ArticleInquiry : a journal of medical care organization, provision and financing
Meningitis Vaccine Delivery Strategies and Their Health Impact in Africa: A Scoping Review to Inform the Introduction of New Vaccines.
Article in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
IntroductionVaccination has played a pivotal role in mitigating the burden of meningitis in the African meningitis belt. However, outbreaks have continued due to the emergence of new serogroups, and logistical barriers. This scoping review synthesizes published evidence on health impact of meningitis vaccine delivery strategies to guide policy and programmatic decision-making and maximize the impact of the new meningitis vaccines.MethodsThe review followed PRISMA extension for scoping reviews. Eligible studies published between 2004 and 2024 in English or with an English translation examining the use of meningitis vaccines and delivery strategies across Africa were included. A systematic search of online databases was conducted using predefined search terms, and following screening of 1,026 articles, 20 were included in the review. Data on relevant themes were extracted into an excel spreadsheet and analyzed guided by PAGER framework.ResultsThe review found limited real-world evidence on meningitis vaccine delivery strategies, with many studies relying on modelling approaches. Findings showed that routine infant immunization and campaign-based strategies have been used to deliver meningitis vaccines in Africa. Compared to routine vaccination, campaign-based strategies were shown to achieve high coverage rates (∼95%), high risk reduction (71%) and high decline in suspected cases (82%). However, routine immunization combined with an initial catch-up campaign was cost-effective, saving USD1.3 for every USD1 invested. The use of the Controlled Temperature Chain (CTC) system for Men A conjugate vaccines enhanced accessibility and cost-effectiveness, particularly for remote facilities lacking cold chain infrastructure. Integrated campaigns were more cost-effective than stand-alone campaigns. Combining campaigns with routine immunization resulted in significant reduction of disease burden, despite potential disruptions during mass vaccination campaigns.ConclusionsCombining routine and campaign-based immunization strategies will enhance the impact of the new meningitis vaccines. There is need for more real-world implementation and cost-effectiveness research from Africa.
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