Spatial dynamics of meningococcal meningitis in Niger: observed patterns in comparison with measles
AffiliationDepartment of Ecology and Evolutionary Biology and Center for Health and Wellbeing, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton NJ, USA; MIVEGEC, UMR CNRS 5290, IRD 224, UM1, UM2, Montpellier, France; Epicentre, Paris, France; Department of Biology, Department of Statistics, and Center for Infectious Disease Dynamics, Penn State University, PA, USA; Ministry of Health, Niamey, Niger; Emerging Pathogens Institute and Department of Geography, University of Florida, Gainesville FL, USA; Fogarty International Center, National Institutes of Health, Bethesda MD, USA
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JournalEpidemiology and Infection
AbstractSUMMARYThroughout the African meningitis belt, meningococcal meningitis outbreaks occur only during the dry season. Measles in Niger exhibits similar seasonality, where increased population density during the dry season probably escalates measles transmission. Because meningococcal meningitis and measles are both directly transmitted, we propose that host aggregation also impacts the transmission of meningococcal meningitis. Although climate affects broad meningococcal meningitis seasonality, we focus on the less examined role of human density at a finer spatial scale. By analysing spatial patterns of suspected cases of meningococcal meningitis, we show fewer absences of suspected cases in districts along primary roads, similar to measles fadeouts in the same Nigerien metapopulation. We further show that, following periods during no suspected cases, districts with high reappearance rates of meningococcal meningitis also have high measles reintroduction rates. Despite many biological and epidemiological differences, similar seasonal and spatial patterns emerge from the dynamics of both diseases. This analysis enhances our understanding of spatial patterns and disease transmission and suggests hotspots for infection and potential target areas for meningococcal meningitis surveillance and intervention.
PublisherCambridge University Press