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Serogroup A meningococcus epidemics occurred in refugee populations in Zaire in August 1994.
The paper analyses the public health impact of a mass vaccination campaign implemented in a large refugee camp.
We compared meningitis incidence rates from 2 similar camps.
In Kibumba camp, vaccination was implemented early in the course of the epidemic whilst in the control camp (Katale), vaccination was delayed.
At a threshold of 15 cases per 100 000 population per week an immunization campaign was implemented. Attack rates were 94 and 134 per 100,000 in Kibumba and Katale respectively over 2 months.
In Kibumba, one week after crossing the threshold, 121,588 doses of vaccine were administered covering 76% of all refugees. Vaccination may have prevented 68 cases (30% of the expected cases).
Despite its rapid institution and the high coverage achieved, the vaccination campaign had a limited impact on morbidity due to meningitis.
In the early phase in refugee camps, the relative priorities of meningitis vaccination and case management need to be better defined.
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