ABSTRACT
Sudan is part of the sub-Saharan meningitis belt with major epidemics expected to occur every 8- 10 years cycles. This paper aims to through some light on the 1999 epidemic in Khartoum state with discussion of vaccination strategy. Active reporting of all suspected cases of meningitis in Khartoum state was established early during the course of epidemic. For each case demographic information and data of disease onset was collected. Lumbar puncture was performed in a proportion of patients. Case reports from localities and provinces were compiled and data was collated and analysed using Excel and Epi-Info software. A total of 3232 cases were reported in Khartoum State from week 7 [February 13th 19th] to week 25 [June 26th - July 2nd] of the year 1999. The overall attack rate was 65.7/100 000 population. The highest numbers of cases were reported from Umbada and Jabal Awlia provinces. Most of cases [81.1%] were from 2 to 29 years old and the most at risk group was 15-29 year's old with an attack rate of 105.2/100 000 population. A total of 282 deaths were reported, giving an overall case fatality rate of 8.7%. The epidemic was caused by N. meningitidis serogroup A, clonal III-I. Over 3 millions "A+C" vaccination doses were administered with an estimated coverage of 73.9%. Conclusions: The 1999 epidemic in Khartoum demonstrated the typical pattern of meningococcal outbreaks in the African meningitis belt. The analysis of data presented in this study emphasizes the need for effective surveillance, improved laboratory facilities and the determination of the most appropriate thresholds to initiate mass vaccination. Close microbiological surveillance is of utmost importance especially with increasing threat of N. meningitidis serogroup W-135