Liverpool School of Tropical Medicine
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
Brenda Anna Kwambana-Adams is a Wellcome International Intermediate Fellow and Senior Lecturer (Academic Career Track) at the Liverpool School of Tropical Medicine and the Malawi-Liverpool-Wellcome Clinical Research Programme. Brenda’s research interests are to characterise the mechanisms that modulate transmission of the pneumococcus using cutting-edge “omics”, with the aim to guide the development of more effective control strategies. As part of her Wellcome Fellowship, Brenda is using an innovative vaccine-probe study to investigate the role of under-fives in within-household transmission of the pneumococcus to infants. In the process of doing this, Brenda is also developing tools for early, rapid, and accurate diagnosis of acute bacterial meningitis (ABM) and bacteraemia that could improve case ascertainment in resource limited settings. Brenda also works with the World Health Organization (WHO) and Regional Reference Laboratories supporting surveillance of acute bacterial meningitis across Africa. She led the WHO technical mission which investigated the 2016 pneumococcal meningitis outbreak in Brong Ahafo Region, Ghana. Brenda contributed to the development of the current WHO guidelines on controlling pneumococcal outbreaks in the African “meningitis belt” and the WHO Defeating Meningitis 2030 Global Roadmap. Brenda has won numerous awards including the first prestigious MRC-LSHTM West Africa Global Health Research Fellowship.

Presenter Of 1 Presentation

O001 - MENINGITIS AND MORTALITY TRENDS AMONG HOSPITALISED UNDER-FIVES FOLLOWING THE INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINES: A TIME-SERIES ANALYSIS IN WEST AND CENTRAL AFRICA (ID 769)

Session Type
Parallel Session
Date
Mon, 20.06.2022
Session Time
15:20 - 16:35
Room
Grand Ballroom Centre
Lecture Time
15:25 - 15:35

Abstract

Background

Pneumococcal conjugate vaccines (PCVs) have been introduced into the infant immunization programmes across West and Central Africa. We modelled trends in numbers of meningitis cases and deaths among children before and after PCV introduction, using WHO-supported sentinel surveillance.

Methods

A total of 36,901 children under five years with suspected meningitis were enrolled at sentinel hospitals across ten West and Central African countries through the Paediatric Bacterial Meningitis (PBM) Surveillance Network between 2010 and 2016. Laboratory testing of cerebrospinal fluid (CSF) specimens was performed using standard microbiologic and molecular methods. To assess trends in disease and mortality case counts before and after 10- and 13-valent PCV introduction, we applied interrupted time-series models and random effects meta-analysis, accounting for seasonality and secular trends.

Results

Across the countries, there was a decline of 35% (95% CI 2-57%, p=0.04) in annual suspected meningitis cases and 26% (95% CI 3-44%, p=0.03) in laboratory confirmed meningitis in the post vs. pre-PCV period; there was a non-significant decrease in suspected meningitis deaths (23% decline, 95% CI -23-52%, p=0.27) post PCV introduction. There was considerable heterogeneity in post-PCV meningitis trends among the different countries; larger and more precise reductions were observed in countries with at least 2 years post-PCV introduction surveillance.

Conclusions

We observed overall declines in paediatric meningitis cases and deaths, but impact was most evident in countries with a longer duration of surveillance post-PCV-introduction. The heterogeneity in the trends across the countries following PCV implementation warrants continued monitoring and surveillance.

Hide