Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas

Gaspard Tékpa; Alain Farra; Eudes Gbangba-Ngaï; Clotaire Rafaï; Jean De Dieu Longo; Fidèle Kitakossi; Pascal Mbelesso

doi:doi:10.11648/j.ijidt.20190401.13

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Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas

Gaspard Tékpa, Alain Farra, Eudes Gbangba-Ngaï, Clotaire Rafaï, Jean De Dieu Longo, Fidèle Kitakossi, Pascal Mbelesso

Published in International Journal of Infectious Diseases and Therapy (Volume 4, Issue 1)

Received: 11 November 2018 Accepted: 11 May 2019 Published: 11 June 2019

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Abstract

Bacterial meningitis is a health problem because of its high frequency and severity. They are endemic and epidemic in the Central African Republic (CAR). The objective of this work was to describe the etiologies of bacterial meningitis in the northern part of the Central African Republic. This was a retrospective descriptive study, conducted at the district hospital in Paoua, covering the period from 1 January 2011 to 30 September 2016. We included in the study, all suspected cases of meningitis (neuro-meningeal and infectious signs) confirmed by isolation of a bacterium from cerebrospinal fluid (CSF) analysis. An anonymous questionnaire collected sociodemographic and biological data that were entered and analyzed with the Epi Info7 software. We included 274 patients whose median age was six years with extremes of 6 months and 54 years. In 75% of the cases, the patients were under 9.5 years old. There were 156 men (56.93%) giving a sex ratio of 1.32. The prevalence of HIV was 4.74% (13/274). Examination of cerebrospinal fluid (CSF) had a turbid appearance in 80.66%, purulent in 7.66%, clear in 6.57%, hematic in 3.65% and xanthochromic in 1.46%. The bacteriological examination revealed the following main germs S. pneumoniae in 51.82%, 40.15% N. meningitidis, H. influenzae 7.30%. We found a case of E. coli (0.36%) and Streptococcus group B (0.36%). On an evolutionary level, the overall lethality was 14.96%. This lethality rate was 20.42% (29/142) for S. pneumoniae, 30% (6/20) for H. influenzae and 5.45% (6/110) for N. meningitidis. In our study, the main causes of bacterial meningitis were S. pneumoniae, N. meningitidis and H. influenzae against which there are effective vaccines. Increasing immunization coverage against these germs may help to reduce the magnitude and severity of these infections.

Published in	International Journal of Infectious Diseases and Therapy (Volume 4, Issue 1)
DOI	10.11648/j.ijidt.20190401.13
Page(s)	13-17
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Bacterial Meningitis, Etiology, Paoua, Central African Republic

