Date of Conferral

2018

Degree

Ph.D.

School

Public Health

Advisor

Gonzalez German

Abstract

Meningococcal meningitis is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (N. meningitidis A) was the predominant pathogen causing deathly epidemics. MenAfriVac® vaccine protects against N. meningitidis A. It was introduced in 2010 into highest meningitis risk health districts. There was limited data on the effects of MenAfriVac®, mainly on the degree of relationship between N. meningitidis A and the MenAfriVac® immunization. The social ecological model was used as a theoretical framework for this study. The purpose of this quantitative study was to assess the effectiveness of MenAfriVac® from 2010 to 2017 in 21 out of 26 countries of the African meningitis belt. The four research questions contributed to establishing the effects of MenAfriVac®. An interrupted time series design and nonprobability sampling were used. Secondary data were retrieved from World Health Organization database. The binomial negative regression and Pearson’s Chi-Square tests were used. The study found that after the MenAfriVac® introduction there were 39% decline of incidence rate of the meningitis suspected cases (IRR 0.61, 95% CI 0.48 – 0.79, p < .001), a high degree of relationship between N. meningitidis A and MenAfriVac® immunization (χ2 (1) = 11039.49, p = 0.000, Phi = 0.657, P=0.000), 99% decline of the risk of N. meningitidis A (RR 0.01, 95% CI 0.08-0.013), and 99.6% decline of risk of epidemic due to N. meningitidis A (RR 0.004, 95% CI 0.001-0.016). The study demonstrated that high MenAfriVac® coverage and enhanced surveillance are pivotal to reduce the meningitis burden. Results will be used to inform policy and public health practice to reduce the meningitis cases and improve quality of live in the community.

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