Pediatric bacterial meningitis surveillance - African region, 2002--2008.

Sub-Saharan Africa has one of the world's greatest disease burdens of Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis infections. In 2000, Hib and S. pneumoniae infections accounted for approximately 500,000 deaths in the region; during the past 10 years, N. meningitidis has been responsible for recurring epidemics resulting in approximately 700,000 cases of meningitis. Introduction of vaccines against bacterial pathogens in Africa has been constrained by competing public health priorities, limited availability of Hib and S. pneumoniae vaccines, suboptimal N. meningitidis vaccine, inadequate funding, and limited information regarding the disease burden associated with these infections. The World Health Organization (WHO) and CDC analyzed data for 2002--2008 from the Pediatric Bacterial Meningitis (PBM) Surveillance Network, which collects information on laboratory-confirmed bacterial meningitis cases among children aged <5 years at sentinel hospitals in countries throughout the WHO African Region. The results of that analysis determined that, during 2002-2008, a total of 74,515 suspected cases of meningitis were reported. Among the 69,208 suspected cases with known laboratory results, 4,674 (7%) samples were culture-positive for the three bacterial infections under surveillance: 2,192 (47%) were positive for S. pneumoniae, 1,575 (34%) for Haemophilus influenzae, and 907 (19%) for N. meningitidis. The majority of the remaining culture results were negative. These and other PBM network findings will help guide strategies for strengthening laboratory and data management capacity at existing sentinel hospitals and for planning future network expansion in the WHO African Region.