Informing Reactive Vaccination Strategies for Meningococcal Meningitis in sub-Saharan Africa using Dust and Climate Predictors

Abstract:

Epidemics of meningococcal meningitis occur in sub-Saharan Africa during the dry season, a period when the region is affected by the Harmattan, a dry and dusty northeasterly trade wind blowing from the Sahara into the Gulf of Guinea. Although the mechanisms remain unclear, the location and seasonality of meningitis epidemics suggest that environmental factors, such as low absolute or relative humidity, high temperatures, and dusty atmospheric conditions play an important role. Using a 20-year time series of meningitis incidence in Niger we examined the potential of statistical models to predict seasonal incidence based on data that would be operationally available, such as climate and dust, population and previous incidence. We used surface dust concentration estimates from a model given the paucity of direct in situ measurements especially at district level. The soil dust aerosol component of the model was thoroughly evaluated with existing satellite and in situ data over the region of interest showing daily aerosol optical depth correlations around 0.6 (p < 0.05). Our results show that wind and dust information along with incidence in the early dry season predict a significant part of the year-to-year variability of the seasonal incidence at both national and district levels. Such a model could provide an early-season alert when wind, dust, and other conditions are conducive to an epidemic. We additionally discuss how this research has focused at “getting science into practice” by engaging with practitioner communities to inform operational decision-making for reactive vaccination.