Meningococcal oligosaccharide A, C, W135 and Y conjugate vaccine solution for injection 0.5ml vials

IntroductionClinical trials are evaluating the efficacy of serogroup B meningococcal (MenB) outer membrane vesicle (OMV) vaccines in preventing gonorrhoea. We assessed the global epidemiology of gonorrhoea and MenB invasive meningococcal disease (IMD) and reviewed national MenB-OMV vaccination policies to inform potential use of these vaccines.MethodsWe included country-specific epidemiologic data from 2015 through October 2025. Gonorrhoea prevalence data for general populations of women were extracted from published systematic reviews and case reports taken from well-established reporting systems. Country-specific MenB IMD incidence rates were drawn from published reviews and surveillance reports. National MenB-OMV immunization policies were obtained from published reviews and databases from the World Health Organization and vaccine manufacturers.ResultsForty-two countries had ≥1 gonorrhoea prevalence study. Mean prevalence was DiscussionEpidemiologic data were lacking in many countries; only a handful had a substantial burden of both gonorrhoea and MenB IMD. Low- and middle-income countries with high gonorrhoea prevalence typically reported no MenB IMD or lacked data, whereas high-income countries with higher MenB IMD incidence and MenB-OMV vaccine use had low gonorrhoea prevalence but high rates in subpopulations like MSM.ConclusionsIf trials confirm MenB-OMV vaccine cross-protection against gonorrhoea, global epidemiology can help identify settings and populations for potential vaccine use against gonococcal infection alone, or for both conditions. Improved data collection and cost-effectiveness analyses across both conditions can further inform decision-making.

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BackgroundMeningitis is a significant health concern that is associated with high fatality rates, particularly in resource-limited settings such as Ghana, whose northern regions lie within the African Meningitis Belt. Despite the plethora of primary research data on meningitis in Ghana, a systematic review that provides comprehensive information to guide prevention, control, and management efforts is yet to be undertaken. This systematic review, therefore, aimed at bridging this gap by describing the epidemiology of meningitis in Ghana, including its prevalence, aetiology, and antimicrobial resistance.MethodA comprehensive review of electronic databases, including PubMed and Scopus, was conducted between 2nd and 4th December, 2023, following the established PRISMA guidelines. The search encompassed articles published from 1975 to 2023. With no age limitations on study participants, data extraction was performed on peer-reviewed journal articles reporting primary findings. Studies that exclusively reported on meningitis in animal models, in vitro or in vivo were excluded. Studies with a sample size of less than ten were excluded from the analysis. A meta-analysis was carried out to determine the pooled estimate of meningitis prevalence in the country.ResultsThere were 71,205 suspected meningitis cases analysed during the study period, with 3865 confirmed, and a pooled (overall) prevalence of 18.13%. Specifically, the cases that occurred during non-outbreak and outbreak periods had a pooled prevalence of 16.22% and 23.91%, respectively. The case fatality rates ranged from 20% to 47% between 1998 and 2015 and from 0.82% to 28.6% between 2016 and 2021. The three northern regions - Upper East (30.8%-54.35%), Northern (16.3%-46.4%), and Upper West (17.96%-38.8%) - had relatively high meningitis prevalence, while the Greater Accra and Ashanti Regions had prevalence ranging between 0.8% and 3.29%. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae were the predominant isolates, accounting for 0.48%-77.7%, 2.5%-69.5%, and 0.90%-3.40% of the cases, respectively. All bacterial isolates from meningitis cases were susceptible to ceftriaxone. The most common Neisseria meningitidis serogroups were W135, A, Y, and X, while Serotype 1 dominated among the Streptococcus pneumoniae serotypes.ConclusionThere is a disparity in the distribution of meningitis in Ghana, with the highest prevalence occurring in the northern parts of the country. There seems to have been a reduction in the case fatality rate over the years, probably due to interventions such as vaccinations. Ceftriaxone continues to be a suitable treatment option for meningitis. There should be continuous surveillance of meningitis aetiological agents - especially serotyping of the common pathogens - to help guide national vaccination policies and programmes.

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IntroductionNeisseria meningitidis (Nm) is a major cause of meningitis and septicemia. Most people are infected with latent infections or are carriers. We aimed to estimate the carriage prevalence of Nm in China.MethodsWe did a systematic review of published work to assess the prevalence of meningococcal carriage in China. The quality assessment was conducted by the risk of bias tool according to Damian Hoy's study. We estimated pooled proportions of carriage and its 95% confidence interval (95% CI) using fixed effect model for studies with low heterogeneity and random effect model for studies with moderate or high heterogeneity. Subgroup analyses were also conducted by region and age group.ResultsIn total, 115 studies were included. The quality evaluation grades of all included documents were medium or high grade. The weighted proportion of carriage was 2.86% (95% CI: 2.25-3.47%, I2: 97.7%, p = 0). The carriage prevalence of Nm varied between provinces, ranged from 0.00% (95% CI: 0.00-0.66%) to 15.50% (95% CI: 14.01-16.99%). Persons aged 15 years and older had the highest carriage 4.38% (95% CI: 3.15-5.62%, I2: 95.4%, p 2: 98.6%, p = 0) took up the highest proportion, and serogroup X (0.02%, 95% CI: 0.00-0.09%, I2: 0.00%, p = 1) accounted for the lowest proportion.ConclusionThe meningococcal carriage in China was estimated low and varied by region and age group. Understanding the epidemiology and transmission dynamics of meningococcal infection in insidious spreaders is essential for optimizing the meningococcal immunization strategies of the country.

