Epidemiology and Infection

Meningococcal infection

Modelling meningococcal meningitis in the African meningitis belt

T. J. IRVINGa1a2a3 c1, K. B. BLYUSSa4, C. COLIJNa3 and C. L. TROTTERa2

a1 Bristol Centre for Complexity Sciences, University of Bristol, UK

a2 School of Social and Community Medicine, University of Bristol, UK

a3 Department of Engineering Mathematics, University of Bristol, UK

a4 Department of Mathematics, University of Sussex, UK

SUMMARY

Meningococcal meningitis is a major public health problem in a large area of sub-Saharan Africa known as the meningitis belt. Disease incidence increases every dry season, before dying out with the first rains of the year. Large epidemics, which can kill tens of thousands of people, occur frequently but unpredictably every 6–14 years. It has been suggested that these patterns may be attributable to complex interactions between the bacteria, human hosts and the environment. We used deterministic compartmental models to investigate how well simple model structures with seasonal forcing were able to qualitatively capture these patterns of disease. We showed that the complex and irregular timing of epidemics could be caused by the interaction of temporary immunity conferred by carriage of the bacteria together with seasonal changes in the transmissibility of infection. This suggests that population immunity is an important factor to include in models attempting to predict meningitis epidemics.

(Accepted June 24 2011)

(Online publication July 25 2011)

Correspondence:

c1 Author for correspondence: Mr T. J. Irving, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK. (Email: tom.irving@bristol.ac.uk)

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