Background:
Across the African Meningitis Belt (AMB), high quality epidemiologic and laboratory data are used to develop national meningitis bulletins to guide epidemic response and vaccination decisions. However, variation in bulletin structure, data cleaning practices, and analytical outputs limits comparability for regional situational awareness. We document the process of developing and validating a Standard Operating Procedure (SOP) for generating harmonized meningitis epidemiologic bulletins for the AMB.
Methods:
During December 2025—March 2026, a multidisciplinary approach involving desk reviews of national bulletins and surveillance workflows, asynchronous data management trainings, and stakeholder consultations were employed to draft the SOP. The development process culminated in a 4-day SOP validation workshop convening 22 participants from 12 organizations, including ministries of health, implementing partners, and academics working across the AMB. Participants included surveillance officers, epidemiologists, laboratorians and data managers from Benin, Burkina Faso, Mali, Niger and Togo. Section-by-section reviews of the SOP were conducted in small-groups, which were intentionally mixed by country and subject-matter expertise to ensure generalizability. Plenary sessions were used to reconcile divergent practices, identify essential analytic outputs, and build consensus on minimum data management standards.
Results:
The SOP development process identified and addressed key gaps in bulletin production, data cleaning, analytic outputs, and cross-country comparability. Workshop participants reached consensus on an SOP comprising 6 sections, identifying 18 minimum variables required for cleaning, and 10 data cleaning steps (e.g. completeness checks, duplicate detection, date validation). The SOP recommends 11 core analyses presented in all meningitis bulletins, and 16 complementary analyses that countries may adopt based on data availability. Core analyses include epidemic curves, geographic distribution, age and sex breakdowns, serogroup trends, and specimen transport timeliness. Additionally, participants outlined other sections of SOPs on dissemination pathways, country approval processes, and a standardized analysis code bank.
Conclusion:
This participatory, AMB-focused SOP development process demonstrates the value of multi-country engagement in producing technically robust and operationally feasible surveillance tools. Countries expressed strong commitment to piloting the SOP, integrating data standards into routine meningitis surveillance, and using standardized bulletins to monitor trends and inform public health action, including adoption of the new pentavalent meningococcal vaccine, Men5CV.