Assessment of bacteriological exams quality in the surveillance of the meningitis in Mali from 2006 to 2010

Abstract

Objective: Assessment of bacteriological diagnosis quality of the of meningitis was a need to pass from "enhanced surveillance" to the "surveillance case by case" after the introduction of vaccine MenAfriVac ® in Mali. Materials and methods: The study was cross-sectional and took place at the National Institute of Research in Public Health, Bamako (Mali) from 2006 to 2010. The sampling was complete and data collection has been made from laboratory registry and individual notification sheet. It focused on the quality of cerebrospinal fluids, date of collection, transport, conventional bacteriological tests (Gram stain, research of the soluble antigens, culture) and PCR. The laboratory assessment was performed using a scoring system and external quality control. Results: A total of 2567 CSF samples with 1972 tubes and 595 inoculated into the trans -isolate (TI) medium were analyzed. The average transport time was one day; samples were adequate to 92.70 %. The main bacteria identified were Neisseria meningitidis (67.88 %), Streptococcus pneumoniae (19.50%) and Haemophilus influenzae b (9.56 %). WHO Collaborating Centers confirmed 100% our positives cases of cultures results. The total quality score assigned according to the scoring system established was 13.41 / 20 (average quality) or 67.05 % of successful completion of exams. Conclusion: These results show that further efforts are to make for the quality of ours bacteriological exams.