• Muhamed-Kheir Taha, Jessica Presa, and Lidia Serra.
• Institut Pasteur, Invasive Bacterial Infections Unit, 25-28 Rue du Docteur Roux, 75015 Paris, France. Electronic address: muhamed-kheir.taha@pasteur.fr.
• Int. J. Infect. Dis. 2021 Mar 1; 104: 189-197.

ObjectiveThis narrative review considers the epidemiology of invasive meningococcal disease (IMD) in North Africa and the adequacy of current preventive measures to provide guidance for future vaccination strategies.MethodsLiterature searches were conducted using PubMed for articles published from 1998 onwards to identify publications on IMD in North Africa. Additional relevant articles not included within the search results and data sources were identified from the reference lists of identified publications, authors' personal files, and publicly available government or regional surveillance data.ResultsAlthough IMD is an endemic and notifiable disease in several North African countries, inadequacies exist regarding each country's surveillance, vaccination strategies, and disease understanding. Studies showed bacterial meningitis in North Africa caused by Neisseria meningitidis mostly affects young children (aged <5 years), with meningococcal serogroup B (MenB) being the most frequently identified serotype. Importantly, MenB isolates were genetically heterogeneous. Serogroup A incidence and meningococcal outbreaks decreased over time in Morocco and Egypt, possibly because of their nationwide or school-based vaccination programs. Within the region, meningococcal vaccines are only included in the national immunization program of Egypt.ConclusionsImproving IMD diagnosis and surveillance would provide a reliable estimate of IMD burden, leading to better vaccination strategies.Copyright © 2020 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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