Four years of case-based surveillance of meningitis following the introduction of MenAfriVac in Moissala, Chad: lessons learned

Autor: Kadidja Gamougam, Anne-Laure Page, Klaudia Porten, Mbaihol Tamadji, Northan Hurtado, Celine Lastrucci, Francois-Charles Tehoua, Dominique A. Caugant, Florence Fermon, Matthew E. Coldiron, Mahmaat Ali Acyl
Rok vydání: 2017
Předmět:
Adult
Male
Pediatrics
medicine.medical_specialty
Adolescent
Chad
030231 tropical medicine
Meningococcal Vaccines
Meningitis
Meningococcal
medicine.disease_cause
Polymerase Chain Reaction
Disease Outbreaks
Pneumococcal Vaccines
Young Adult
03 medical and health sciences
0302 clinical medicine
Neisseria meningitidis
Serogroup A
Streptococcus pneumoniae
Humans
Medicine
030212 general & internal medicine
Child
Vaccines
Conjugate
Neisseria meningitidis serogroup
medicine.diagnostic_test
Meningitis
Pneumococcal
business.industry
Lumbar puncture
Incidence
Vaccination
Public Health
Environmental and Occupational Health
Infant
Outbreak
Middle Aged
medicine.disease
Latex fixation test
Infectious Diseases
Child
Preschool
Female
Parasitology
African meningitis belt
business
Meningitis
MenAfriVac
Latex Fixation Tests
Zdroj: Tropical medicine & international health
ISSN: 1360-2276
DOI: 10.1111/tmi.12987
Popis: OBJECTIVE Case-based surveillance of bacterial meningitis in sentinel districts has been recommended after the introduction of the conjugated vaccine against Neisseria meningitidis serogroup A (NmA), MenAfriVac, in the African meningitis belt. Here we report data and lessons learnt from four years of surveillance in the district of Moissala, Chad. METHODS All suspected cases of meningitis were referred free of charge to the district hospital for lumbar puncture and treatment. Cerebrospinal fluid samples were tested with Pastorex latex agglutination in Moissala, and inoculated trans-isolate media were used for culture and PCR at the national reference laboratory and/or at the Norwegian Institute of Public Health. RESULTS From July 2012 to December 2016, 237 suspected cases of meningitis were notified, and a specimen was collected from 224. Eighty-three samples were positive for a bacterial pathogen by culture, PCR or Pastorex, including 58 cases due to Streptococcus pneumoniae with only 28 of 49 pneumococcal meningitis confirmed by culture or PCR correctly identified by Pastorex. Four cases of NmA were detected by Pastorex, but none were confirmed by PCR. CONCLUSION Implementation of case-based surveillance for meningitis is feasible in Chad, but has required political and technical engagement. Given the high proportion of S. pneumoniae and its poor detection by Pastorex, continued use of PCR is warranted for surveillance outside of outbreaks, and efforts to accelerate the introduction of pneumococcal conjugate vaccines are needed. Introduction of MenAfriVac in routine immunisation and future availability of a pentavalent meningococcal conjugate vaccine will be key elements for the sustained reduction in meningitis outbreaks in the area.
Databáze: OpenAIRE
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