Assessments for the impact of mineral dust on the meningitis incidence in West Africa.
Résumé
Recently, mineral dust has been suspected to be one of the important environmental risk factor for meningitis epidemics in West Africa. The current study is one of the first which relies on long-term robust aerosol measurements in the Sahel region to investigate the possible impact of mineral dust on meningitis cases (incidence). Sunphotometer measurements, which allow to derive aerosol and humidity parameters, i.e., aerosol optical thickness, Angström coefficient, and precipitable water, are combined with quantitative epidemiological data in Niger and Mali over the 2004-2009 AMMA (African Monsoon Multidisciplinary Analysis) program period. We analyse how the extremely high aerosol loads in this region may influence both the calendar (onset, peaks, end) and the intensity of meningitis. We highlight three distinct periods: (i) from November to December, beginning of the dry season, humidity is weak, there is no dust and no meningitis cases; (ii) from January to April, humidity is still weak, but high dust loads occur in the atmosphere and this is the meningitis season; (iii) from May to October, humidity is high and there is no meningitis anymore, in presence of dust or not, which flow anyway in higher altitudes. More specifically, the onset of the meningitis season is tightly related to mineral dust flowing close to the surface at the very beginning of the year. During the dry, and the most dusty season period, from February to April, each meningitis peak is preceded by a dust peak, with a 0-2 week lead-time. The importance (duration, intensity) of these meningitis peaks seems to be related to that of dust, suggesting that a cumulative effect in dust events may be important for the meningitis incidence. This is not the case for humidity, confirming the special contribution of dust at this period of the year. The end of the meningitis season, in May, coincides with a change in humidity conditions related to the West African Monsoon. These results, which are interpreted in the context of recent independent epidemiological studies on meningitis highlight, (i) the particular role of dust during the dry season (low humidity conditions) on the onset and the intra-seasonal variability of the meningitis season; (ii) the specific role of high humidity at the end of the meningitis season in two Sahelian countries particularly affected by the disease.