Abstract
Objectives. This study aims to study the epidemiological and geographic characteristics of the meningococcal serogroups four years after the introduction of serogroup A meningococcal conjugate vaccine. Methods. This is a prospective, descriptive, analytical study, and it took place from 2016 to 2018. Cerebrospinal fluid (CSF) samples were taken after the identification of meningitis cases. The samples, thus, taken were sent to the laboratory for culture and identification of Neisseria meningitidis in accordance with WHO standards. Results. Eight hundred and ninety-nine bacterial strains were identified, of which 219 were strains of Neisseria meningitidis. The majority of N. meningitidis-positive samples were from male patients (59.8%) with a median age of 4 (IQR: 1–13). Four of N. meningitidis serogroups were identified, namely, serogroups C (6.8%), W (19.6%), X (1.8%), and A (0.5%). Geographically, 92.7% of the identified N. meningitidis serogroups came from patients who lived in the northern region of the country. The departments most concerned were Alibori (N. meningitidis C (66.7%) and N. meningitidis W (20.9%)); Atacora (N. meningitidis W (41.9%), N. meningitidis X (75.0%), and N. meningitidis C (13.3%)); and Borgou (N. meningitidis W (23.3%)). Conclusion. The results of this study showed that there is an emergence of cases of meningococcal of serogroup C four years after the introduction of MenAfricVac in Benin. These results demonstrated the effectiveness of case-by-case surveillance in detecting small changes in the distribution of serogroups that could have important implications for public health strategies in the coming seasons.
Highlights
A Gram-negative diplococcus, Neisseria meningitidis, is one of the main etiologies of meningitis and sepsis [1], with a mortality history of about 80% among cases registered at the beginning of the first epidemic [2]
An almost total disappearance was observed in confirmed cases of N. meningitidis A, with four cases occurring in 2015 [12]. e results of our surveillance showed a prevalence of 2.15% of meningococcal meningitis from 2016 to 2018. is percentage is lower than that found at the same period in Niger (84.8%) and in Chad (33.2%) [17, 18], both belonging to the African meningitis belt unlike Benin where the northern and central regions are the part found there
E majority of N. meningitidis-positive cases (22.7%) in this study was aged 0 to 4 years and lived in the northern region of the country. us, this high percentage of meningococcal meningitis cases is explained by the immature immune system of children and, the health vulnerability of the latter in the face of N. meningitidis. is vulnerability of children to meningococcal meningitis has been noted in several countries (Burkina-Faso, Chad, Mali, Niger, and Togo) of the African meningitis belt [19]
Summary
A Gram-negative diplococcus, Neisseria meningitidis, is one of the main etiologies of meningitis and sepsis [1], with a mortality history of about 80% among cases registered at the beginning of the first epidemic [2]. Even with the availability of effective antibiotics, meningococcal meningitis is frequently associated with a mortality rate of around 15% [3, 4]. According to the World Health Organization (WHO), approximately 500,000 cases and 50,000 deaths are attributed to N. meningitidis each year worldwide [5]. Advances in Public Health e burden of meningococcal meningitis is disproportionately higher in the African meningitis belt, with a higher incidence in children under 5 years of age [7]. Survivors may have complications such as cognitive impairment, behavioral problems, hearing loss, motor weakness, paralysis, incoordination, or seizure disorder; little data are available in low-resource settings [8], one study found that, up to a quarter of bacterial meningitis survivors had neuropsychological sequelae 3 to 60 months after discharge from hospital [8, 9]. erefore, prompt treatment is recommended, especially in children [10]
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