y | 149 | 46.8 to 211 by district | – | MenACW-PS | [87] | |
| 2017 | C | – | 78 | 189 | 8 | – | [140] | |
| Burkina Faso (2010) | 2002 | W | Infants, young children | 1307 |
251 overall, < 1 y 1092, 1–4 y 660 |
10 | – | [141] |
| 2006 | A | Median 7 y | > 410 | Up to 2800 by village | 7 | MenAC-PS for 2–30 y | [142] | |
| 2010 | X | 5–14 y | – | Up to 130 | 11 | No vaccine available | [143] | |
| 2012 | W | – | – | 51.2 to 105.2 by district | – | MenACWY-PS for 2 districts | [89] | |
| Cameroon (2011) | 2017 | C | – | 25 | – | 32 | – | [140] |
| Central African Republic (2016) | 2008 | A | – | 45 | – | 11 | Mass vaccination | [144] |
| Chad (2011) | 2009 | A and W | – | 1299 | – | 11 | MenACW-PS | [145] |
| 2010 | A | – | 1531 | – | 10 | MenACW-PS | [146] | |
| 2011 | A | – | 923 | – | 6 | MenAC-PS | [146] | |
| Ethiopia (2013) | 60 outbreaks 1999–2004 | Mostly A | – | 5806 | 8.6 | – | Men-PS vaccine | [84] |
| 2015 | C | – | 18 | – | 0 | – | [140] | |
| Gambia (2014) | 2012 | W | 1–14 y | 469 | 111 | 8 | MenACWY-PS | [92, 147] |
| Ghana (2012) | 2001–2004 | A | Median 10 y | 56–113 annually | Up to 80 | 5 | Annual campaigns with MenAC-PS | [148] |
| 2016 | W | – | 763 | 97 | 6 | – | [140] | |
| Guinea (2015) | 2013 | W | – | 404 | – | 9 | MenACW-PS | [146] |
| Mali (2010) | 1997 | A | 0–14 y | 11,228 | – | 10 | – | [149] |
| 2016 | C | 6–14 y | 39 | 23 | 15 | 50,998 (93%) 1–30 y received MenACWY-PS [marked reduction in cases observed] | [150] | |
| Niger (2010) | 1995–2000 | X | Mean 9.2 y | 134 | – | 12 | No vaccine available | [151] |
| 2011 | W | – | 129 | 43 | 10 | – | [140] | |
| 2015 | C | < 30 y | 9367 | 50.6 | 6 | MenACW-PS or MenACWY-PS in 2–15 y, MenACWY-CV in 2–19 y in 1 region | [152] | |
| 2016 | C | – | 760 | 83 | 3 | – | [140] | |
| Nigeria (2011) | 2009 | A | – | 54,766 | 2.8 to 236.2 | 2 to 11 (5 overall) | MenAC-PS, MenACW-PS | [146, 153] |
| 2013 | C | 5–29 y | 856 | 673 | 7 | No vaccine intervention | [154] | |
| 2014 | C | 5–29 y | 333 | 165 | 11 | MenACWY-PS | [154] | |
| 2015 | C | 5–29 y | 6394 | 282 | 5 | 222,000 (89–98%) 1–30 y received MenACWY-PS | [41] | |
| 2016 | C | – | 183 | 183 | 4 | – | [140] | |
| 2016–2017 | C | 1–14 y | 14,518 | – | 8 | 2.1 million (84.4%) 2–29 y received MenC-containing [Immediate drop in case numbers. Outbreak declared over within 2 months] | [40, 155] | |
| South Sudan (2016) | 2018 | ? | – | – | Up to 987 | 18 | MenA-CV | [156] |
| Togo (2014) | 2007 | X | 75 | 33 | 10 | No vaccine available | [143] | |
| 2016 | W | < 15 y | 1995 | 78.8 | 6 | MenACWY-PS [unclear] | [86] | |
| 2017 | W | – | 201 | 12.4 | 9 | Vaccines requested | [146] | |
| 174 districts in Benin, Burkina Faso, Gambia, Ghana, Mali, Niger, Togo, other countries | 1997 | A | – | 60,010 | – | > 10% | MenAC-PS [Estimated to have prevented 59.4% of the predicted cases, or 4217 cases and 464 deaths] | [88] |
CFR case fatality rate, CV conjugate vaccine, Men(A/C/W/Y) meningococcal vaccine containing one serogroup or combinations of serogroups A, C, W and Y, PS polysaccharide vaccine, Ref source reference, y years of age
*Enhanced surveillance networks were established progressively from 2003
**Suspected or confirmed