Climate and environmental information and the control of epidemic meningitis in Africa

Epidemics of bacterial meningitis have plagued the African continent for over a century creating public health emergencies with considerable morbidity and mortality. Although many bacteria can cause meningitis, most epidemics are due to a small number of meningococcal serogroups, especially groups A, C, X, Y and W135 with more than 90% of these epidemics due to group A Neisseria meningitidis. Current group A vaccines have serious shortcomings, although a new conjugate vaccine, likely to be licensed in the near future, is expected to greatly modify the epidemiology of the disease. The distribution of the epidemics has a strong association with the environment and these associations have been used to develop models to predict their location and incidence with varying degrees of success. Here we describe the characteristics of epidemic meningitis in Africa, its association with the environment, the approaches currently available for control and the advantages of the new vaccines. We also discuss the problems that may be faced with the advent of the vaccines and their large-scale implementation and how geographical information systems and climate and environmental information could play a role in informing vaccine strategies monitoring vaccine efficacy, and controlling epidemics in Africa.