Reducing invasive meningococcal disease (IMD) through MenACWY immunization is a critical healthcare strategy in the Kingdom of Saudi Arabia (KSA). Robust IMD surveillance is essential to help assess the need for additional immunization initiatives in target populations. This is particularly important in KSA, where mass gatherings accompanying Hajj/Umrah pilgrimages have been associated with IMD outbreaks within the local KSA population, and subsequent intercontinental spread via returning pilgrims. This narrative review of the published literature describes the changing epidemiology of IMD in KSA to provide a perspective on the impact of current immunization strategies and potential gaps. As recent published surveillance data are lacking, we also evaluated publicly reported data from the KSA Ministry of Health (MoH) for 2012-2019 to inform more recent IMD trends. Between 1995 and 2011, national surveillance data indicate that 1103 IMD cases were reported in KSA: 60% in 2000-2001, involving two (mainly MenW) outbreaks involving KSA citizens/residents and pilgrims focused in Mecca and Medina. Across 2002-2011, 184 cases of IMD were reported, with a higher proportion occurring in KSA citizens/residents, and with less focus within pilgrimage centers than apparent in previous years. Our analysis of MoH data found that, between 2012 and 2019, 44 IMD cases were reported, all in KSA citizens/residents, and chiefly in children or infants. No pilgrimage-associated outbreaks have occurred since 2001. Serogroup data were available for 62.5% of all cases for 2002-2011; MenW (40.0%), MenA (35.7%), and MenB (16.5%). Serogroup data for 2012-2019 remain incompletely reported, and the existing surveillance system could be improved, as some element of underestimation/underreporting of IMD may exist. While existing MenACWY immunization strategies for KSA citizens/residents and visiting pilgrims have been successful in reducing IMD due to specific serogroups, disease due to MenB remains a potential risk, and additional immunization strategies should be considered.

中文翻译：

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沙特阿拉伯王国侵袭性脑膜炎球菌病的流行病学：带有更新分析的叙述性审查。

通过 MenACWY 免疫减少侵袭性脑膜炎球菌病 (IMD) 是沙特阿拉伯王国 (KSA) 的一项重要医疗保健战略。强大的 IMD 监测对于帮助评估目标人群中额外免疫计划的需求至关重要。这在沙特阿拉伯尤为重要，在那里伴随朝觐/副朝朝圣的群众集会与当地 KSA 人口中的 IMD 爆发有关，随后通过返回的朝圣者进行洲际传播。对已发表文献的叙述性评论描述了 KSA 不断变化的 IMD 流行病学，以提供有关当前免疫策略的影响和潜在差距的观点。由于缺乏最近公布的监测数据，我们还评估了沙特阿拉伯卫生部 (MoH) 2012-2019 年公开报告的数据，以了解最近的 IMD 趋势。1995 年至 2011 年间，国家监测数据表明，沙特阿拉伯报告了 1103 起 IMD 病例：2000 年至 2001 年间占 60%，涉及两次（主要是 MenW）爆发，涉及沙特阿拉伯公民/居民和集中在麦加和麦地那的朝圣者。2002 年至 2011 年期间，报告了 184 例 IMD，其中沙特阿拉伯公民/居民的比例更高，而且朝圣中心的关注度低于前几年。我们对卫生部数据的分析发现，2012 年至 2019 年间，报告了 44 例 IMD 病例，均发生在沙特阿拉伯公民/居民中，主要是儿童或婴儿。自 2001 年以来没有发生过与朝圣相关的暴发。2002-2011 年所有病例中有 62.5% 的血清组数据可用；MenW (40.0%), MenA (35. 7%) 和 MenB (16.5%)。2012-2019 年的血清组数据仍不完整报告，现有的监测系统可以改进，因为可能存在一些低估/漏报 IMD 的因素。虽然针对 KSA 公民/居民和来访朝圣者的现有 MenACWY 免疫策略已成功减少因特定血清群引起的 IMD，但 MenB 引起的疾病仍然是潜在风险，应考虑额外的免疫策略。