Background: Centre MURAZ of Bobo-Dioulasso (Burkina Faso) organized in 2009 and 2010 a system of Cerobro-Spinal Fluid (CSF) collection in eight pilot Districts as an initial step for the future Ministry of Health’s led strategy of individual surveillance in a context of meningococcal conjugate A vaccine introduction. Methods: CSF samples were analyzed with Polymerase Chain Reaction (PCR). This allowed for meningitis etiologies dynamics studies in the pilot Districts. Results: Because of geographical difficulties and lack of means, less than 40% of suspected cases had their CSF analyzed at PCR reference laboratory. In 2009, among confirmed cases at reference laboratory, Sp (Streptococcus pneumonia), NmA (Neisseria meningitis A) and Hib (Hemophilus influenzae b) were responsible respectively for 90%, 6.6% and 4.4% of cases. In 2010, serogroup distribution among confirmed cases was: Sp 62.7%, NmX 32.2% and NmA 5.1%. Sp which was continuously present in Burkina Faso takes more significant proportions, just as serogroup X which until there was sporadically encountered. The attack rates of NmX were tree to twelve times higher than for NmA in the two Districts where NmX has been notified. Conclusion: As a consequence of such results, efforts must be maintained in epidemiologic surveillance field and in reinforcement of laboratory capacities. Fast care should be guaranteed to patients with adequate antibiotics according to country national guideline and chemoprophylaxis measures should be undertaken among contacts of patients to prevent secondary cases. A plea must be made on one hand for pneumococcal vaccine introduction in Burkina Faso and on other hand towards manufacturers for taking into account serogroup X into meningococcal polyvalent vaccine composition. With this polyvalent vaccine including serougruop X, we suggested to conduct periodically mass campaign vaccination of people before the beginning of meningitis epidemiological season.
Molesworth, A.M., Thomson, M.C., Connor, S.J., Cresswell, M.P., et al. (2002) Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 96, 242-249.
Schuchat, A., Robinson, K., Wenger, J.D., Harrison, L.H., et al. (1997) Bacterial meningitis in the United States in 1995. The New England Journal of Medicine, 337, 970-976. doi:10.1056/NEJM199710023371404
Koumare, B., Bougoudogo, F., Cisse, M., Doumbia, T., et al. (1993) Bacteriological aspects of purulent meningitis in Bamako district: A propos of 1541 bacterial strains collected from 1979 to 1991 (in French). Bulletin de la Société de Pathologie Exotique, 86, 136-140.
Djibo, S., Nicolas, P., Alonso, J.M., Djibo, A., et al. (2003) Outbreaks of serogroup X meningococcal meningitis in Niger 1995-2000. Tropical Medicine & International Health, 8, 1118-1123.
Gagneux, S.P., Hodgson, A., Smith, T.A., Wirth, T., et al. (2002) Prospective study of a serogroup X Neisseria meningitidis outbreak in northern Ghana. The Journal of Infectious Diseases, 185, 618-626. doi:10.1086/339010
Chanteau, S., Sidikou, F., Djibo, S., Moussa, A., et al. (2006) Scaling up of PCR-based surveillance of bacterial meningitis in the African meningitis belt: Indisputable benefits of multiplex PCR assay in Niger. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100, 677-680. doi:10.1016/j.trstmh.2005.09.006
Garcia, P., Garcia, J.L., Garcia, E. and Lopez, R. (1986). Nucleotide sequence and expression of the pneumococcal autolysin gene from its own promoter in Escherichia coli. Gene, 43, 265-272. doi:10.1016/0378-1119(86)90215-5
Tzeng, Y.L., Noble, C. and Stephens, D.S. (2003) Genetic basis for biosynthesis of the (alpha 1→4)-linked N-acetyl-d-glucosamine 1-phosphate capsule of Neisseria meningitidis serogroup X. Infection and Immunity, 71, 6712-6720. doi:10.1128/IAI.71.12.6712-6720.2003
Gesner, B.D., Mueller, J.E. and Yaro, S. (2010) African meningitis belt pneumococcal disease epidemiology indicates a need for an effective serotype 1 containing vaccine, including for older children and adults. BMC Infectious Diseases, 10, 10-22.
David, M.M., Guillermo, P., Judith, M., Charles, N., et al. (2009) Epidemiology and risk factors for serogroup X Meningococcal Meningitis during an outbreak in Western Kenya, 2005-2006. The American Journal of Tropical Medicine and Hygiene, 80, 619-624.
Leimkugel, J., Hodgson, A., Adams Forger, A., et al. (2007) Clonal waves of Neisseria colonization and disease in the African meningitis belt: Eight year longitudenal study in Northern Ghana. PLoS Medicine, 4, 0535-0544.
Taha, M.K., Deghmane, A.E., Antignac, A., Zarantonelli, M.L., Larribe, M. and Alonso, J.M. (2002) The duality of virulence and transmissibility in Neisseria meningitidis. Trends Microbiology, 10, 376-382.
MacLennan, J.M., Urwin, R., Obaro, S., Griffiths, D., et al. (2000) Carriage of serogroup W-135, ET-37 meningococci in the Gambia: Implications for immunisation policy? The Lancet, 356, 1078.
Traoré, Y., Njanpop-Lafourcade, B.M., Adjogble, K.L., Lourd, M., et al. (2006) The rise and fall of epidemic Neisseria meningitidis serogroup W135 meningitis in Burkina Faso, 2002-2005. Clinical Infectious Diseases, 43, 817-822.
Singleton, R.J., Hennessy, T.W., Bulkow, L.R., Hammitt, L.L., et al. (2007) Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. The Journal of the American Medical Association, 297, 1784-1792.