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Epidemiological profile of meningitis in Iran before pentavalent vaccine introduction
Zeinab Berangi1, Manoochehr Karami2,3, Younes Mohammadi4
1Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, 65178-3-8736, Iran.
Background:
No reliable and comprehensive study has been published on the incidence and epidemiological profile of meningitis in Iran from 2008 to 2014, before pneumococcal conjugate vaccine (PCV) and pentavalent vaccine (DTPw-Hep B-Hib (PRP-T) vaccine (pentavac) (adsorbed)) introduction. The present study aimed to portray the epidemiological profile of meningitis in Iran from 2008 to 2014.
Methods:
Data on meningitis cases aged from 1 day to 110 years were extracted from national notifiable diseases surveillance system from March 2008 to December 2014 in Iran. A total number of 48,006 cases of suspected meningitis were identified and 1468 cases of which met the criteria for diagnosis-confirmed meningitis. Of 1468 cases, 1352 patients were included in the study.
Results:
The great number of cases reported from urban areas. Moreover, males were more predominant than females (58.51% vs. 33.81%) in total. The estimated annual incidence rate of meningitis varied from 0.28/100000 in 2008 to 0.09/100000 in 2014. Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis were the most leading pathogens causing bacterial meningitis, accounted for 266(23.44%), 145(12.78%), 95(8.37%) of cases, respectively. Each of the three bacterial species showed a descending trend. The majority of infected subjects are children under five years.
Conclusions:
Unlike the decreasing trend of meningitis and high percentage of cultures with negative results, according to World Health Organization recommendation PCV introduction into routine immunization is evident. Implementing an enhanced surveillance system to provide high quality data on epidemiological profile of meningitis in Iran is necessary.
Insights
This study analyzed meningitis cases in Iran from 2008-2014, finding a decreasing incidence trend. Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis were the primary bacterial causes, predominantly affecting young children.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Limited comprehensive studies on meningitis epidemiology in Iran pre-2014.
- The period studied precedes the introduction of pneumococcal conjugate vaccine (PCV) and pentavalent vaccine.
Purpose of the Study:
- To describe the epidemiological profile of meningitis in Iran.
- To analyze meningitis incidence and trends from 2008 to 2014.
Main Methods:
- Utilized data from Iran's national notifiable diseases surveillance system.
- Included 1352 confirmed meningitis cases aged 1 day to 110 years.
- Extracted data from March 2008 to December 2014.
Main Results:
- Meningitis incidence decreased from 0.28/100,000 in 2008 to 0.09/100,000 in 2014.
- Key pathogens were Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, all showing descending trends.
- The majority of cases occurred in children under five, with a male predominance.
Conclusions:
- Despite decreasing trends, PCV introduction is recommended by WHO.
- Enhanced surveillance is crucial for high-quality meningitis data in Iran.
- High rates of negative cultures warrant further investigation into diagnostic methods.
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