Département de Microbiologie, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire;, UFR des Sciences Médicales.
Sentinel Site Surveillance Laboratory of Paediatric Bacterial Meningitis and Rotavirus Diarrhoea, Centre Hospitalier Universitair de Yopougon, Abidjan, Côte d'Ivoire.
Clin Infect Dis. 2019 Sep 5;69(Suppl 2):S114-S120. doi: 10.1093/cid/ciz475.
Bacterial meningitis remains a major disease affecting children in Côte d'Ivoire. Thus, with support from the World Health Organization (WHO), Côte d'Ivoire has implemented pediatric bacterial meningitis (PBM) surveillance at 2 sentinel hospitals in Abidjan, targeting the main causes of PBM: Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus). Herein we describe the epidemiological characteristics of PBM observed in Côte d'Ivoire during 2010-2016.
Cerebrospinal fluid (CSF) was collected from children aged <5 years admitted to the Abobo General Hospital or University Hospital Center Yopougon with suspected meningitis. Microbiology and polymerase chain reaction (PCR) techniques were used to detect the presence of pathogens in CSF. Where possible, serotyping/grouping was performed to determine the specific causative agents.
Overall, 2762 cases of suspected meningitis were reported, with CSF from 39.2% (1083/2762) of patients analyzed at the WHO regional reference laboratory in The Gambia. In total, 82 (3.0% [82/2762]) CSF samples were positive for bacterial meningitis. Pneumococcus was the main pathogen responsible for PBM, accounting for 69.5% (52/82) of positive cases. Pneumococcal conjugate vaccine serotypes 5, 18C, 19F, and 6A/B were identified post-vaccine introduction. Emergence of H. influenzae nontypeable meningitis was observed after H. influenzae type b vaccine introduction.
Despite widespread use and high coverage of conjugate vaccines, pneumococcal vaccine serotypes and H. influenzae type b remain associated with bacterial meningitis among children aged <5 years in Côte d'Ivoire. This reinforces the need for enhanced surveillance for vaccine-preventable diseases to determine the prevalence of bacterial meningitis and vaccine impact across the country.
细菌性脑膜炎仍然是科特迪瓦儿童的主要疾病。因此，在世界卫生组织（世卫组织）的支持下，科特迪瓦在阿比让的 2 家哨点医院开展了小儿细菌性脑膜炎（PBM）监测，针对 PBM 的主要病因：肺炎链球菌（肺炎球菌）、流感嗜血杆菌和脑膜炎奈瑟菌（脑膜炎球菌）。在此，我们描述了 2010 年至 2016 年期间在科特迪瓦观察到的 PBM 的流行病学特征。
从疑似脑膜炎的 5 岁以下儿童中收集阿博博综合医院或尤蓬贡大学医院中心的脑脊液（CSF）。使用微生物学和聚合酶链反应（PCR）技术检测 CSF 中病原体的存在。在可能的情况下，进行血清分型/分组以确定特定的病原体。
共有 2762 例疑似脑膜炎病例报告，其中 39.2%（1083/2762）的患者的 CSF 在冈比亚的世卫组织区域参考实验室进行了分析。共有 82 例（3.0%[82/2762]）CSF 样本对细菌性脑膜炎呈阳性。肺炎球菌是导致 PBM 的主要病原体，占阳性病例的 69.5%（52/82）。在疫苗接种后，发现了疫苗接种后出现的肺炎球菌结合疫苗血清型 5、18C、19F 和 6A/B。在乙型流感嗜血杆菌疫苗接种后，出现了不可分型流感嗜血杆菌脑膜炎。
尽管广泛使用和高覆盖率的结合疫苗，但在科特迪瓦，5 岁以下儿童的细菌性脑膜炎仍与肺炎球菌疫苗血清型和乙型流感嗜血杆菌有关。这强化了需要加强对疫苗可预防疾病的监测，以确定全国细菌性脑膜炎的流行情况和疫苗的影响。
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