Sentinel surveillance of pediatric bacterial meningitis in three Hospitals, Ethiopia

Abstract

Introduction: Acute Bacterial meningitis (ABM) is one of childhood diseases with high fatality rate and sequelae. Globally, 1.2 million people are affected each year. Sub-Saharan African countries share the highest burden of the disease.

Objective: To estimate the disease burden, impact of vaccination & to identify circulating serotypes. 

Materials and methods: This is a cross-sectional study of the period from January, 2002 to December 2015. The sources of data presented in this study were obtained from pediatric bacterial meningitis sentinel surveillance sites. All acute bacterial meningitis cases that meet the standard criteria of WHO case definitions were included in this study (WHO IB-VPD case definition).

Result: A total of 8,274, suspected meningitis cases of acute bacterial meningitis were enrolled from sentinel hospitals. Pathogens were identified in 724 (8.8 %) of the patients. More than 90% of the disease was caused by vaccine-preventable bacterias with S. pneumonea being the leading cause 46.9% (n=307) followed by H. influenzae 31.7% (n=207) and N. meningitides 21.4 %( n=140). The prevalence of acute bacterial meningitis declined from 16.4 % to 2.9% (OR; 0.153, 95% CL; 0.12-0.195) with in the years (2007-2014) following Hib and PCV conjugate vaccines intervention. 

Conclusion: Although this study involves 10 years of data from three sentinel Hospital sites, we have found a statistically significant reduction in the occurrence of acute bacterial meningitis following vaccine intervention. Therefore, we recommend strengthening child vaccination programs and expansion of surveillance sites to include other geographic areas.