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Luis Cuevas, Mohammed Yassin Madeleine Thomson Tony Hart

Luis Cuevas, Mohammed Yassin Madeleine Thomson Tony Hart. Environmental and epidemiological determinants of epidemic meningitis at the local level : Ethiopia. Meningitis in Ethiopia. Within the meningitis belt Epidemics affect mostly the Northwest Spread to the South Incidence. Aims.

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Luis Cuevas, Mohammed Yassin Madeleine Thomson Tony Hart

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  1. Luis Cuevas, Mohammed Yassin Madeleine Thomson Tony Hart Environmental and epidemiological determinants of epidemic meningitis at the local level : Ethiopia

  2. Meningitis in Ethiopia • Within the meningitis belt • Epidemics affect mostly the Northwest • Spread to the South • Incidence

  3. Aims Southern Region • To develop forecasting methods to predict meningococcal epidemics at the local level and • Expand our understanding of the dynamics of epidemics.

  4. Southern region • Epidemics 1999-2004

  5. Incidence • Varied by Woreda and year • Up to 650 /100,000 pop

  6. Environmental information

  7. Profile classes for precipitation and absolute humidity • Precipitation • Absolute Humidity

  8. Logistic regressions • Eleven environmental variables • Only land-cover independently associated with epidemics

  9. Acute respiratory infections

  10. Acute respiratory infections and the environment • Elevation • Population • Temperature • A. humidity Poor correlation with meningitis epidemics

  11. Malaria

  12. Malaria and the environment • Altitude • NDVI • temperature But poor correlation with meningitis

  13. Duration of meningitis epidemics and vaccination(Alert + epidemic thresholds, 1999-2004) • Sixty epidemics 45% ≤ 6 weeks

  14. Cumulative number of cases (%) occurring by week of the epidemic

  15. CARRIAGE • 9 Woredas

  16. Districts selected • 3 - low incidence in 2002 < 50th quartile) • 3 - high incidence • 3 - epidemic levels (top 75th quartile) • Cross sectional surveys • Before dry season • During dry season • 1800 participants

  17. carriage

  18. Usual risk factors • Age • Smoking • Attending religious gatherings • Markets But poor correlation with meningitis epidemics

  19. Conclussion • Poor association with ARI, malaria and carriage • Association with environmental factors less clear cut than large scale models • Vaccination prevented cases • Epidemics are rapid events, often presented as summation of smaller events • Effect of vaccination in neighbouring areas by distance should be better defined

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