Bacterial Meningitis in Malawian Adults, Adolescents, and Children During the Era of Antiretroviral Scale-up and Haemophilus influenzae Type b Vaccination, 2000-2012

Emma C. Wall*, Dean B. Everett, Mavuto Mukaka, Naor Bar-Zeev, Nicholas Feasey, Andreas Jahn, Mike Moore, Joep J. van Oosterhout, Paul Pensalo, Kenneth Baguimira, Stephen B. Gordon, Elizabeth M. Molyneux, Enitan D. Carrol, Neil French, Malcolm E. Molyneux, Robert S. Heyderman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background. We documented bacterial meningitis trends among adults and children presenting to a large teaching hospital in Malawi during introduction of Haemophilus influenzae type b (Hib) vaccination and the rollout of antiretroviral therapy (ART).

Methods. We analyzed data from 51 000 consecutive cerebrospinal fluid (CSF) samples obtained from adults, adolescents, and children with suspected meningitis admitted to the Queen Elizabeth Central Hospital, Blantyre, Malawi, between 2000 and 2012.

Results. There was a significant decline in the total number of CSF isolates over 12 years (incident rate ratio [IRR], 0.93; 95% CI, .92-.94; P <.001). This decline was entirely in children aged

Conclusions. Rates of bacterial meningitis have declined in children, but not adults, coinciding with the introduction of Hib vaccination. The highly successful rollout of ART has not yet resulted in a reduction in the incidence in adults where the burden remains high. Long-term surveillance of bacterial meningitis outside of the epidemic "meningitis belt" in Africa is essential.

Original languageEnglish
Pages (from-to)E137-E145
Number of pages9
JournalClinical Infectious Diseases
Volume58
Issue number10
Early online date4 Feb 2014
DOIs
Publication statusPublished - 15 May 2014

Keywords

  • meningitis
  • Africa
  • HIV
  • vaccination
  • antiretroviral therapy
  • STREPTOCOCCUS-PNEUMONIAE
  • NEISSERIA-MENINGITIDIS
  • CONJUGATE VACCINE
  • NORTHERN MALAWI
  • RISK-FACTORS
  • MORTALITY
  • SEQUELAE
  • AFRICA
  • DEATH

Fingerprint

Dive into the research topics of 'Bacterial Meningitis in Malawian Adults, Adolescents, and Children During the Era of Antiretroviral Scale-up and Haemophilus influenzae Type b Vaccination, 2000-2012'. Together they form a unique fingerprint.

Cite this