Meningococcal meningitis prevention programs for college students: a review of the literature.

BACKGROUND AND PURPOSE The incidence of meningococcal meningitis in college students is higher than in other populations. College students, especially 1st-year students living in dormitories or residence halls, are among those at highest risk of developing the disease. It is estimated that immunization can prevent up to 83% of cases among adolescents and college students. A review of the literature was undertaken to identify and critique the research-based prevention programs that are focused on college students. METHOD An extensive search of the Cochrane Database of systematic reviews, Medline, PubMed, and CINAHL was undertaken. The Journal of American College Health was hand searched, and bibliographies were reviewed for studies not otherwise identified. Four publications met the search criteria. These studies were reviewed and graded for level of evidence. FINDINGS One study could not be compared with the other three because of its lack of detail. Of the other three studies, two were descriptive and factors were identified that related to vaccination and nonvaccination in the college student population (both Evidence Grade C). Only one study was described that included an educational intervention, which resulted in increased vaccination rates in a college student population (Evidence Grade B). CONCLUSIONS AND IMPLICATIONS The published literature is severely limited in the area of meningococcal meningitis prevention programs in the at-risk college student population. A critical need exists for controlled studies to test the interventions that are most effective in this population as well as broader-based studies to further identify those students at increased risk for the disease as well as for nonvaccination.