Meningitis Environmental Risk Information Technologies (MERIT) Project

Introduction

Meningitis control activities currently rely on the early identification of epidemics followed by a rapid deployment of polysaccharide vaccines.  Although the efficacy of these interventions is debated; it is widely recognized that there is only a short lead-time for vaccination once an epidemic is underway.  This constraint is because current vaccines lack immunological memory and confer no significant herd immunity nor do they produce long-lasting protection; or protect very young children.  Given the association of the epidemics with a dry and dusty environment and their higher incidence in the so-called Meningitis belt , recent research has focused on developing maps that identify the areas at high risk of epidemics and climate-driven early warning systems that could provide longer lead-times for initiating response.

Although not the number one killer disease in Africa, meningitis is one of the most feared diseases and of major public health importance in West Africa.  What's most frightening about the disease is the speed at which it develops and the severity of the after-effects:

• At least 10 percent of infected individuals die during the acute episode
• Some 10-20 percent of survivors develop permanent sequelae such as epilepsy, hearing loss, or mental retardation.

Goal and Objectives

The goal of the project is to reduce the suffering and death from bacterial meningitis in the Meningitis Belt of Africa by helping public health practitioners and other key stakeholders to increase the effectiveness of current and new meningitis vaccination strategies and programs. 

The MERIT project objectives are:

• To realize fully current meningitis research and development, and to align these activities with the operational priorities of the WHO, wherever possible, to increase the rate of implementation of new disease surveillance techniques within the WHO AFRO Member countries.

• To build capacity within the health and climate community to work together towards improving health outcomes through greater knowledge of disease transmission dynamics, eco-epidemiology, improved climate monitoring and forecasting, monitoring of interventions and the creation of operational health related climate products.

• To identify gaps and accelerate opportunities in the development of new warning and intervention strategies, including better understanding and use of environmental information; improving communication between people at risk and public health practitioners and surveillance experts; and enhanced collection of demographic and health information.

• To map health risk by district by enhancing the tools capable of quantifying meningitis risk, based on HealthMapper and its successor; and to work with public health practitioners to help prioritize the deployment of conjugate vaccines; and to serve as a framework for the evaluation of their efficacy to control epidemics

• To monitor the effect that the introduction of conjugate vaccines has on the pan-continental spread of meningococcal epidemics.