DEFEATING MENINGITIS BY 2030: baseline situation analysis 20 February 2019 The 2010 MenAfriVac® vaccine launch in Burkina Faso PATH/Gabe Bienczycki Contents 1. Overview ...................................................................................................................................................... 3 1.1 Purpose ............................................................................................................................................ 3 1.2 Scope ............................................................................................................................................... 3 1.3 Content ............................................................................................................................................ 3 2. Global and regional burden of meningitis ................................................................................................... 4 2.1. Epidemiology ................................................................................................................................... 4 2.2. Modelling the burden of meningitis ..................................................................................................... 6 2.3. Global mortality and incidence ............................................................................................................ 6 2.4. Regional mortality and incidence ....................................................................................................... 10 2.5. Complications and sequelae ............................................................................................................... 11 2.6. Monitoring roadmap progress from 2015 to 2030 ............................................................................ 12 3. Prevention and epidemic control .................................................................................................................. 14 3.1 Prevention: licensed vaccines and vaccines in clinical development ...................................................... 14 3.2 Prevention: vaccination programmes ..................................................................................................... 18 3.2.1 Recommended vaccination programmes (EPI, outbreaks) .............................................................. 18 3.2.2 Implementation status: global/regional ........................................................................................... 19 3.2.3 Barriers to implementation .............................................................................................................. 23 3.2.4 Gap analysis (programme implementation, R&D) ........................................................................... 24 3.3 Prevention: chemoprophylaxis ................................................................................................................ 25 3.3.1 Recommended practice .................................................................................................................... 25 3.3.2 Implementation status: global/regional ........................................................................................... 26 3.3.3 Barriers to implementation .............................................................................................................. 26 3.3.4 Gap analysis ...................................................................................................................................... 26 3.4 Epidemic control ...................................................................................................................................... 26 3.4.1 Recommended practice .................................................................................................................... 26 3.4.2 Implementation status ..................................................................................................................... 27 3.4.3 Barriers to implementation .............................................................................................................. 27 3.4.4 Gap analysis ...................................................................................................................................... 28 4. Diagnosis and Treatment ............................................................................................................................... 29 4.1 Diagnosis .................................................................................................................................................. 29 4.1.1 Laboratory tests ................................................................................................................................ 29 4.1.2 Recommended practice .................................................................................................................... 30 4.1.3 Implementation status: global/regional ........................................................................................... 32 4.1.4 Barriers to implementation .............................................................................................................. 32 4.1.5 Gap analysis ...................................................................................................................................... 32 4.2 Treatment ................................................................................................................................................ 33 4.2.1 Recommended practice .................................................................................................................... 33 4.2.2 Implementation status ..................................................................................................................... 36 4.2.3 Barriers to implementation .............................................................................................................. 36 4.2.4 Gap analysis ...................................................................................................................................... 36 5. Disease surveillance....................................................................................................................................... 36 5.1 Introduction ......................................................................................................................................... 37 5.2 Recommended surveillance practices ................................................................................................. 38 5.3 Implementation status: global/regional .............................................................................................. 39 5.4 Barriers to implementation ................................................................................................................. 40 5.5. Gap analysis ........................................................................................................................................ 40 6. Support and after-care for families and survivors ......................................................................................... 41 6.1 Introduction ................................................................................................................................... 41 6.2 Recommended practice: rehabilitation and psychosocial support ............................................... 41 1 Defeating meningitis by 2030: baseline situation analysis 6.3 Implementation status .................................................................................................................. 42 6.4 Barriers to implementation ........................................................................................................... 43 6.5 Gap analysis ................................................................................................................................... 44 7. Advocacy and information ........................................................................................................................ 46 7.1 Advocacy ............................................................................................................................................ 46 7.1.1 Introduction ...................................................................................................................................... 46 7.1.2 Recommended practice .................................................................................................................... 48 7.1.3 Status ................................................................................................................................................ 48 7.1.4 Barriers to implementation .............................................................................................................. 49 7.1.5 Gap analysis ...................................................................................................................................... 50 7.2 Information .............................................................................................................................................. 51 7.2.1 Introduction ...................................................................................................................................... 51 7.2.2 Recommended practice .................................................................................................................... 52 7.2.3 Implementation status .....................................................................................................................