References

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[3]	World Health Organization. Activités de surveillance et de réponse à la méningite épidémique pour la saison 2002-2003 dans les pays de la ceinture africaine. Rapport d’une consultation informelle de l’OMS; Genève 2003. WHO/CDS/CSR/GAR/2003.13
[4]	Mbelesso P, Tatangba-Bakozo A, Fikouma V. Les méningites bactériennes de l’adulte en milieu hospitalier centrafricain. Bull Soc Pathol Exot, 2006, 99 (4): 261-263.
[5]	Yassibanda S, Kamalo CG, Mbolidi CD, Koffi B, Camengo SP et al. – Les infections neuroméningées de l’adulte en milieu hospitalier à Bangui: Aspects étiologiques, cliniques et évolutifs. Méd Afr Noire, 2002; 49: 299-303
[6]	Bercion R, Bobossi-Sérengbe G, Gody JC, Beyam EN, Manirakiza A, Le Faou A. Acute Bacterial meningitidis at the complexe pédiatric of Bangui, Central African Republic. Journal of Trop Ped. 54 (2): 125-128.
[7]	Clouzeau J, Matera D, Bobossi G. Étiologies des méningites chez les enfants traités au complexe pédiatrique du CNHU de Bangui, République Centrafricaine, 1996. In. Treizièmes rencontres franco-africaines de pédiatrie, 1999. Faculté de médecine de Paris, France, A135-49.
[8]	Faye-Ketté H, Doukou ES, Boni C, Akoua-Koffi C, Diallo-Touré K, Kacou-N’Douba A, Bouzid S, Dossso M, Timité-Konan M. Agents des méningites purulentes communautaires de l’enfant tendance épidémiologique à Abidjan, de 1995 à l’an 2000. Bull Soc Pathol Exot, 2003; 96 (4): 313-316.
[9]	Ben Haj Khalifa A, Mastouri M, Ben Abdallah H, Noomen S, Kheder M. Les méningites purulentes dans la région de Monastir, Tunisie (1999–2006): aspects bactériologiques et état de résistance aux antibiotiques. Bull. Soc. Pathol. Exot, 2011; 104 (1): 42-49
[10]	Nguefack S, Chiabi A, Enoh J, El HadjiDjouberou, Mah E, KengneKamga K, Tatah S, Mbonda E. Etiologies and Outcome of Children with Purulent Meningitis at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (Cameroon). Open Journal of Pediatrics, 2014; 4: 269-75.
[11]	Central African Institute of Statistics and Economic and Social Studies. Enquête par grappes à indicateurs multiples MICS RCA 2010, Rapport final. Bangui, RCA ICASEES.
[12]	Békondji C, Bernede C, Passone N, Minssart P, Kamalo C, Mbolidi D, Germani Y. Primary and opportunistic pathogens associated with meningitis in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. International journal of infectious diseases, 2006; 10: 387-95.
[13]	College of Infectious and Tropical Disease Academics. Maladies infectieuses tropicales. e-Pilly Trop 2012, édition alinéa plus, 995p.
[14]	Raobijaona H, Rabesandratana N, Razanamparany M, Migliani R, Pfister P, Roux JF. Les méningites aiguës bactériennes du nourrisson observées au Service de Pédiatrie A de Befelatanana, Centre Hospitalier Universitaire d'Antananarivo (Madagascar). Arch Inst Pasteur Madagascar 1999; 65 (2): 70.
[15]	Razafindralambo M, Ravelomanana N, Randriamiharisoa FA, Migliani R, Clouzeau J, Raobijaona H, Rasamoelisoa J, Pfister P. Haemophilus influenzae, deuxième cause des méningites bactériennes de l’enfant à Madagascar. Bull Soc Pathol Exot, 2004; 97 (2): 100-103.
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Gaspard Tékpa, Alain Farra, Eudes Gbangba-Ngaï, Clotaire Rafaï, Jean De Dieu Longo, et al. (2019). Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. International Journal of Infectious Diseases and Therapy, 4(1), 13-17. https://doi.org/10.11648/j.ijidt.20190401.13

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ACS Style

Gaspard Tékpa; Alain Farra; Eudes Gbangba-Ngaï; Clotaire Rafaï; Jean De Dieu Longo, et al. Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. Int. J. Infect. Dis. Ther. 2019, 4(1), 13-17. doi: 10.11648/j.ijidt.20190401.13

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AMA Style

Gaspard Tékpa, Alain Farra, Eudes Gbangba-Ngaï, Clotaire Rafaï, Jean De Dieu Longo, et al. Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. Int J Infect Dis Ther. 2019;4(1):13-17. doi: 10.11648/j.ijidt.20190401.13

