I.1) BACKGROUND
Bacterial meningitis is an infectious disease characterized by
infection and inflammation of the meninges due to the penetration and
multiplication of the bacterium in the cerebrospinal fluid. It results in
significant morbidity and mortality globally [1][2], and is
estimated to be fatal in 50% of cases with affecting approximately 1.2 million
people each year with two thirds occurring under 5 years of age
[2].
In USA, bacterial meningitis was responsible for an estimated
4100 cases and 500 deaths annually between 2003 and 2007, while in 2012, in
Africa World Health Organization identified 22000 meningitis cases in 14
countries in the meningitis belt [1][ 3].
Meningitis can be difficult to diagnose clinically
particularly in young infants who do not seem to reliably display the classic
features of the disease [4], where symptoms observed vary from
the bulging fontanel in neonates to frank meningeal signs in older children,
thus high index of suspicion is needed [5].Sequelae vary based
primarily on the etiologic agent [6] where higher mortality
rates tend to be associated with Haemophilus influenza type b
meningitis, pneumococcal meningitis and meningococcal meningitis
[7].
The different etiologies of bacterial meningitis in children
were observed in various studies where Anouk et al demonstrated in 2018 that in
Northern America Streptococcus pneumoniae was the most common pathogen
with weighted mean 43.1% [1].
Touré et al also showed in 2017 in Ivory Coast in a
study that Streptococcus pneumoniae and Neisseria meningitidis
were the commonest incriminated pathogens [8]. In
Cameroon in a study in 2014, it was seen that the incidence of bacterial
meningitis still remained high despite the introduction of vaccins against the
three most incriminated bacteria, notably Haemophilus influenzae which
was the most common pathogens constituting 39.2%, followed Streptococcus
pneumoniae with 31.6% and Neisseria meningitidis 10.5%
[3].
2
I.2) RATIONALE AND JUSTIFICATION
Bacterial meningitis is a serious often disabling and fatal
infection which causes 170,000 deaths worldwide each year [5].
On a review on meningococcal meningitis particularly, it was
demonstrated that the rate of 15 cases per 100,000 per week for two weeks
provokes vaccination of children aged greater than 2 years with one injection
of group A and C polysaccharide. Even still only about 50 % of cases of
meningitis are preventable[9].
Despite the development of vaccines, ad useful tools of rapid
identification of pathogens and potential antibiotherapy, bacterial meningitis
still remains a significant cause of preventable childhood deaths and a major
cause of neurological deficits and physical handicaps in children [5][
10], especially in sub-Saharan Africa where populations seem to be
more exposed to the different causative agents than any other part of the
world.
Though many reviews, above 100, have been conducted on
bacterial meningitis, especially in Cameroon, we can agree from those reviews
that this disease still makes one to ask question on the control and prevention
of the disease, through the implementation and correct dispensing of the three
main vaccins against the three major causative agents which are;Haemophilus
influenzae typeb ,Neisseria meningitidis and Streptococcus
pneumoniae.
Therefore, the purpose of this study is in line with the goal
3.2 of Sustainable Development Goal (SDG) which has as objective to ensure by
2030 a decrease, of avoidable death of newborns and children of less than 5
years [11], to determine the new incidence, etiologic agents,
clinical manifestations and hospital outcome of bacterial meningitis in
children.
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