Neisseria meningitidis Meningitis in Burkina Faso: Review of the Literature

Abstract

Introduction: Neisseria meningitidis meningitis is a permanent threat in Burkina Faso due to its epidemic potential. Objective: To study the epidemiological aspects of meningitis caused by Neisseria meningitidis and to identify the main current trends.  Patients and Methods: This was a descriptive cross-sectional study with retrospective collection of data from the literature on Neisseria meningitidis epidemics in Burkina Faso.  Results: Burkina Faso has experienced several epidemics of meningitis caused by Neisseria meningitidis serogroup A. Indeed, the country was hit by epidemics due to this serogroup in 1957, 1985, 1994, 1995, 1996, 1997, 2004, 2005, 2006, 2007, 2008 and 2009. The 1996 epidemic was particularly deadly with 4363 deaths recorded. Neisseria meningitidis serogroup W has also been responsible for several epidemics including those of 1992, 2001, 2002, 2003, and 2012. While Neisseria meningitidis serogroup X was responsible for the first major epidemic in 2010. As for Neisseria meningitidis serogroup C, after a first outbreak in 1979, it was in 2019 that this serogroup was again responsible for an outbreak in eastern Burkina Faso. In all these outbreaks, children were the most affected and case fatality was high (more than 14%). In addition to the therapeutic management of cases, a vaccine response was used to contain these epidemics. The vaccines used were initially polysaccharide vaccines (meningococcal A+C vaccine, tetravalent A+C+Y+W vaccine), and since 2010, the MenAfriVac® conjugate vaccine, which has eliminated epidemics due to meningococcus (Nm) A. However, it is noted that other Neisseria meningitidis serogroups (X,C,W) continue to circulate. Epidemiological surveillance data showed a clear decline in Neisseria meningitidis in week 48 of 2022, behind Streptococcus pneumoniae which has become the leading cause of bacterial meningitis in Burkina Faso. The same trend has been observed since the mass vaccination campaign with the MenAfriVac® conjugate vaccine. Conclusion: The persistent circulation of Neisseria meningitidis serogroups W, X, and C raises concerns about further meningitis epidemics. It is important to maintain a high level of epidemiological surveillance of Neisseria meningitidis in Burkina Faso.