Skip to main content
NCBI home page
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1989;67(5):479–486.

Approaches to prevent acute bacterial meningitis in developing countries.

P F Wright
PMCID: PMC2491289  PMID: 2611973

Abstract

Endemic acute bacterial meningitis of childhood appears to be neglected as a cause of morbidity and mortality in developing countries, probably because it has been overshadowed by the dramatic epidemics of meningococcal disease in sub-Saharan Africa. The available data based on reviews of hospitalized patients suggest that endemic meningitis is mostly a disease of young infants, Streptococcus pneumoniae and Haemophilus influenzae type b being the most important etiologic agents. The epidemiological pattern appears to be different in developing countries, compared with northern Europe or the USA, and closely resembles the early age of onset and high incidence of meningitis observed among the native American populations in Alaska. The mortality from meningitis appears to be much higher in developing countries than in industrialized countries. The availability of vaccines against the pneumococcus and haemophilus, particularly those in which the bacterial polysaccharide is conjugated to a protein, promises protection against systemic bacterial infection from these organisms. The assessment of the efficacy of such vaccines will have to include a close examination of meningitis as an outcome. It is suggested that before such vaccines become available careful clinical and epidemiological studies of meningitis will help both to define the impact of this disease and how to design an intervention strategy.

Full text

PDF
479

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bernard-Bonnin A. C., Ekoe T. Les méningites purulentes de l'enfant à Yaoundé: aspects épidémiologiques et pronostiques. Ann Soc Belg Med Trop. 1985;65(1):59–68. [PubMed] [Google Scholar]
  2. Claesson B., Trollfors B., Jodal U., Rosenhall U. Incidence and prognosis of Haemophilus influenzae meningitis in children in a Swedish region. Pediatr Infect Dis. 1984 Jan-Feb;3(1):35–39. doi: 10.1097/00006454-198401000-00009. [DOI] [PubMed] [Google Scholar]
  3. Coulehan J. L., Michaels R. H., Williams K. E., Lemley D. K., North C. Q., Jr, Welty T. K., Rogers K. D. Bacterial meningitis in Navojo Indians. Public Health Rep. 1976 Sep-Oct;91(5):464–468. [PMC free article] [PubMed] [Google Scholar]
  4. Eskola J., Peltola H., Takala A. K., Käyhty H., Hakulinen M., Karanko V., Kela E., Rekola P., Rönnberg P. R., Samuelson J. S. Efficacy of Haemophilus influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine in infancy. N Engl J Med. 1987 Sep 17;317(12):717–722. doi: 10.1056/NEJM198709173171201. [DOI] [PubMed] [Google Scholar]
  5. Fraser D. W., Geil C. C., Feldman R. A. Bacterial meningitis in Bernalillo County, New Mexico: a comparison with three other American populations. Am J Epidemiol. 1974 Jul;100(1):29–34. doi: 10.1093/oxfordjournals.aje.a112005. [DOI] [PubMed] [Google Scholar]
  6. Goldacre M. J. Acute bacterial meningitis in childhood. Incidence and mortality in a defined population. Lancet. 1976 Jan 3;1(7949):28–31. doi: 10.1016/s0140-6736(76)92921-4. [DOI] [PubMed] [Google Scholar]
  7. Greenwood B. M. Selective primary health care: strategies for control of disease in the developing world. XIII. Acute bacterial meningitis. Rev Infect Dis. 1984 May-Jun;6(3):374–389. doi: 10.1093/clinids/6.3.374. [DOI] [PubMed] [Google Scholar]
  8. Habte-Gabr E., Muhe L., Olcen P. Rapid etiological diagnosis of pyogenic meningitis by coagglutination, latex agglutination and immunoosmophoresis of cerebrospinal fluid, serum and urine. Trop Geogr Med. 1987 Apr;39(2):137–143. [PubMed] [Google Scholar]
  9. Mohammed I., Obineche E. N., Onyemelukwe G. C., Zaruba K. Control of epidemic meningococcal meningitis by mass vaccination. I. Further epidemiological evaluation of groups A and C vaccines in northern Nigeria. J Infect. 1984 Sep;9(2):190–196. doi: 10.1016/s0163-4453(84)91429-4. [DOI] [PubMed] [Google Scholar]
  10. Nottidge V. A. Haemophilus influenzae meningitis: a 5-year study in Ibadan, Nigeria. J Infect. 1985 Sep;11(2):109–117. doi: 10.1016/s0163-4453(85)91931-0. [DOI] [PubMed] [Google Scholar]
  12. Peltola H., Virtanen M. Systemic Haemophilus influenzae infection in Finland. Clin Pediatr (Phila) 1984 May;23(5):275–280. doi: 10.1177/000992288402300507. [DOI] [PubMed] [Google Scholar]
  13. Riley I. D., Lehmann D., Alpers M. P., Marshall T. F., Gratten H., Smith D. Pneumococcal vaccine prevents death from acute lower-respiratory-tract infections in Papua New Guinean children. Lancet. 1986 Oct 18;2(8512):877–881. doi: 10.1016/s0140-6736(86)90409-5. [DOI] [PubMed] [Google Scholar]
  14. Shann F., Gratten M., Germer S., Linnemann V., Hazlett D., Payne R. Aetiology of pneumonia in children in Goroka Hospital, Papua New Guinea. Lancet. 1984 Sep 8;2(8402):537–541. doi: 10.1016/s0140-6736(84)90764-5. [DOI] [PubMed] [Google Scholar]
  15. Vimont-Vicary P., Rogerie F. Epidémie de méningite cérébrospinale à Neisseria meningitidis dans la région sanitaire de Ruhengeri (Rwanda). Med Trop (Mars) 1983 Mar-Apr;43(2):155–161. [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES