Bacterial meningitis in Africa

Abstract

Bacterial meningitis differs globally, and the incidence and case fatality rates vary by region, country, pathogen, and age group; being a life-threatening disease with a high case fatality rate and long-term complications in low-income countries. Africa has the most significant prevalence of bacterial meningitis illness, and the outbreaks typically vary with the season and the geographic location, with a high incidence in the meningitis belt of the sub-Saharan area from Senegal to Ethiopia. Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are the main etiological agents of bacterial meningitis in adults and children above the age of one. Streptococcus agalactiae (group B Streptococcus), Escherichia coli, and Staphylococcus aureus are neonatal meningitis's most common causal agents. Despite efforts to vaccinate against the most common causes of bacterial neuro-infections, bacterial meningitis remains a significant cause of mortality and morbidity in Africa, with children below 5 years bearing the heaviest disease burden. The factors attributed to this continued high disease burden include poor infrastructure, continued war, instability, and difficulty in diagnosis of bacterial neuro-infections leading to delay in treatment and hence high morbidity. Despite having the highest disease burden, there is a paucity of African data on bacterial meningitis. In this article, we discuss the common etiologies of bacterial neuroinfectious diseases, diagnosis and the interplay between microorganisms and the immune system, and the value of neuroimmune changes in diagnostics and therapeutics.

Surveillance of Bacterial Meningitis in the Italian Hospital of Desio: A Twenty-Year Retrospective Study

“…Reviewing the literature, our data concerning the most frequent etiological agents causing meningitis agreed with results obtained by Giorgi Rossi and coauthors in their monitoring of bacterial meningitis in Lazio, Italy [4], and, similarly, with results reported in different surveillance studies worldwide, such as African regions, Georgia, India, and England [3,[5][6][7]10].…”

“…Bacterial meningitis presents a high fatality rate (up to 20%) that can affect young people, and among infectious agents, such as bacteria, fungi, viruses, and parasites, the most common microorganisms involved are Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis. In fact, there are three available and effective vaccines against these bacteria, and their epidemiological proportions vary among geographic regions, depending on the vaccination schedule [1,[3][4][5][6]. Surveillance systems are essential to monitor the distribution of cases, describe the circulating causative organisms, estimate the number of cases that can be prevented, and analyze vaccination failures [1,3,7,8].…”

Meningitis Screening in Young Infants Based on a Novel, Non- Invasive, Transfontanellar Ultrasound Device: a Proof-of- Concept Study

“…As a result, LPs are seldom performed, and meningitis is managed empirically whenever suspected. This likely severely underestimates the number of true ABM cases and contributes to unnecessary prolonged and broadspectrum antibiotic use, increasing the risk of antimicrobial resistances 17 . The protocolized approach to screen for ABM in place in most high-income countries (HICs) induces the proactive performance of LPs in those children (0-28 days of life) with a higher risk of invasive bacterial disease, to ensure that no ABM cases are missed.…”

Demographic profiles and risk factors for mortality in acute meningitis: A nationwide population‐based observational study

“… 2 , 3 , 4 Remarkable variations in the types of meningitis and resultant mortality rates exist among different countries and regions, possibly reflecting the level of industrial development and the accessibility of medical resources. 5 , 6 In general, meningitis types can be classified into those caused by infectious and noninfectious processes. 7 The typical infectious etiologies encompass bacterial, viral (aseptic), fungal, and tuberculous meningitis, while noninfectious causes include carcinomatous meningitis, autoimmune meningitis, and drug‐induced meningitis.…”