Epidemics of meningococcal meningitis have been described in Africa since 1840 , and large-scale, cyclic epidemics have been described throughout what is called the African meningitis belt during the last century [2, 3]. Historically, the largest epidemics of meningococcal meningitis in the meningitis belt were caused by Neisseria meningitidis serogroup A (NmA). The introduction of a highly effective conjugate vaccine against NmA (MenAfriVac) in 2010 has had a major impact on the incidence of all-cause meningitis in the African meningitis belt , dramatic effects on the incidence of NmA , and has virtually eliminated its nasopharyngeal carriage .