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@article{10.11648/j.ijidt.20190401.13,
  author = {Gaspard Tékpa and Alain Farra and Eudes Gbangba-Ngaï and Clotaire Rafaï and Jean De Dieu Longo and Fidèle Kitakossi and Pascal Mbelesso},
  title = {Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {4},
  number = {1},
  pages = {13-17},
  doi = {10.11648/j.ijidt.20190401.13},
  url = {https://doi.org/10.11648/j.ijidt.20190401.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20190401.13},
  abstract = {Bacterial meningitis is a health problem because of its high frequency and severity. They are endemic and epidemic in the Central African Republic (CAR). The objective of this work was to describe the etiologies of bacterial meningitis in the northern part of the Central African Republic. This was a retrospective descriptive study, conducted at the district hospital in Paoua, covering the period from 1 January 2011 to 30 September 2016. We included in the study, all suspected cases of meningitis (neuro-meningeal and infectious signs) confirmed by isolation of a bacterium from cerebrospinal fluid (CSF) analysis. An anonymous questionnaire collected sociodemographic and biological data that were entered and analyzed with the Epi Info7 software. We included 274 patients whose median age was six years with extremes of 6 months and 54 years. In 75% of the cases, the patients were under 9.5 years old. There were 156 men (56.93%) giving a sex ratio of 1.32. The prevalence of HIV was 4.74% (13/274). Examination of cerebrospinal fluid (CSF) had a turbid appearance in 80.66%, purulent in 7.66%, clear in 6.57%, hematic in 3.65% and xanthochromic in 1.46%. The bacteriological examination revealed the following main germs S. pneumoniae in 51.82%, 40.15% N. meningitidis, H. influenzae 7.30%. We found a case of E. coli (0.36%) and Streptococcus group B (0.36%). On an evolutionary level, the overall lethality was 14.96%. This lethality rate was 20.42% (29/142) for S. pneumoniae, 30% (6/20) for H. influenzae and 5.45% (6/110) for N. meningitidis. In our study, the main causes of bacterial meningitis were S. pneumoniae, N. meningitidis and H. influenzae against which there are effective vaccines. Increasing immunization coverage against these germs may help to reduce the magnitude and severity of these infections.},
 year = {2019}
}

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TY - JOUR
T1 - Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas
AU - Gaspard Tékpa
AU - Alain Farra
AU - Eudes Gbangba-Ngaï
AU - Clotaire Rafaï
AU - Jean De Dieu Longo
AU - Fidèle Kitakossi
AU - Pascal Mbelesso
Y1 - 2019/06/11
PY - 2019
N1 - https://doi.org/10.11648/j.ijidt.20190401.13
DO - 10.11648/j.ijidt.20190401.13
T2 - International Journal of Infectious Diseases and Therapy
JF - International Journal of Infectious Diseases and Therapy
JO - International Journal of Infectious Diseases and Therapy
SP - 13
EP - 17
PB - Science Publishing Group
SN - 2578-966X
UR - https://doi.org/10.11648/j.ijidt.20190401.13
AB - Bacterial meningitis is a health problem because of its high frequency and severity. They are endemic and epidemic in the Central African Republic (CAR). The objective of this work was to describe the etiologies of bacterial meningitis in the northern part of the Central African Republic. This was a retrospective descriptive study, conducted at the district hospital in Paoua, covering the period from 1 January 2011 to 30 September 2016. We included in the study, all suspected cases of meningitis (neuro-meningeal and infectious signs) confirmed by isolation of a bacterium from cerebrospinal fluid (CSF) analysis. An anonymous questionnaire collected sociodemographic and biological data that were entered and analyzed with the Epi Info7 software. We included 274 patients whose median age was six years with extremes of 6 months and 54 years. In 75% of the cases, the patients were under 9.5 years old. There were 156 men (56.93%) giving a sex ratio of 1.32. The prevalence of HIV was 4.74% (13/274). Examination of cerebrospinal fluid (CSF) had a turbid appearance in 80.66%, purulent in 7.66%, clear in 6.57%, hematic in 3.65% and xanthochromic in 1.46%. The bacteriological examination revealed the following main germs S. pneumoniae in 51.82%, 40.15% N. meningitidis, H. influenzae 7.30%. We found a case of E. coli (0.36%) and Streptococcus group B (0.36%). On an evolutionary level, the overall lethality was 14.96%. This lethality rate was 20.42% (29/142) for S. pneumoniae, 30% (6/20) for H. influenzae and 5.45% (6/110) for N. meningitidis. In our study, the main causes of bacterial meningitis were S. pneumoniae, N. meningitidis and H. influenzae against which there are effective vaccines. Increasing immunization coverage against these germs may help to reduce the magnitude and severity of these infections.
VL - 4
IS - 1
ER -

