[Agents of community acquired purulent meningitis in the child: epidemiologic trends in Abidjan, Côte d'Ivoire, from the year 1995 to 2000].

OBJECTIVE: To assess prevalence and trends of community acquired bacterial meningitis in childhood in a tertiary-care hospital before introduction of the HIB conjugate vaccine.

STUDY DESIGN: Laboratory based data were recorded from January 1995 to December 2000 on two hundred and eighty seven children with bacterial meningitis. Identification of bacterial agents was performed with conventional methods. Information including age, gender, bacterial aetiology of meningitis, month and annual prevalence of agents was examined.

RESULTS: The age of infected children ranges from 1 to 10 years with an average and median age of 34.2 months and 12 months respectively. Fifty five percent of children were male. The overall prevalence of agents were respectively 47.8% for Streptococcus pneumoniae followed by Haemophilus influenzae 39% and Neisseria meningitidis 13.2% with predominance of serogroup C. Stratification by age group shows that Haemophilus influenzae was the most common agent among children < 1 year of age following by S. pneumoniae and N. meningitidis. After 5 years, the number of cases of S. pneumoniae and N. meningitidis was prevalent. After 10 years, N. meningitidis was the first aetiology of bacterial meningitis. The six years data recorded highlighted the high and stable prevalence of H. influenzae B and S. pneumoniae and the low prevalence of N. meningitidis and high incidence of invasive meningococcal, pneumococcal and Haemophilus influenzae during the six years between September and February.

CONCLUSION: Conjugated HIB vaccine is needed in our country to lower incidence of H. influenzae meningitis as already seen in developed countries. Continuous surveillance is necessary to monitor the disease trends, serotype distribution and antimicrobial susceptibility in order to implement appropriate public health interventions against community acquired bacterial meningitis.