Specifications for a rapid diagnostic test for meningitis, African meningitis belt

Overview

In 2014, WHO set up a Guideline Development Group to review the evidence and recommendations for meningitis epidemic control in the African meningitis belt. Regarding the use of currently available rapid diagnostic tests (RDTs) in outbreak management, the Group recommended: (i) the use of RDTs (latex agglutination or immunochromatography dipsticks) in the investigation of meningitis outbreaks and, (ii) If RDTs are positive for a vaccine preventable serogroup, verification of serogroup by polymerase chain reaction (PCR) or culture is recommended before a decision is taken to initiate a vaccine response.

Hence, on one hand RDTs were recognized as a useful field tool in the surveillance African context, but on the other hand, their limited performance necessitated other testing methods for a definite confirmation of the disease.

In addition, the Group also recommended that WHO and partners should strongly promote the production of heat-stable RDTs and that the development of RDTs which detect a range of microorganisms (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis) should be a priority, in particular the development of a N. meningitidis serogroup X RDT.

The group also emphasized that the delivery of RDTs should include programmatic elements such as training, organized transmission of results and related information, and quality control.