Strengthening regional surveillance: MenMap Network's year 1 findings on bacterial meningitis in Jordan, Egypt, and Iraq (2023-2024)

Lamia Al-Kershi; Deema Al Bakri; Zeina Abdel Majeed; Sara Abu Khudair; Magid Al Gunaid; Dominique A Caugant; Muhamed-Kheir Taha; Saber Yezli; Tarek Al-Sanouri; Maya Joukhadar; Rund Al-Qaseer; Ener Cagri Dinleyici; Areej Shoubaki; Marwa Abdel Shafy; Sahar Sami; Rawya Mohamed; Hussein Al Shammary; Ahmed Abdulsattar Salman; Florence Coste; Alp Dogu; Laure Badet; Amine Amiche; Ray Borrow

doi:10.1016/j.ijregi.2026.100896

Strengthening regional surveillance: MenMap Network's year 1 findings on bacterial meningitis in Jordan, Egypt, and Iraq (2023-2024)

IJID Reg. 2026 Apr 16:19:100896. doi: 10.1016/j.ijregi.2026.100896. eCollection 2026 Jun.

Authors

Lamia Al-Kershi¹, Deema Al Bakri¹, Zeina Abdel Majeed¹, Sara Abu Khudair¹, Magid Al Gunaid¹, Dominique A Caugant², Muhamed-Kheir Taha³, Saber Yezli⁴, Tarek Al-Sanouri¹, Maya Joukhadar¹, Rund Al-Qaseer¹, Ener Cagri Dinleyici⁵, Areej Shoubaki⁶, Marwa Abdel Shafy⁷, Sahar Sami⁸, Rawya Mohamed⁸, Hussein Al Shammary⁹, Ahmed Abdulsattar Salman¹⁰, Florence Coste¹¹, Alp Dogu¹², Laure Badet¹¹, Amine Amiche¹², Ray Borrow¹³

Affiliations

¹ Eastern Mediterranean Public Health Network, Amman, Jordan.
² Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway.
³ Institut Pasteur, Invasive bacterial infections unit, Paris, France.
⁴ Biostatistics, Epidemiology, and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
⁵ Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Eskisehir, Türkiye.
⁶ Surveillance Department, Ministry of Health, Amman, Jordan.
⁷ Acute Infections Neurological Disease Control Program, Ministry of Health, Cairo, Egypt.
⁸ Ministry of Health, Cairo, Egypt.
⁹ Central Public Health Laboratories, Ministry of Health, Baghdad, Iraq.
¹⁰ Communicable Diseases Control Center, Ministry of Health, Baghdad, Iraq.
¹¹ Sanofi Vaccines, Global Medical, Lyon, France.
¹² Sanofi Vaccines, Global Medical, Dubai, UAE.
¹³ Meningococcal Reference Unit, UK Health Security Agency, Manchester Royal Infirmary, Manchester, UK.

Abstract

Objectives: Vaccine-preventable invasive bacterial diseases remain a public health concern in the Middle East and North Africa (MENA) region. To address surveillance and diagnostic gaps, the Meningitis and Septicemia Mapping Network (MenMap) was launched as a prospective, multicenter sentinel surveillance system to strengthen laboratory capacity and regional collaboration in Jordan, Egypt, and Iraq. This study reports the first-year MenMap findings (December 2023 to November 2024), describing bacterial meningitis epidemiology, pathogen distribution, vaccination status, clinical presentation, and outcomes among laboratory-confirmed cases in Jordan, Egypt, and Iraq.

Methods: Prospective sentinel hospital-based surveillance was implemented in 16 hospitals, targeting children aged 1 month to 18 years. Suspected cases were defined according to World Health Organization criteria and included patients presenting with clinical signs of meningitis and undergoing cerebrospinal fluid and/or blood sampling. Standardized protocols included clinical evaluations, real-time polymerase chain reaction for pathogen detection, and continuous monitoring systems. An external quality assessment scheme ensured laboratory diagnostic quality and accuracy.

Results: Between December 2023 and November 2024, 2104 suspected cases were reported, with 191 (9%) confirmed. S. pneumoniae was the most prevalent (90.0%), followed by H. influenzae (7.9%) and N. meningitidis (2.1%). Most confirmed cases were from Iraq (63.3%), and 62% across the three countries occurred in children aged <5 years.

Conclusion: MenMap strengthens bacterial meningitis surveillance in the MENA region and provides critical evidence to support vaccine policy decisions, including expansion of pneumococcal and Haemophilus influenzae type b immunization programs, alongside improvements in pathogen detection and characterization.

Keywords: Bacterial meningitis; Eastern Mediterranean Region; Invasive bacterial diseases; Middle East and North Africa; Real-time PCR; Surveillance.