The epidemiology of bacterial meningitis in Kosovo.

Sadie Avdiu Namani,Murat Mehmeti,Emine Qehaja-Buçaj,Lindita Ajazaj-Berisha,Remzie A Koci

doi:10.3855/jidc.3553

Abstract

The purpose of this study was to present the epidemiologic features of bacterial meningitis in the developing country of Kosovo. Data were collected from active surveillance of bacterial meningitis cases treated at the University Clinical Center of Kosovo in the years 2000 (first post-war year) and 2010. Meningitis cases in 2000 compared with 2010 showed a 35.5% decline in incidence (from 4.8 to 3.1 cases per 100,000 population) and a decrease in the case fatality rate from 10% to 5%. In children, there was a lower mortality rate (5% versus 2%) and a lower incidence of neurological complications (13% versus 16%) as compared to adults (32% versus 10% and 16% versus 35%, respectively). Neisseria meningitidis was the most common pathogen of bacterial meningitis in both study periods. Bacterial meningitis was most prevalent in the pediatric population, and showed an increase in the median age, from three years in 2000 to seven years in 2010. A steady number of bacterial meningitis cases in adults throughout last decade (around 20 cases per year) was recorded. During the last decade, gradual changes have been observed in the epidemiology of bacterial meningitis that are unrelated to the introduction of new vaccines, but are partly due to the improvement of living conditions.

Highlights

The purpose of this study was to present the epidemiologic features of bacterial meningitis in the developing country of Kosovo
The two most important epidemiologic changes in bacterial meningitis have been the reduction in the incidence of H. influenzae meningitis and the emergence of antibiotic-resistant S. pneumoniae [11,12,18,21,23,24,25,26,27,28]
Since the introduction of the H. influenzae type b and S. pneumoniae conjugate vaccines to the infant immunization schedule, the peak incidence of bacterial meningitis shifted from children under five years of age to adults [19,20,23,29]

Summary

Introduction

Three other control measures (i.e., universal screening and antibiotic prophylaxis of pregnant women for Group B streptococci [GBS] and the implementation and availability of the S. pneumoniae and N. meningitidis conjugate vaccines) have likely further decreased the incidence of these meningeal pathogens [19,29]. Since the introduction of the H. influenzae type b and S. pneumoniae conjugate vaccines to the infant immunization schedule, the peak incidence of bacterial meningitis shifted from children under five years of age to adults [19,20,23,29]. Gradual changes have been observed in the epidemiology of bacterial meningitis in Kosovo, unrelated to the introduction of new polysaccharide and conjugate vaccines

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Results

Conclusion