Abstract
BackgroundNo reliable and comprehensive study has been published on the incidence and epidemiological profile of meningitis in Iran from 2008 to 2014, before pneumococcal conjugate vaccine (PCV) and pentavalent vaccine (DTPw-Hep B-Hib (PRP-T) vaccine (pentavac) (adsorbed)) introduction. The present study aimed to portray the epidemiological profile of meningitis in Iran from 2008 to 2014.MethodsData on meningitis cases aged from 1 day to 110 years were extracted from national notifiable diseases surveillance system from March 2008 to December 2014 in Iran. A total number of 48,006 cases of suspected meningitis were identified and 1468 cases of which met the criteria for diagnosis-confirmed meningitis. Of 1468 cases, 1352 patients were included in the study.ResultsThe great number of cases reported from urban areas. Moreover, males were more predominant than females (58.51% vs. 33.81%) in total. The estimated annual incidence rate of meningitis varied from 0.28/100000 in 2008 to 0.09/100000 in 2014. Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis were the most leading pathogens causing bacterial meningitis, accounted for 266(23.44%), 145(12.78%), 95(8.37%) of cases, respectively. Each of the three bacterial species showed a descending trend. The majority of infected subjects are children under five years.ConclusionsUnlike the decreasing trend of meningitis and high percentage of cultures with negative results, according to World Health Organization recommendation PCV introduction into routine immunization is evident. Implementing an enhanced surveillance system to provide high quality data on epidemiological profile of meningitis in Iran is necessary.
Highlights
No reliable and comprehensive study has been published on the incidence and epidemiological profile of meningitis in Iran from 2008 to 2014, before pneumococcal conjugate vaccine (PCV) and pentavalent vaccine (DTPw-Hep B-Hib (PRP-T) vaccine) introduction
The sex distribution suggested that the incidence of bacterial meningitis in men is higher than women
The present study demonstrated that the frequency of aseptic meningitis is more common in age group of under 5 years (62.21%) as 38% of which were seen in children under 1 year and 49.42% of bacterial origin were observed among children under 5 years (p < 0.001)
Summary
No reliable and comprehensive study has been published on the incidence and epidemiological profile of meningitis in Iran from 2008 to 2014, before pneumococcal conjugate vaccine (PCV) and pentavalent vaccine (DTPw-Hep B-Hib (PRP-T) vaccine (pentavac) (adsorbed)) introduction. The present study aimed to portray the epidemiological profile of meningitis in Iran from 2008 to 2014. In high-income countries, bacterial meningitis is among the top ten causes of death in children under the age of 14 [8]. Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis the most leading organisms causing bacterial meningitis universally,are responsible for 90% of reported cases in childhood [9]. Subsequent to the development of highly effective conjugated vaccines to prevent meningitis universally, major variations in the epidemiological profile of meningitis are expected. The monitoring of disease trend in pre and post-vaccination era and the scrutiny of its epidemiological characteristics those of bacterial meningitis seem necessary
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