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Published on: September 11, 2020
Pediatric bacterial meningitis surveillance - African region, 2002--2008
Insights
Bacterial meningitis from Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis causes significant disease in Sub-Saharan Africa. Surveillance data from 2002-2008 revealed these pathogens in 7% of suspected pediatric meningitis cases.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Sub-Saharan Africa faces a substantial burden from Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis.
- These pathogens caused an estimated 500,000 deaths in 2000 and recurrent Neisseria meningitidis epidemics affecting 700,000 individuals over a decade.
- Vaccine introduction is hindered by competing health priorities, limited vaccine availability, suboptimal vaccines, funding issues, and insufficient disease burden data.
Purpose of the Study:
- To analyze the disease burden of bacterial meningitis caused by Hib, S. pneumoniae, and N. meningitidis in children under 5 in the WHO African Region.
- To inform strategies for improving laboratory capacity and surveillance networks.
Main Methods:
- Analysis of laboratory-confirmed bacterial meningitis cases from the Pediatric Bacterial Meningitis (PBM) Surveillance Network (2002-2008).
- Data collected from sentinel hospitals across the WHO African Region.
- Focus on children aged under 5 years with culture-positive results for the target pathogens.
Main Results:
- A total of 74,515 suspected meningitis cases were reported between 2002 and 2008.
- Of 69,208 cases with known lab results, 4,674 (7%) were culture-positive for S. pneumoniae (47%), H. influenzae (34%), or N. meningitidis (19%).
- The majority of remaining cases had negative culture results.
Conclusions:
- S. pneumoniae, H. influenzae, and N. meningitidis are significant causes of pediatric bacterial meningitis in the WHO African Region.
- Findings support strengthening laboratory and data management at sentinel hospitals.
- Results will guide future expansion of the PBM surveillance network.
Abstract:
Sub-Saharan Africa has one of the world's greatest disease burdens of Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis infections. In 2000, Hib and S. pneumoniae infections accounted for approximately 500,000 deaths in the region; during the past 10 years, N. meningitidis has been responsible for recurring epidemics resulting in approximately 700,000 cases of meningitis. Introduction of vaccines against bacterial pathogens in Africa has been constrained by competing public health priorities, limited availability of Hib and S. pneumoniae vaccines, suboptimal N. meningitidis vaccine, inadequate funding, and limited information regarding the disease burden associated with these infections. The World Health Organization (WHO) and CDC analyzed data for 2002--2008 from the Pediatric Bacterial Meningitis (PBM) Surveillance Network, which collects information on laboratory-confirmed bacterial meningitis cases among children aged <5 years at sentinel hospitals in countries throughout the WHO African Region. The results of that analysis determined that, during 2002-2008, a total of 74,515 suspected cases of meningitis were reported. Among the 69,208 suspected cases with known laboratory results, 4,674 (7%) samples were culture-positive for the three bacterial infections under surveillance: 2,192 (47%) were positive for S. pneumoniae, 1,575 (34%) for Haemophilus influenzae, and 907 (19%) for N. meningitidis. The majority of the remaining culture results were negative. These and other PBM network findings will help guide strategies for strengthening laboratory and data management capacity at existing sentinel hospitals and for planning future network expansion in the WHO African Region.
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