Factors associated with acute bacterial meningitis before and after the introduction of the conjugate A vaccine in 2017 in Mali

Abstract

Introduction: Acute bacterial meningitis is a public health problem because of its epidemic potential despite the vaccination strategies adopted. The aim was to study the epidemiological profile and the factors associated with acute bacterial meningitis before and after the introduction of the conjugate vaccine A in Mali. Methods: This was a cross-sectional study with an analytical aim. All samples received at the National Reference Laboratory for suspected meningitis from 2014-2019 were included in this study. Results: We recorded 646 patients with acute bacterial meningitis, including 330 before and 316 after the introduction of the conjugate vaccine A. Children under one year old were the most affected. S pneumoniae was the most responsible 186 (56%) of acute bacterial meningitis before against 176 (56%) after the introduction of the conjugate vaccine in children under one year of age. The introduction of the conjugate vaccine A led to the disappearance of meningococcal A. However, other strains of meningococci: Neisseria meningitidis C, X and W135 remain the most responsible for acute bacterial meningitis in children over 5 years old. The age groups of less than one year (p=0.001), 5 – 14 years, 14 – 29 years (p=0.001), people living in rural areas (p=0.001) and the cloudy aspect of the CSF (p=0.001) were independently associated with acute bacterial meningitis. Conclusion: Acute bacterial meningitis remains a public health problem, good vaccination coverage remains the only solution for the elimination of meningitis taking into account changes in serotypes at the origin of epidemics.