ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Declining Incidence of Invasive Meningococcal Disease in South Africa: 2003-2016.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Epidemiological distribution of bacterial meningitis infections in South Africa: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Global epidemiology of serogroup Y invasive meningococcal disease: a literature review.Epidemiology and infection · 2024Pooled it
- Genomic Diversity and Antimicrobial Susceptibility of Invasive Neisseria meningitidis in South Africa, 2016-2021.The Journal of infectious diseases · 2024Article
- Meningococcal Disease in Persons With HIV Reported Through Active Surveillance in the United States, 2009-2019.Open forum infectious diseases · 2024Article
- Demographic and pathogen characteristics of incident bacterial meningitis in infants in South Africa: A cohort study.PloS one · 2024Article
- Molecular diagnostics and next-generation sequencing reveal real etiological characteristics of invasiveEmerging microbes & infections · 2022Article
- Excess Invasive Meningococcal Disease Associated With Seasonal Influenza, South Africa, 2003-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Toward Establishing Integrated, Comprehensive, and Sustainable Meningitis Surveillance in Africa to Better Inform Vaccination Strategies.The Journal of infectious diseases · 2021Article
- Human Immunodeficiency Virus Infection Is Associated With Increased Meningococcal Carriage Acquisition Among First-year Students in 2 South African Universities.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- A Narrative Review of the W, X, Y, E, and NG of Meningococcal Disease: Emerging Capsular Groups, Pathotypes, and Global Control.Microorganisms · 2021Review
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Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundInvasive meningococcal disease (IMD) is endemic to South Africa, where vaccine use is negligible. We describe the epidemiology of IMD in South Africa.
methodsIMD cases were identified through a national, laboratory-based surveillance program, GERMS-SA, from 2003-2016. Clinical data on outcomes and human immunodeficiency virus (HIV) statuses were available from 26 sentinel hospital sites. We conducted space-time analyses to detect clusters of serogroup-specific IMD cases.
resultsOver 14 years, 5249 IMD cases were identified. The incidence was 0.97 cases per 100 000 persons in 2003, peaked at 1.4 cases per 100 000 persons in 2006, and declined to 0.23 cases per 100 000 persons in 2016. Serogroups were confirmed in 3917 (75%) cases: serogroup A was present in 4.7% of cases, B in 23.3%, C in 9.4%; W in 49.5%; Y in 12.3%, X in 0.3%; Z in 0.1% and 0.4% of cases were non-groupable. We identified 8 serogroup-specific, geo-temporal clusters of disease. Isolate susceptibility was 100% to ceftriaxone, 95% to penicillin, and 99.9% to ciprofloxacin. The in-hospital case-fatality rate was 17% (247/1479). Of those tested, 36% (337/947) of IMD cases were HIV-coinfected. The IMD incidence in HIV-infected persons was higher for all age categories, with an age-adjusted relative risk ratio (aRRR) of 2.5 (95% confidence interval [CI] 2.2-2.8; P < .001) from 2012-2016. No patients reported previous meningococcal vaccine exposure. Patients with serogroup W were 3 times more likely to present with severe disease than those with serogroup B (aRRR 2.7, 95% CI 1.1-6.3); HIV coinfection was twice as common with W and Y diseases (aRRR W = 1.8, 95% CI 1.1-2.9; aRRR Y = 1.9, 95% CI 1.0-3.4).
conclusionsIn the absence of significant vaccine use, IMD in South Africa decreased by 76% from 2003-2016. HIV was associated with an increased risk of IMD, especially for serogroup W and Y diseases.
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