African meningitis belt pneumococcal disease epidemiology indicates a need for an effective serotype 1 containing vaccine, including for older children and adults

Table 4 Streptococcus pneumoniae (Sp) meningitis case fatality ratios by age group and country [4, 5, 7–9]; Neisseria meningitidis meningitis case fatality ratios were available from Burkina Faso, Senegal, and Niger and summary means are presented for comparison.

Age (yrs)	Burkina Faso*	Senegal	Niger*	Ghana*	Mean^† Sp CFR (mortality)^‡	Mean^† Nm^‡ CFR (mortality^§)
<1	52%	55%	58%	44%	53% (53)	12% (2.9)
1 to 4	50%	50%	57%		52% (7.4)	17% (3.3)
5 to 9	45%	48%	16%		36% (3.6)	10% (1.8)
10 to 14		50%	35%		43% (3.5)	10% (1.7)
15 to 19	44%	35%	62%		47% (3.5)	9% (1.0)
20 to 29		60%	58%		54% (3.1)	16% (0.8)
30 to 39		70%	20%		45% (4.2)	24% (0.8)
40 to 49		85%	60%		63% (7.9)	21% (0.6)
50 to 59		78%			61% (5.9)	43% (1.4)
60+		93%			66% (6.7)	43% (1.2)

*Not all studies reported age groups at the detail shown in column 1. The CFRs in Burkina Faso for persons age 5 to 14 and 15+ years, in Niger for persons 40+ years, and in Ghana for all ages combined were 45%, 44%, 60%, and 44%, respectively.
^†Weighted mean based on population under surveillance; Ghana was not included in the weighted means. Where data were not available from a study site for a specific age group, the next oldest age group was used in the calculation of the weighted mean.
^‡ Nm = Neisseria meningitidis. For comparison, data on Nm are presented for the same surveillance periods and sites except for Ghana, which did not report these data.
^§Mortality rate per 100,000 per year, based on the product of the meningitis incidence rate and the case fatality ratio.

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