Causes of bacterial meningitis in children from 1 month to 15 years in the department of pediatrics at Hopital du Mali from 2012 to 2018

Abstract

Introduction: Bacterial meningitis is a serious public health problem due to the high mortality rate it induces in developing countries. Each year the WHO counts nearly a million new cases with a lethality of 10%. Since the introduction of the Haemophilus influenzae b (Hib) vaccine in 2005, the Streptococcus pneumoniæ vaccine in 2011 and the mass vaccinations against Neisseria meningitidis A, no studies have focused on bacterial meningitis in the service of pediatrics of the hospital of Mali from where the initiation of this work.
Materials and methods: It was a retrospective descriptive study covering the period from January 1, 2012 to December 31, 2017 and prospective ranging from January 01 to December 31, 2018 in children from one month to 15 years hospitalized in the pediatric department of the Hospital from Mali.
Results: During the period of our study we recorded a hospital frequency of 1.4%. The sex ratio was 1.5. Children under the age of 5 were the most affected (71.6%). The children were immunized against Hib (72.7%), pneumococcus (71.6%) and meningococcus (13.6%). Fever was present in 80.6% of our children, associated or not with coma (68.2%), seizure (56.8%) and agitation (13.6%). The main germs isolated were: Streptococcus pneumoniæ (36.4%), Neisseria meningitidis W135, X, C (12.5%) and Haemophilus influenzae (9.1%). The combination of Ceftriaxone and gentamycin has been used successfully in 77.3% of our children. The cure rate was 64.8%, the sequelae rate (12.5%) and the case fatality rate (18.2%).
Conclusion: The pneumococcus is the main cause of bacterial meningitis despite the introduction of the thirteen valent pneumococcal conjugate vaccine. The meningococcal serogroups W135, X, and C which are also responsible for meningitis in our department.