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CSU 90/2011: THE EPIDEMIOLOGY OF MENINGOCOCCAL DISEASE IN INDIA

Tuesday, 15th of March 2011 Print
THE EPIDEMIOLOGY OF MENINGOCOCCAL DISEASE IN INDIA
From the conclusions:   'New serogroup A-containing meningococcal conjugate vaccines are now being developed and reaching the market, including an affordable monovalent serogroup A vaccine manufactured in India, but intended primarily for use in Africa. These new tools may have a role in containing future Indian epidemics, but their usefulness is dependent on early identification of epidemics. This will require a functional disease surveillance system with adequate laboratory support throughout India.'
 
Full text is at http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02660.x/full
 

The epidemiology of meningococcal disease in India

1.     David Sinclair1, Marie-Pierre Preziosi2, T. Jacob John3, Brian Greenwood4

Article first published online: 5 NOV 2010

Tropical Medicine & International Health

Volume 15, Issue 12, pages 1421–1435, December 2010

Additional Information(Show All)

How to CiteAuthor InformationPublication History

How to Cite

Sinclair, D., Preziosi, M.-P., Jacob John, T. and Greenwood, B. (2010), The epidemiology of meningococcal disease in India. Tropical Medicine & International Health, 15: 1421–1435. doi: 10.1111/j.1365-3156.2010.02660.x

Author Information

1.        1  The South Asian Cochrane Centre, Christian Medical College, Vellore, India

2.        2  Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland

3.        3  Formerly of Christian Medical College, Vellore, India (Retired)

4.        4  London School of Tropical Medicine and Hygiene, London, UK

*Correspondence: Corresponding Author David Sinclair, The South Asian Cochrane Centre, Christian Medical College, Vellore, India. E-mail: davesinkers@yahoo.com

Summary

Objective  To undertake a review of the literature on the epidemiology of meningococcal disease in India, with a view to informing future control policies.

Methods  We searched the PUBMED, EMBASE, Global Health, IMSEAR and MedIND databases for observational studies relating to the burden of endemic meningococcal disease in India, the occurrence and epidemiological characteristics of epidemics, and the prevalence of individual meningococcal serogroups.

Results  The relatively few reports identified suggest that the incidence of endemic meningococcal disease in India is low, but that occasional epidemics of meningococcal disease have been recorded for at least 100 years. The larger epidemics have affected mainly the cities of northern India and have almost universally been caused by meningococci belonging to serogroup A. These epidemics have showed a few characteristics, including a marked seasonality, which are similar to those of epidemic meningococcal A disease in Africa.

Conclusions  New serogroup A-containing meningococcal conjugate vaccines are now being developed and reaching the market, including an affordable monovalent serogroup A vaccine manufactured in India, but intended primarily for use in Africa. These new tools may have a role in containing future Indian epidemics, but their usefulness is dependent on early identification of epidemics. This will require a functional disease surveillance system with adequate laboratory support throughout India.

L’épidémiologie des maladies à méningocoques en Inde

Objectif: Revue de la littérature sur l’épidémiologie des maladies à méningocoque en Inde, en vue d’informer les futures politiques de lutte.

Méthodes: Nous avons effectué une recherche sur les bases de données PubMed, Embase, Global Health, IMSEAR et MedIND pour des études observationnelles relatives à la charge des maladies méningococales endémiques en Inde, la présence et les caractéristiques épidémiologiques des épidémies, ainsi que la prévalence des différents sérogroupes de méningocoques.

Résultats: Les publications relativement peu nombreuses identifiées suggèrent que l’incidence des maladies méningococales endémiques en Inde est faible, mais que des épidémies occasionnelles de maladies méningococales ont été enregistrées depuis au moins 100 ans. Les épidémies les plus importantes ont touché principalement les villes du nord de l’Inde et ont été presque universellement causées par des méningocoques appartenant au sérogroupe A. Ces épidémies ont montré des caractéristiques comprenant une saisonnalité marquée, similaires à celles de l’épidémie des maladies à méningocoque A en Afrique.

Conclusions: De nouveaux vaccins conjugués contenant le méningocoque du sérogroupe A sont en cours de développement et arrivent sur marché, y compris un vaccin monovalent du sérogroupe A abordable, fabriqué en Inde, mais principalement destinéà l’Afrique. Ces nouveaux outils peuvent jouer un rôle en limitant de futures épidémies en Inde, mais leur utilité dépend de l’identification précoce des épidémies. Il faudra pour cela un système fonctionnel de surveillance des maladies avec le soutien approprié des laboratoires dans toute l’Inde.

Mots-clés: méningocoque, Inde, épidémiologie

Epidemiología de la enfermedad meningocócica en la India

Objetivo: Realizar una revisión de la literatura sobre la epidemiología de la enfermedad meningocócica en la India con el fin de informar de cara a futuras políticas de control.

Métodos: Se realizaron búsquedas en las bases de datos de PUBMED, EMBASE, Global Health, IMSEAR y MedIND de estudios observacionales relacionados con la carga de la enfermedad meningocócica en India, la incidencia y las características de epidemias, y la prevalencia de serogrupos meningocócicos individuales.

Resultados: El número relativamente pequeño de artículos identificados sugiere que la incidencia de la enfermedad meningocócica en India es baja, aunque las epidemias ocasionales de enfermedad meningocócica han sido reportadas durante al menos los últimos 100 años. Las epidemias más grandes han afectado principalmente las ciudades del norte de la India, y han sido casi universalmente causadas por meningococos del serogrupo A. Estas epidemias han mostrado características, incluyendo una marcada estacionalidad, similares a aquellas de las epidemias por meningococo del grupo A en África.

Conclusiones: Nuevas vacunas meningocócicas conjugadas que contienen el serogrupo A están siendo desarrolladas y van llegando al mercado, incluyendo una vacuna monovalente para el grupo A, asequible y manufacturada en India, pero principalmente intencionada para ser utilizada en África. Estas nuevas herramientas juegan un papel importante en la contención de futuras epidemias en la India, pero su utilidad depende de la identificación temprana de las epidemias. Para ello, se requiere un sistema de vigilancia de la enfermedad con un apoyo laboratorial adecuado alrededor de toda la India.



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