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Author Information

Gaspard Tékpa

Department of Infectious Diseases, H?pital de l’Amitié, Bangui, Central African Republic; Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic
Alain Farra

Department of Mycobacteriology, Institut Pasteur, Bangui, Central African Republic
Eudes Gbangba-Ngaï
Clotaire Rafaï
Jean De Dieu Longo

Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic
Fidèle Kitakossi

Department of Infectious Diseases, H?pital de l’Amitié, Bangui, Central African Republic
Pascal Mbelesso

Department of Neurology, H?pital de l’Amitié, Bangui, Central African Republic; Faculty of Health Sciences, University of Bangui, Bangui, Central African Republic

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APA Style

Gaspard Tékpa, Alain Farra, Eudes Gbangba-Ngaï, Clotaire Rafaï, Jean De Dieu Longo, et al. (2019). Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. International Journal of Infectious Diseases and Therapy, 4(1), 13-17. https://doi.org/10.11648/j.ijidt.20190401.13

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ACS Style

Gaspard Tékpa; Alain Farra; Eudes Gbangba-Ngaï; Clotaire Rafaï; Jean De Dieu Longo, et al. Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. Int. J. Infect. Dis. Ther. 2019, 4(1), 13-17. doi: 10.11648/j.ijidt.20190401.13

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AMA Style

Gaspard Tékpa, Alain Farra, Eudes Gbangba-Ngaï, Clotaire Rafaï, Jean De Dieu Longo, et al. Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas. Int J Infect Dis Ther. 2019;4(1):13-17. doi: 10.11648/j.ijidt.20190401.13

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@article{10.11648/j.ijidt.20190401.13,
  author = {Gaspard Tékpa and Alain Farra and Eudes Gbangba-Ngaï and Clotaire Rafaï and Jean De Dieu Longo and Fidèle Kitakossi and Pascal Mbelesso},
  title = {Etiologies of Bacterial Meningitis in Context of Conflict in Central African Rural Areas},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {4},
  number = {1},
  pages = {13-17},
  doi = {10.11648/j.ijidt.20190401.13},
  url = {https://doi.org/10.11648/j.ijidt.20190401.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20190401.13},
  abstract = {Bacterial meningitis is a health problem because of its high frequency and severity. They are endemic and epidemic in the Central African Republic (CAR). The objective of this work was to describe the etiologies of bacterial meningitis in the northern part of the Central African Republic. This was a retrospective descriptive study, conducted at the district hospital in Paoua, covering the period from 1 January 2011 to 30 September 2016. We included in the study, all suspected cases of meningitis (neuro-meningeal and infectious signs) confirmed by isolation of a bacterium from cerebrospinal fluid (CSF) analysis. An anonymous questionnaire collected sociodemographic and biological data that were entered and analyzed with the Epi Info7 software. We included 274 patients whose median age was six years with extremes of 6 months and 54 years. In 75% of the cases, the patients were under 9.5 years old. There were 156 men (56.93%) giving a sex ratio of 1.32. The prevalence of HIV was 4.74% (13/274). Examination of cerebrospinal fluid (CSF) had a turbid appearance in 80.66%, purulent in 7.66%, clear in 6.57%, hematic in 3.65% and xanthochromic in 1.46%. The bacteriological examination revealed the following main germs S. pneumoniae in 51.82%, 40.15% N. meningitidis, H. influenzae 7.30%. We found a case of E. coli (0.36%) and Streptococcus group B (0.36%). On an evolutionary level, the overall lethality was 14.96%. This lethality rate was 20.42% (29/142) for S. pneumoniae, 30% (6/20) for H. influenzae and 5.45% (6/110) for N. meningitidis. In our study, the main causes of bacterial meningitis were S. pneumoniae, N. meningitidis and H. influenzae against which there are effective vaccines. Increasing immunization coverage against these germs may help to reduce the magnitude and severity of these infections.},
 year = {2019}
}

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