article · GeoHealth
The African meningitis belt covers 26 countries in sub-Saharan Africa, where meningococcal meningitis exhibits the highest global incidence. Disease outbreaks correspond strongly with the dry season, a period marked by low rainfall, low humidity, elevated temperatures, and increased levels of dust and wind speed. Because these environmental factors vary simultaneously, identifying the precise climatic drivers of outbreaks has proved challenging. An evaluation of existing evidence shows that atmospheric dust and wind speed hold the strongest statistical associations and predictive capability for meningitis outbreaks compared to other variables. Furthermore, interconnected environmental dynamics reinforce these conditions. Rising temperatures and reduced rainfall dry out soil, which increases the volume of dust available for atmospheric uplift, while lower humidity accelerates moisture loss. Consequently, broader climatic shifts in rainfall, temperature, and land cover converge to elevate atmospheric dust levels, driving higher meningitis risk and incidence across the region.
Meningococcal meningitis imposes a severe public health burden across 26 sub-Saharan African nations. Clarifying how interconnected climatic conditions trigger outbreaks provides crucial understanding of environmental disease pathways. Recognising atmospheric dust as a primary driver, influenced by wider environmental patterns of heat and drying, assists public health specialists in understanding regional vulnerability and anticipating seasonal epidemics.
The findings offer early-stage epidemiological insights that could inform the development of climate-based early warning systems and predictive risk-mapping tools. Such applications would primarily serve public health authorities, epidemiologists, and international health agencies managing seasonal vaccination and preparedness campaigns across sub-Saharan Africa. Because this work represents early-stage synthesis of observational literature rather than an operational forecasting product, substantial applied modelling and testing remain necessary before real-world operational deployment.
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Globally, the highest incidence of meningococcal meningitis occurs within the African meningitis belt, spanning 26 countries across sub-Saharan Africa. Meningococcal meningitis incidence is highly seasonal in this region specifically, with outbreaks mostly occurring during the dry season, characterized by low rainfall and atmospheric humidity, high temperature, and increased dust and wind speed. The strong seasonality of meningococcal outbreaks coincides with seasonal variation in climatic factors. This multicollinearity can make it difficult to identify environmental drivers of disease and the mechanisms by which they operate. This review aims to collate existing evidence to better clarify the mechanisms by which climatic variables influence meningococcal meningitis incidence. We examined the impact of dust, wind speed, temperature, rainfall, and land cover on meningococcal meningitis outbreaks. Within the literature, atmospheric dust and wind speed had the strongest statistical association with meningococcal outbreaks and demonstrated greater predictive probability than other climatic variables. However, several climatic factors have demonstrable influences on one another, reflected in the seasonality of meningococcal meningitis. Atmospheric dust can reduce precipitation levels in part through its radiative properties. Decreased rainfall and increasing temperatures can dry out soil, increasing its availability to be uplifted as dust. Alongside, this lower atmospheric humidity increases evaporative demand, leading to faster soil moisture loss and enhanced surface drying. We argue that rainfall, temperature, and land cover variability may act as part of a broader climatic mechanism, increasing atmospheric dust. This increases the incidence and risk of meningococcal meningitis.
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DOI: 10.1029/2025gh001749
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