{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:27:12Z","timestamp":1783643232381,"version":"3.55.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"Supplement_4","license":[{"start":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T00:00:00Z","timestamp":1572480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MenAfriNet Consortium"},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1084298"],"award-info":[{"award-number":["OPP1084298"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>During 2014, 4 regions in Togo within the African meningitis belt implemented vaccination campaigns with meningococcal serogroup A conjugate vaccine (MACV). From January to July 2016, Togo experienced its first major Neisseria meningitidis serogroup W (NmW) outbreak. We describe the epidemiology, response, and management of the outbreak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Suspected, probable, and confirmed cases were identified using World Health Organization case definitions. Through case-based surveillance, epidemiologic and laboratory data were collected for each case. Cerebrospinal fluid specimens were analyzed by polymerase chain reaction, culture, or latex agglutination. Vaccination campaigns were conducted in affected districts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From January 11 to July 5, 2016, 1995 suspected meningitis cases were reported, with 128 deaths. Among them, 479 (24.0%) were confirmed by laboratory testing, and 94 (4.7%) and 1422 (71.3%) remained as probable and suspected cases, respectively. Seven epidemic districts had cumulative attack rates greater than 100 per 100 000 population. Of the confirmed cases, 91.5% were NmW; 39 of 40 available NmW isolates were sequence type-11\/clonal complex-11.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This outbreak demonstrates that, although high coverage with MACV has reduced serogroup A outbreaks, large meningococcal meningitis outbreaks due to other serogroups may continue to occur; effective multivalent meningococcal conjugate vaccines could improve meningococcal disease prevention within meningitis belt populations.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiz330","type":"journal-article","created":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T11:11:47Z","timestamp":1563966707000},"page":"S216-S224","source":"Crossref","is-referenced-by-count":13,"title":["Neisseria meningitidis Serogroup W Meningitis Epidemic in Togo, 2016"],"prefix":"10.1093","volume":"220","author":[{"given":"Didier","family":"Mounkoro","sequence":"first","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Dapaong, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle S","family":"Nikiema","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 et de l\u2019Hygi\u00e8ne Publique, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issaka","family":"Maman","sequence":"additional","affiliation":[{"name":"Institut National d\u2019Hygi\u00e8ne, Lom\u00e9, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souleymane","family":"Sakand\u00e9","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Ouagadougou, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine H","family":"Bozio","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoua","family":"Tall","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Ouagadougou, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adodo Yao","family":"Sadji","sequence":"additional","affiliation":[{"name":"Institut National d\u2019Hygi\u00e8ne, Lom\u00e9, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthe-Marie","family":"Njanpop-Lafourcade","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agoro","family":"Sibabe","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 et de l\u2019Hygi\u00e8ne Publique, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dadja E","family":"Landoh","sequence":"additional","affiliation":[{"name":"Organisation Mondiale de la Sant\u00e9, Bureau Pays, Lom\u00e9, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essofa O","family":"Abodji","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Dapaong, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agbenoko","family":"Kodjo","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 et de l\u2019Hygi\u00e8ne Publique, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsidi A","family":"Tamekloe","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 et de l\u2019Hygi\u00e8ne Publique, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00e9n\u00e9 Alima","family":"Essoh","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Abidjan, C\u00f4te d\u2019Ivoire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9t\u00e8ma W","family":"Maba","sequence":"additional","affiliation":[{"name":"Minist\u00e8re de la Sant\u00e9 et de l\u2019Hygi\u00e8ne Publique, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford D","family":"Gessner","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C","family":"Mo\u00efsi","sequence":"additional","affiliation":[{"name":"Agence de M\u00e9decine Pr\u00e9ventive, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2019110101094036400_CIT0001","first-page":"1","article-title":"[Cerebrospinal meningitis in Africa]","volume":"28","author":"Lapeyssonnie","year":"1963","journal-title":"Bull World Health Organ"},{"key":"2019110101094036400_CIT0002","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0035-9203(99)90106-2","article-title":"Manson Lecture. 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