Pediatric Bacterial Meningitis Surveillance in the World Health Organization African Region Using the Invasive Bacterial Vaccine-Preventable Disease Surveillance Network, 2011-2016.

Abstract

BACKGROUND:

Bacterial meningitis is a major cause of morbidity and mortality in sub-Saharan Africa. We analyzed data from the World Health Organization's (WHO) Invasive Bacterial Vaccine-preventable Diseases Surveillance Network (2011-2016) to describe the epidemiology of laboratory-confirmed Streptococcus pneumoniae (Spn), Neisseria meningitidis, and Haemophilus influenzae meningitis within the WHO African Region. We also evaluated declines in vaccine-type pneumococcal meningitis following pneumococcal conjugate vaccine (PCV) introduction.

METHODS:

Reports of meningitis in children <5 years old from sentinel surveillance hospitals in 26 countries were classified as suspected, probable, or confirmed. Confirmed meningitis cases were analyzed by age group and subregion (South-East and West-Central). We described case fatality ratios (CFRs), pathogen distribution, and annual changes in serotype and serogroup, including changes in vaccine-type Spn meningitis following PCV introduction.

RESULTS:

Among 49 844 reported meningitis cases, 1670 (3.3%) were laboratory-confirmed. Spn (1007/1670 [60.3%]) was the most commonly detected pathogen; vaccine-type Spn meningitis cases declined over time. CFR was the highest for Spn meningitis: 12.9% (46/357) in the South-East subregion and 30.9% (89/288) in the West-Central subregion. Meningitis caused by N. meningitidis was more common in West-Central than South-East Africa (321/954 [33.6%] vs 110/716 [15.4%]; P < .0001). Haemophilus influenzae (232/1670 [13.9%]) was the least prevalent organism.

CONCLUSIONS:

Spn was the most common cause of pediatric bacterial meningitis in the African region even after reported cases declined following PCV introduction. Sustaining robust surveillance is essential to monitor changes in pathogen distribution and to inform and guide vaccination policies.

• Authors: Jason M Mwenda, Elizabeth Soda, Goitom Weldegebriel, Regis Katsande, Joseph Nsiari-Muzeyi Biey, Tieble Traore, Linda de Gouveia, Mignon du Plessis, Anne von Gottberg, Martin Antonio, Brenda Kwambana-Adams, Archibald Worwui, Ryan Gierke, Stephanie Schwartz, Chris van Beneden, Adam Cohen, Fatima Serhan, Fernanda C Lessa
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 69 Issue Suppl 2 Pg. S49-S57 (09 05 2019) ISSN: 1537-6591 [Electronic] United States
• PMID: 31505629 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Pneumococcal Vaccines
• Vaccines, Conjugate

Topics

• Africa, Eastern (epidemiology)
• Child, Preschool
• Female
• Haemophilus influenzae type b (classification)
• Humans
• Infant
• Male
• Meningitis, Bacterial (epidemiology, mortality)
• Mortality
• Neisseria meningitidis (classification)
• Pneumococcal Vaccines (administration & dosage)
• Prevalence
• Sentinel Surveillance
• Serogroup
• South Africa (epidemiology)
• Streptococcus pneumoniae (classification)
• Vaccination (statistics & numerical data)
• Vaccine-Preventable Diseases (epidemiology, microbiology)
• Vaccines, Conjugate (administration & dosage)
• World Health Organization