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© 1992 Oxford University Press

research-article

Detection of Meningitis Epidemics in Africa: A Population-Based Analysis

PATRICK S MOORE*, BRIAN D PLIKAYTIS*, GAIL A BOLAN*, MARGARET J OXTOBY*, ADAMOU YADA**, ALAIN ZOUBGA**, ARTHUR L REINGOLD* and CLAIRE V BROOME*,

*Meningitis and Special Pathogens Branch, Center for Infectious Diseases, US Public Health Service, Centers for Disease Control Atlanta, GA 30333, USA
**Ministry of Public Health , Ouagadougou, Hurkina Faso

Reprint requests to: Dr C V Broome

Moore P S (Meningitis and Special Pathogens Branch, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA, 30333 USA), Plikaytis B D, Bolan G A, Oxtoby M J, Yada A, Zoubga A, Reingold A L and Broome C V. Detection of meningitis epidemics in Africa: a population-based analysis. International Journal of Epidemiology 1992; 21: 155–162.

Portions of sub-Saharan Africa are subject to major epidemics of meningococcal meningitis that require early detection and rapid control. We evaluated the usefulness of weekly meningitis rates derived from active surveillance data in Burkina Faso for detecting a meningitis epidemic. By analysing the rates of disease in 40 × 40km areas within a study region of Burkina Faso, we found that a threshold of 15 cases/100000/week averaged over 2 weeks was 72–93% sensitive and 92–100% specific in detecting epidemics exceeding 100 cases/100000/year. During epidemic periods, the positive predictive value of this threshold approached 100% for detecting local epidemics. Additionally, meningitis incidence was proportional to village size, with villages greater then 8000 having the highest disease rates during a major group A meningococcal epidemic in 1983–1984. Despite the rudimentary nature of surveillance data available in many developing countnes, these data can be used to detect the early emergence of meningitis epidemics. Additional studies are needed to determine the relevance of this approach for detecting epidemics.

Received 1 July 1991


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