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BackgroundMeningococcal disease is caused by the bacteria Neisseria meningitidis, leading to substantial mortality and severe morbidity; with serogroups A, B, C, W135, X and Y most significant in causing disease. An outbreak is defined as multiple cases of the same serogroup occurring in a population over a short time-period. A systematic review was performed to gain insight into outbreaks of meningococcal disease and to describe the temporal pattern over the last 50 years in non-African countries.MethodsPubMed and EMBASE were searched for English-language publications on outbreaks of meningococcal disease in non-African countries between January 1966 and July 2017, with an additional grey literature search. Articles and reports were considered eligible if they reported confirmed meningococcal outbreak cases, included the region, number of cases, and the start and end dates of the outbreak. Data on outbreaks was stratified by geographical region in accordance with the World Health Organization (WHO) regional classification, and case-fatality rates (CFRs) were calculated.ResultsOf the identified publications, 3067 were screened and 73 included, reporting data from 83 outbreaks. The majority of outbreaks were identified in the regions of the Americas (41/83 outbreaks), followed by the European region (30/83 outbreaks). In each of the Western Pacific, Eastern Mediterranean, and South-East Asian regions there were ConclusionsThese data present a retrospective view of the patterns for meningococcal disease outbreaks in non-African countries, and provide valuable data for monitoring future changes in disease epidemiology and informing preventive measures.

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ObjectiveTo perform systematic review and meta-analysis of meningococcal disease burden in India.MethodsWe searched publications on meningococcal disease in India between 1996 and 2020 using PubMed and Google Scholar. Prevalence (proportion) of Meningococcal meningitis and Case-fatality ratio (CFR) were pooled using random effects model. Other outcomes were pooled qualitatively.ResultsThe prevalence of Meningococcal meningitis in epidemic and endemic conditions was 12.1% (95% CI: 5.2-21.4) and 0.76% (95% CI: 0.3-1.4), respectively, with a CFR of 12.8% (95% CI: 6.8-20.4) in epidemic settings; N. meningitis caused 3.2% (95% CI: 1.6-5.3) of Acute Bacterial Meningitis (ABM) cases in endemic settings. The disease appeared in infants, adolescents, and adults with Serogroup A prevalence. Treatment and prophylaxis were limited to antibiotics despite increased resistance.ConclusionThe study reveals epidemic and endemic presence of the disease in India with high fatality and serogroup A prevalence. Further monitoring and immunization are required to prevent outbreaks.

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BackgroundInvasive meningococcal disease (IMD) represents a global health burden. However, its epidemiology in the Eastern Mediterranean (EM) and North Africa (NA) regions is currently not well understood. This review had four key objectives: to describe asymptomatic meningococcal carriage, IMD epidemiology (e.g. serogroup prevalence, case-fatality rates [CFRs]), IMD presentation and management (e.g. clinical diagnosis, antibiotic treatments) and economic impact and evaluation (including health technology assessment [HTA] recommendations) in EM and NA.MethodsA systematic literature search (MEDLINE and EMBASE) was conducted (January 2000 to February 2021). Search strings included meningococcal disease and the regions/countries of interest. Identified publications were screened sequentially by title/abstract, followed by screening of the full-text article; articles were also assessed on methodological quality. Literature reviews, genetic sequencing or diagnostic accuracy studies, or other non-pertinent publication type were excluded. An additional grey literature search (non-peer-reviewed sources; start date January 2000) was conducted to the end of April 2019.ResultsOf the 1745 publications identified, 79 were eligible for the final analysis (n = 61 for EM and n = 19 for NA; one study was relevant to both). Asymptomatic meningococcal carriage rates were 0-33% in risk groups (e.g. military personnel, pilgrims) in EM (no data in NA). In terms of epidemiology, serogroups A, B and W were most prevalent in EM compared with serogroups B and C in NA. IMD incidence was 0-20.5/100,000 in EM and 0.1-3.75/100,000 in NA (reported by 7/15 countries in EM and 3/5 countries in NA). CFRs were heterogenous across the EM, ranging from 0 to 57.9%, but were generally lower than 50%. Limited NA data showed a CFR of 0-50%. Data were also limited in terms of IMD presentation and management, particularly relating to clinical diagnosis/antibiotic treatment. No economic evaluation or HTA studies were found.ConclusionsHigh-risk groups remain a significant reservoir of asymptomatic meningococcal carriage. It is probable that inadequacies in national surveillance systems have contributed to the gaps identified. There is consequently a pressing need to improve national surveillance systems in order to estimate the true burden of IMD and guide appropriate prevention and control programmes in these regions.

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