Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines

# Background Bacterial meningitis (BM) is a significant cause of mortality in children; with deaths from BM in children aged \<5 years in Angola estimated at 2395 in 2015. *Streptococcus pneumoniae* is one causative agent for BM in young children, and Angola introduced routine immunization with...

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Main Authors: Suvi Urtti, Manuel L. Cruzeiro, Linda de Gouveia, Heikki Peltola, Anne von Gottberg, Moe H. Kyaw, Tuula Pelkonen
Format: Article
Language:English
Published: Inishmore Laser Scientific Publishing Ltd 2019-12-01
Series:Journal of Global Health Reports
Online Access:https://doi.org/10.29392/joghr.3.e2019091
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author Suvi Urtti
Manuel L. Cruzeiro
Linda de Gouveia
Heikki Peltola
Anne von Gottberg
Moe H. Kyaw
Tuula Pelkonen
author_facet Suvi Urtti
Manuel L. Cruzeiro
Linda de Gouveia
Heikki Peltola
Anne von Gottberg
Moe H. Kyaw
Tuula Pelkonen
author_sort Suvi Urtti
collection DOAJ
description # Background Bacterial meningitis (BM) is a significant cause of mortality in children; with deaths from BM in children aged \<5 years in Angola estimated at 2395 in 2015. *Streptococcus pneumoniae* is one causative agent for BM in young children, and Angola introduced routine immunization with a 13-valent pneumococcal vaccine (PCV13) in 2012. This study assessed BM etiology in children in Angola following introduction of PCV13. # Methods This was a prospective, observational, single-site study conducted from October 2016 to October 2017. Children aged 3 months--15 years were included. Suspected meningitis was defined according to the World Health Organization (WHO) guidelines. Detection and characterization of *S. pneumoniae, Neisseria meningitidis,* and *Haemophilus influenzae* was carried out using polymerase chain reaction (PCR) assay. # Results A total of 1732 patients were enrolled and bacteria were detected in 137 cerebrospinal fluid samples. The most common pathogen detected was *S. pneumoniae* (43/137, 31.4%), followed by *H. influenzae* (21/137, 15.3%) and *N. meningitidis* (16/137, 11.7%) with 48% (10/21) of *S. pneumoniae* cases caused by PCV13 vaccine serotypes. *N. meningitidis* isolates were serogroups B, C and Y, and 67% (10/15) of *H. influenzae* isolates were type b. In patients with meningitis and a pathogen detected, mortality (38% (50/132) vs. 12% (101/818), *P*\<0.0001) and severe neurological sequelae (15% (10/67) vs. 5% (35/667), *P*=0.002) were higher than in those without pathogens detected. # Conclusions These data highlight that strategies to reduce the incidence of BM caused by *N. meningitidis, S. pneumoniae* and *H. influenzae* must continue to reduce mortality and morbidity.
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spelling doaj-art-b21af263a9664f05917a1768e684a9ae2025-08-20T02:40:08ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232019-12-01310.29392/joghr.3.e2019091Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccinesSuvi UrttiManuel L. CruzeiroLinda de GouveiaHeikki PeltolaAnne von GottbergMoe H. KyawTuula Pelkonen# Background Bacterial meningitis (BM) is a significant cause of mortality in children; with deaths from BM in children aged \<5 years in Angola estimated at 2395 in 2015. *Streptococcus pneumoniae* is one causative agent for BM in young children, and Angola introduced routine immunization with a 13-valent pneumococcal vaccine (PCV13) in 2012. This study assessed BM etiology in children in Angola following introduction of PCV13. # Methods This was a prospective, observational, single-site study conducted from October 2016 to October 2017. Children aged 3 months--15 years were included. Suspected meningitis was defined according to the World Health Organization (WHO) guidelines. Detection and characterization of *S. pneumoniae, Neisseria meningitidis,* and *Haemophilus influenzae* was carried out using polymerase chain reaction (PCR) assay. # Results A total of 1732 patients were enrolled and bacteria were detected in 137 cerebrospinal fluid samples. The most common pathogen detected was *S. pneumoniae* (43/137, 31.4%), followed by *H. influenzae* (21/137, 15.3%) and *N. meningitidis* (16/137, 11.7%) with 48% (10/21) of *S. pneumoniae* cases caused by PCV13 vaccine serotypes. *N. meningitidis* isolates were serogroups B, C and Y, and 67% (10/15) of *H. influenzae* isolates were type b. In patients with meningitis and a pathogen detected, mortality (38% (50/132) vs. 12% (101/818), *P*\<0.0001) and severe neurological sequelae (15% (10/67) vs. 5% (35/667), *P*=0.002) were higher than in those without pathogens detected. # Conclusions These data highlight that strategies to reduce the incidence of BM caused by *N. meningitidis, S. pneumoniae* and *H. influenzae* must continue to reduce mortality and morbidity.https://doi.org/10.29392/joghr.3.e2019091
spellingShingle Suvi Urtti
Manuel L. Cruzeiro
Linda de Gouveia
Heikki Peltola
Anne von Gottberg
Moe H. Kyaw
Tuula Pelkonen
Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
Journal of Global Health Reports
title Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
title_full Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
title_fullStr Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
title_full_unstemmed Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
title_short Surveillance of bacterial meningitis in an Angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
title_sort surveillance of bacterial meningitis in an angolan pediatric hospital after the introduction of pneumococcal conjugate vaccines
url https://doi.org/10.29392/joghr.3.e2019091
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