Epidemiological aspects and follow-up of purulent meningitis sequelae in the Zinder Region, Niger in 2023.

Abstract

Introduction: Objectives: Purulent meningitis is a major public health problem, as it is often responsible for deadly epidemics in the Sahel. This study aims to investigate the epidemiological aspects and assess the sequelae of such meningitis. Material and methods: This is a cross-sectional descriptive study of purulent meningitis cases from January 1st to July 31st, 2023, at the Department of Infectious and Tropical Diseases of the National Hospital of Zinder. All patients admitted for febrile meningitis syndrome were included. Results: A total of 396 patients were hospitalized for febrile meningitis syndrome, with a prevalence of purulent meningitis at 87.1% (345/396). Most patients, 87.8% (303/345), came from the urban commune of Zinder. The average admission delay was 2.6 days [0-10 days]. The mean age was 14.09 years [3 months-75 years]. Gram staining was performed in 62.4% (216/345), revealing Gram-negative diplococci in 94.9% (205/216). Seventy-seven samples were analyzed by Polymerase Chain Reaction, identifying Neisseria meningitidis serogroups. Serogroup C was found in 84.41%, W135 in 1.30%, and Streptococcus pneumoniae in 7.79%. The average length of hospital stay was 8 days. The case fatality rate was 10.4% (36/345). Recovery was achieved in 89.6% of patients (309/345), of whom 5.5% presented sequelae (17/309). These sequelae included blindness, deafness, strabismus, hypoacusia, hemiplegia, and neuropsychiatric disorders. The main complications were meningoencephalitis in 11.6% (40/345) and meningococcemia in 38.3% (132/345). Conclusion: Meningitis epidemics in Niger are mainly due to serogroup C Neisseria meningitidis. Follow-up of sequelae should be associated with the management of these meningitis outbreaks.