Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

A Ky-Ba, J Tranchot, I Sanou, P Christiansen, AS Ouedraogo, K Ouattara, M Kienou, M Tamboura, D Kambiré, R Ouédraogo-Traoré, L Sangaré

 

Abstract

The aims of this study were to evaluate the impact of conjugate vaccine A, MenAfriVac, on Neisseria meningitidis (Nm) asymptomatic carriage and cerebrospinal meningitis in three health districts (Bogodogo, Kaya, and Dandé) of Burkina Faso. Asymptomatic carriage of Nm was assessed by performing cross-sectional studyrepeated (rounds 1 to 10) before and after introduction of the conjugate vaccine against serogroup A of N. meningitidis (NmA), MenAfriVac. In each round at least 1,500 people were enrolled in each district for a month. Data oncases of meningococcal meningitis in the three studied health districts were collected through meningitides epidemiological surveillance of Burkina Faso.Nm was identified in680 of 23,885 throat swabs before vaccination (2. 84%)withNmYasthe dominant serogroup(1.87%). During the same period (2009 and 2010), 891 cases of suspected meningitis were reported in the three health districts among whom 42 were due toNm (4.71%) withNmX (3.70%) asthe most frequently identified serogroup. After vaccination, Nm was identified in 1117 of 27,245 pharyngeal samples (6.42%); NmX (4.42%) wasthe dominantserogroup. From 2011 to 2013, 965 cases of suspected meningitis were reported in all health facilities in the three studied health districts located in the geographical study area; 91 was due toNm (9.43%) andNmWasthe most commonserogroup(52 cases= 5.38%).After introduction of conjugate vaccine A (MenAfriVac), the NmAserogroup almost disappeared both in asymptomatic carriers and in patients with cerebrospinal meningitis. However the presence of the NmW and NmXserogroups, which appear to have replaced serogroup A, is very worrying with regard to meningitis prevention and control in Burkina Faso. It appears necessary to strengthen surveillance and laboratory diagnosis of the different meningococcal serogroups circulating in Africa.

Keywords: meningococcal meningitis, serogroups W and X, meningococcal carriage, MenAfriVac.

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Meningococcal carriage and cerebrospinal meningitis after MenAfriVac mass immunization in Burkina Faso

Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)

Absatou Ky-Ba, Mahamoudou Sanou, Juliette -Diallo Trancho, Paul A. Christiasen, Abdoul Salam Ouedraogo, Mamadou Tamboura, Dinanibé Kambiré, Kalifa Ouattara, Maxime Kienou, Idrissa Sanou, Isaïe Medah, Daouda Koussoubé, Rasmata Ouédraogo

 

Abstract

The aim of this study was to analyze ten (10) years of epidemiological surveillance data of meningitis in Burkina Faso for high risk germs patterns identification in order to contribute to the strengthening of prevention strategies.

A retrospective study of the past decade (2005- 2014) of cases of acute bacterial meningitis occurred in the thirteen health regions, collected through epidemiological surveillance data meningitis in Burkina Faso. From a total of 88 057 suspected cases of acute bacterial meningitis, we recorded 9134 deaths. From the laboratory confirmed cases, the identified germs were as follows: 56.79% of Neisseria meningitidis, 41.09% of Streptococcus pneumoniae and 2.13% of Haemophilus influenzae. Among the meningococcus isolated, we observed the following distribution: 23.11% of NmA, 58.84% of NmW and 18% of NmX.

Mortality associated with acute bacterial meningitis remains still high in Burkina Faso despite the complete disappearance of NmA since 2012, after the conjugate vaccine A (MenAfriVac) has been introduced in this country. However the emergence of NmX, the reemergence of NmW and the persistence of high prevalence of Streptococcus pneumoniae are a major concern in the fight against meningitis in Burkina Faso. So, it is necessary, in addition to the strengthening of surveillance, diagnosis and case management to develop and make available and accessible a conjugate trivalent vaccine against NmA the NmX and NmW serogroups.

Keywords: meningococcal meningitis, W and X serogroups, Streptococcus pneumoniae, MenAfriVac

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Dynamics of germs responsible for acute bacterial meningitis in Burkina Faso in the last ten years (2005-2014)

Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria

PM Lar, VK Pam, Julius Ayegba, Hosea Zumbes

 

Abstract

Background: The immunologic status of an individual can determine outcomes of treatment and their capacity to combat opportunistic infections. Co-infection with other parasites will confound the situation; however there is inadequate information on the interaction of HIV and helminth infections. We wanted to establish the relationship of the immunologic status and the prevalence of intestinal parasites in HIV/AIDS patients enrolled for antiretroviral therapy at the Vom Christian health centre.

Materials & Methods: With their consent, stool samples of 205 subjects were collected and examined parasitologically by direct microscopy and concentration techniques. Their most resent CD4+ cell counts were obtained at the centre. The demographic characteristics of the subjects were determined from their response to a questionaire.

Results: Out of the 205 subjects examined 61.9% of them had various parasites with helminthes occurring in 51.9% of the cases. The age group of 31-40 years was the most significantly infected (P< 0.05). Hookworms and Schistosoma mansonii were most frequent with prevalence rates of 18.1% and 16.5% respectively. The highest prevalence of parasites occurred in HIV/AIDS people with CD4+ cells between 101-200 cells/μ and those with counts below 100 cells/al.Occupation was highly associated with parasitic infections (p< 0.05).

Conclusion: Parasitic infection remained highly prevalent among the subjects examined in spite of ART treatment and in the case of intense infection in the immunocompromised, treatment outcome may be compromised.

Keywords: HIV/AIDS, Parasites, ART, Coinfection

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Prevalence and distribution of intestinal parasite infections in HIV seropositive individuals on antiretroviral therapy in Vom, Plateau State Nigeria