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Seasonal upsurge of pneumococcal meningitis in the Central African Republic

A high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by Streptococcus pneumoniae (249/328; 75.9%), w...

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Autores principales: Crellen, Thomas, Rao, V. Bhargavi, Piening, Turid, Zeydner, Joke, Siddiqui, M. Ruby
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000 Research Limited 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480959/
https://www.ncbi.nlm.nih.gov/pubmed/31069258
http://dx.doi.org/10.12688/wellcomeopenres.14868.2
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author Crellen, Thomas
Rao, V. Bhargavi
Piening, Turid
Zeydner, Joke
Siddiqui, M. Ruby
author_facet Crellen, Thomas
Rao, V. Bhargavi
Piening, Turid
Zeydner, Joke
Siddiqui, M. Ruby
author_sort Crellen, Thomas
collection PubMed
description A high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by Streptococcus pneumoniae (249/328; 75.9%), which occurred disproportionately during the dry season (November-April) with a high case-fatality ratio of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt have typically been caused by Neisseria meningitidis (meningococcal meningitis), and our observations suggest that the risk of contracting S. pneumoniae (pneumococcal) meningitis is increased by the same environmental factors. Cases of meningococcal meningitis (67/328; 20.4%) observed over the same period were predominantly group W and had a lower case fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing medical facilities, it is likely that the reported cases represented only a small proportion of the overall burden. Nationwide vaccination campaigns in the CAR against meningitis have been limited to the use of MenAfriVac, which targets only meningococcal meningitis group A. We therefore highlight the need for expanded vaccine coverage to prevent additional causes of seasonal outbreaks.
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spelling pubmed-64809592019-05-07 Seasonal upsurge of pneumococcal meningitis in the Central African Republic Crellen, Thomas Rao, V. Bhargavi Piening, Turid Zeydner, Joke Siddiqui, M. Ruby Wellcome Open Res Research Note A high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by Streptococcus pneumoniae (249/328; 75.9%), which occurred disproportionately during the dry season (November-April) with a high case-fatality ratio of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt have typically been caused by Neisseria meningitidis (meningococcal meningitis), and our observations suggest that the risk of contracting S. pneumoniae (pneumococcal) meningitis is increased by the same environmental factors. Cases of meningococcal meningitis (67/328; 20.4%) observed over the same period were predominantly group W and had a lower case fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing medical facilities, it is likely that the reported cases represented only a small proportion of the overall burden. Nationwide vaccination campaigns in the CAR against meningitis have been limited to the use of MenAfriVac, which targets only meningococcal meningitis group A. We therefore highlight the need for expanded vaccine coverage to prevent additional causes of seasonal outbreaks. F1000 Research Limited 2019-03-29 /pmc/articles/PMC6480959/ /pubmed/31069258 http://dx.doi.org/10.12688/wellcomeopenres.14868.2 Text en Copyright: © 2019 Crellen T et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Note
Crellen, Thomas
Rao, V. Bhargavi
Piening, Turid
Zeydner, Joke
Siddiqui, M. Ruby
Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title_full Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title_fullStr Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title_full_unstemmed Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title_short Seasonal upsurge of pneumococcal meningitis in the Central African Republic
title_sort seasonal upsurge of pneumococcal meningitis in the central african republic
topic Research Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480959/
https://www.ncbi.nlm.nih.gov/pubmed/31069258
http://dx.doi.org/10.12688/wellcomeopenres.14868.2
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