Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine-Reference-Cited by-同舟云学术

Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine

Published:2019-09-05 Issue:Supplement_2 Volume:69 Page:S81-S88
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Tagbo Beckie N¹²,Bancroft Rowan E³,Fajolu Iretiola⁴⁵,Abdulkadir Mohammed B⁶,Bashir Muhammad F⁷,Okunola Olusola P⁸,Isiaka Ayodeji H⁹,Lawal Namadi M¹⁰,Edelu Benedict O²,Onyejiaka Ngozi¹¹,Ihuoma Chinonyerem J¹²,Ndu Florence¹³,Ozumba Uchenna C¹²,Udeinya Frances¹²,Ogunsola Folasade¹¹,Saka Aishat O⁶,Fadeyi Abayomi¹⁴,Aderibigbe Sunday A¹⁵,Abdulraheem Jimoh¹⁴,Yusuf Adamu G¹⁶,Sylvanus Ndow Peter³,Ogbogu Philomena¹⁷,Kanu Chinomnso¹⁸,Emina Velly¹⁹,Makinwa Olajumoke J¹¹,Gehre Florian²²⁰,Yusuf Kabir¹⁰,Braka Fiona²¹,Mwenda Jason M²²,Ticha Johnson M⁹,Nwodo Dorothy⁹,Worwui Archibald³,Biey Joseph N²²,Kwambana-Adams Brenda A³,Antonio Martin³²³

Affiliation:

1. Institute of Child Health, University of Nigeria Teaching Hospital, Ituku-Ozalla

2. Department of Paediatrics University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State

3. World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul

4. Department of Paediatrics, Lagos University Teaching Hospital

5. Department of Paediatrics, College of Medicine, University of Lagos

6. Department of Paediatrics and Child Health, University of Ilorin Teaching Hospital

7. Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi

8. Department of Child Health, University of Benin Teaching Hospital

9. WHO Country office, Abuja

10. Department of Disease Control and Immunization, National Primary Health Care Development Agency, Abuja

11. Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital

12. Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State

13. Mother of Christ Specialist Hospital Enugu

14. Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Kwara

15. Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Kwara

16. Medical Microbiology Department, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi

17. Department of Medical Microbiology, University of Benin Teaching Hospital

18. Department of Community Health, University of Benin Teaching Hospital

19. Department of Community Health and Primary Care, Lagos University Teaching Hospital, Nigeria

20. Department of Infectious Disease Epidemiology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany

21. WHO, Nigeria EPI Cluster Lead

22. WHO Regional Office for Africa WHO/AFRO, Republic of Congo, Brazzaville

23. Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Abstract

Abstract Background Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). Methods From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. Results A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. Conclusions Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the country.

Funder

WHO

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

http://academic.oup.com/cid/article-pdf/69/Supplement_2/S81/31569945/ciz474.pdf

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