Bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa: About a systematic review and critical reading of the literature

Abstract

Objective : Bacterial meningitis is a serious, urgent, debilitating and fatal disease. It is therefore necessary to have data on bacterial epidemiology and the profile of sensitivity to antibiotics on which the emergency treatment protocol could be based. The objective of this study was to identify the bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa by conducting a systematic review of recent literature.Methods : This is a systematic review of the literature for which we visited free databases including PubMed, Cochrane, Medline, Google scholar and PMC Free. The key words used were: bacterial meningitis, Sub-Saharan Africa, Acute bacterial meningitis; Culture; Gram stain; Incidence, meningitis; pneumococcus; Haemophilus influenzae. Our research considered articles conducted in sub-Saharan Africa, of all languages, and published since 2004. In total, the search generated 48 studies, which after applying the criteria mentioned above, only 7 studies were retained.Results : This systematic review showed that the bacterial flora during meningitis in children aged between 3 months to 15 years is essentially dominated by Streptococcus pneumonia in the majority with a weighted frequency of 42.9% (35.2-47. 4) and significant heterogeneity between different authors (p < 0.001). This was followed by Haemophilus influenzae with a weighted frequency of 13.8% (11.3-18.1). Escherichia coli and meningococci were observed in a small proportion. The germs identified were more sensitive to cefotaxime, ceftriaxone, then to amoxicillin, gentamicin and oxacillin.Conclusion : Studies are necessary to regularly revisit the bacterial flora during meningitis in children in order to adapt the treatment according to the antibiogram and for probabilistic antibiotic therapy to be based on research results, because this flora bacterial infection varies from one period to another and from one country to another.