From genomics to surveillance, prevention and control: New challenges for the African meningitis belt

Alonso, Jean-Michel; Bertherat, Eric; Perea, William; Borrow, Ray; Chanteau, Suzanne; Cohet, Catherine; Dodet, Betty; Greenwood, Brian; LaForce, F. Marc; Rouzic, Erwan Muros‐Le; Teyssou, R.; Ouédraogo-Traoré, Rasmata; Sow, Idrissa

doi:10.1016/j.vaccine.2006.03.037

Cited by 8 publications

(13 citation statements)

References 19 publications

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“…The same might be the case for bacterial and viral meningitis, which was almost absent (0.2%). This low proportion of meningitis further underlines that not only geographically, Gabon is not part of the West-African meningitis belt 20 . The incorporation of the H. influenzae type b vaccine into the Gabonese EPI ten years ago might have contributed to the decline of meningitis cases as seen in Ivory Coast 21 .…”

Section: Discussionmentioning

confidence: 81%

Causes of fever in Gabonese children: a cross-sectional hospital-based study

Fernandes

Held

Dorn

et al. 2020

Sci Rep

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The causes of infections in pediatric populations differ between age groups and settings, particularly in the tropics. Such differences in epidemiology may lead to misdiagnosis and ineffective empirical treatment. Here, we investigated the current spectrum of pathogens causing febrile diseases leading to pediatric hospitalization in Lambaréné, Gabon. From August 2015 to March 2016, we conducted a prospective, cross-sectional, hospital-based study in a provincial hospital. Patients were children ≤ 15 years with fever ≥ 38 °C and required hospitalization. A total of 600 febrile patients were enrolled. Malaria was the main diagnosis found in 52% (311/600) patients. Blood cultures revealed septicemia in 3% (17/593), among them four cases of typhoid fever. The other causes of fever were heterogeneously distributed between both bacteria and viruses. Severe infections identified by Lambaréné Organ Dysfunction Score (LODS) were also most often caused by malaria, but children with danger signs did not have more coinfections than others. In 6% (35/600) of patients, no pathogen was isolated. In Gabon, malaria is still the major cause of fever in children, followed by a bacterial and viral disease. Guidelines for both diagnosis and management should be tailored to the spectrum of pathogens and resources available locally.Causes of fever in African pediatric populations are more diverse than previously thought. A landmark study conducted in Tanzania showed that due to a change in epidemiology, a broad spectrum of pathogens replaced P. falciparum malaria as the most common cause of disease in children in this area 1 . However, a few years later, P. falciparum malaria, is still seen to be the main cause of febrile illnesses in Ghana, West Africa 2 . When unaware, these differences in epidemiology might lead to misdiagnosis as well as inefficient treatment by the medical personnel. The process of medical diagnosis includes the joint interpretation of symptoms, clinical signs and laboratory findings. Careful selection and prioritization of a diagnostic setup are informed by a priori knowledge of the seasonal, local and worldwide frequency and distribution of a given disease 3,4 .Our study describes the distribution of infections, co-infections, and co-morbidities in children hospitalized for febrile illnesses at the Albert Schweitzer Hospital (HAS) in Lambaréné, Gabon, as an example for a hospital in a semiurban Central African region. In addition, we present the current spectrum of pathogens causing severe disease identified by Lambaréné Organ Dysfunction Score (LODS) in these children. ResultsStudy patients. A total of 600 febrile patients ≤ 15 years were enrolled in our study. Of these, 280 (47%) were females; 69% (415/600) patients were < 5 years, and median (IQR) age was 29 [12-68] months (Table 1). Seven percent (40/549, NA = 51) had at least one known chronic medical condition prior to admission, among the main ones: 4% (23/600) patients had homozygous sickle cell disease; 1% (6/600) were HIV positive. Vaccination coverage...

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Section: Discussionmentioning

confidence: 81%

Causes of fever in Gabonese children: a cross-sectional hospital-based study

Fernandes

Held

Dorn

et al. 2020

Sci Rep

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“…In desert zones, the ramarthan wind and the presence of silica nanostructures facilitates the capsular switching process in meningococci strains [26,29-36]. Thus, new experiments using animal models that could confirm this hypothesis have been performed by our group.…”

Section: Resultsmentioning

confidence: 99%

Effects of multi-walled carbon nanotubes (MWCNT) under Neisseria meningitidis transformation process

et al. 2011

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BackgroundThis study aimed at verifying the action of multi-walled carbon nanotubes (MWCNT) under the naturally transformable Neisseria meningitidis against two different DNA obtained from isogenic mutants of this microorganism, an important pathogen implicated in the genetic horizontal transfer of DNA, causing the escape of the principal vaccination measured worldwide by the capsular switching process.Materials and methodsThe bacterium receptor strain C2135 was cultivated and had its mutant DNA donor M2 and M6, which received a receptor strain and MWCNT at three different concentrations. The inhibition effect of DNAse on the DNA in contact with nanoparticles was evaluated.ResultsThe results indicated an in increase in the transformation capacity of N. meninigtidis in different concentrations of MWCNT when compared with negative control without nanotubes. A final analysis of the interaction between DNA and MWCNT was carried out using Raman Spectroscopy.ConclusionThese increases in the transformation capacity mediated by MWCNT, in meningococci, indicate the interaction of these particles with the virulence acquisition of these bacteria, as well as with the increase in the vaccination escape process.

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“…[3][4][5][6][7] Meningitis is characterized by high levels of seasonal endemicity, with large epidemics of meningococcal meningitis occurring cyclically. 8 Each such epidemic typically starts in January and ends in late May. 2 The three main pathogens causing bacterial meningitis in Africa are Neisseria meningitidis, Haemophilus influenzae type b and Streptococcus pneumoniae.…”

Section: Introductionmentioning

confidence: 99%

“…The strategy currently advocated by the World Health Organization (WHO) consists of the early detection of epidemics, the treatment of cases with antibiotics, and mass vaccination to halt the outbreak (if possible, within 4-6 weeks of the epidemic threshold being reached). 8,14,15 The early detection of meningitis epidemics is based mainly on the observation of the trends in weekly incidence. 8,12,14,[16][17][18] The effectiveness of mass vaccination as a strategy for the control of meningitis epidemics has been questioned.…”

Section: Introductionmentioning

confidence: 99%

“…8,14,15 The early detection of meningitis epidemics is based mainly on the observation of the trends in weekly incidence. 8,12,14,[16][17][18] The effectiveness of mass vaccination as a strategy for the control of meningitis epidemics has been questioned. 19 Given the sporadic nature of the outbreaks, the optimal use of vaccines to control both short-term epidemic and endemic meningococcal disease has been the subject of much debate.…”

Section: Introductionmentioning

confidence: 99%

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