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Bacterial Meningitis: Epidemiology and Vaccination
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Bacterial Meningitis: Epidemiology and Vaccination

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Public Health Microbiology".

Deadline for manuscript submissions: closed (15 January 2021) | Viewed by 87528

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Prof. Dr. James Stuart

E-Mail Website
Guest Editor
Department of Population Health Sciences, University of Bristol, Bristol, UK
Interests: meningococcal; meningitis; vaccine control

Special Issue Information

Dear Colleagues,

Bacterial meningitis has serious health, economic and social consequences with a high risk of death and lifelong disability. WHO has published this year the first global road map on meningitis "Defeating meningitis by 2030” to tackle the main causes of acute bacterial meningitis (Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus agalactiae) . The road map is under consideration by the World Health Assembly.

The three main goals are to eliminate epidemics of bacterial meningitis, to reduce cases of and deaths from vaccine-preventable bacterial meningitis, and to reduce disability and improve quality of life after meningitis of any cause. Proposed measures to achieve these goals include development of new vaccines, increased effectiveness of prevention and control strategies, efficient global surveillance with accurate estimates of disease burden including sequelae, and global availability of and access to rapid diagnosis and high quality treatment of meningitis and its after effects.

We welcome original research articles or review articles on epidemiology and vaccination of bacterial meningitis that have direct relevance to advancing the goals of the road map through new vaccines and other measures that will reduce incidence, mortality and sequelae from meningitis. Mathematical models and other methods to refine estimates of disease burden and optimise effectiveness of vaccination programmes are included in this call.

Prof. Dr. James Stuart
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (16 papers)

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Editorial

Jump to: Research, Review

3 pages, 161 KiB  
Editorial
Editorial for the Special Issue: Bacterial Meningitis—Epidemiology and Vaccination
by James M. Stuart
Microorganisms 2021, 9(5), 917; https://doi.org/10.3390/microorganisms9050917 - 24 Apr 2021
Cited by 2 | Viewed by 1849
Abstract
Bacterial meningitis has serious health, economic, and social consequences with a high risk of death and lifelong disability [...] Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)

Research

Jump to: Editorial, Review

10 pages, 1041 KiB  
Article
Field Evaluation of the Performance of Two Rapid Diagnostic Tests for Meningitis in Niger and Burkina Faso
by Marc Rondy, Mamadou Tamboura, Fati Sidikou, Issaka Yameogo, Kambire Dinanibe, Guetwende Sawadogo, Chantal Kambire, Halima Mainassara, Ali Elhaj Mahamane, Baruani Bienvenu, Haladou Moussa, Rasmata Ouedraogo, Katya Fernandez, Muhamed-Kheir Taha and Olivier Ronveaux
Microorganisms 2021, 9(4), 832; https://doi.org/10.3390/microorganisms9040832 - 14 Apr 2021
Cited by 5 | Viewed by 2304
Abstract
New lateral flow tests for the diagnosis of Neisseria meningitidis (Nm) (serogroups A, C, W, X, and Y), MeningoSpeed, and Streptococcus pneumoniae (Sp), PneumoSpeed, developed to support rapid outbreak detection in Africa, have shown good performance under laboratory conditions. We conducted an independent [...] Read more.
New lateral flow tests for the diagnosis of Neisseria meningitidis (Nm) (serogroups A, C, W, X, and Y), MeningoSpeed, and Streptococcus pneumoniae (Sp), PneumoSpeed, developed to support rapid outbreak detection in Africa, have shown good performance under laboratory conditions. We conducted an independent evaluation of both tests under field conditions in Burkina Faso and Niger, in 2018–2019. The tests were performed in the cerebrospinal fluid of suspected meningitis cases from health centers in alert districts and compared to reverse transcription polymerase chain reaction tests performed at national reference laboratories (NRLs). Health staff were interviewed about feasibility. A total of 327 cases were tested at the NRLs, with 26% confirmed Nm (NmC 63% and NmX 37%) and 8% Sp. Sensitivity and specificity were, respectively, 95% (95% CI: 89–99) and 90% (95% CI: 86–94) for Nm and 92% (95% CI: 75–99) and 99% (95% CI: 97–100) for Sp. Positive and negative predictive values were, respectively, 77% (95% CI: 68–85) and 98% (95% CI: 95–100) for Nm and 86% (95% CI: 67–96) and 99% (95% CI: 98–100) for Sp. Concordance showed 82% agreement for Nm and 97% for Sp. Interviewed staff evaluated the tests as easy to use and to interpret and were confident in their readings. Results suggest overall good performance of both tests and potential usefulness in meningitis outbreak detection. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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28 pages, 1021 KiB  
Article
Global Landscape Review of Serotype-Specific Invasive Pneumococcal Disease Surveillance among Countries Using PCV10/13: The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) Project
by Maria Deloria Knoll, Julia C. Bennett, Maria Garcia Quesada, Eunice W. Kagucia, Meagan E. Peterson, Daniel R. Feikin, Adam L. Cohen, Marissa K. Hetrich, Yangyupei Yang, Jenna N. Sinkevitch, Krow Ampofo, Laurie Aukes, Sabrina Bacci, Godfrey Bigogo, Maria-Cristina C. Brandileone, Michael G. Bruce, Romina Camilli, Jesús Castilla, Guanhao Chan, Grettel Chanto Chacón, Pilar Ciruela, Heather Cook, Mary Corcoran, Ron Dagan, Kostas Danis, Sara de Miguel, Philippe De Wals, Stefanie Desmet, Yvonne Galloway, Theano Georgakopoulou, Laura L. Hammitt, Markus Hilty, Pak-Leung Ho, Sanjay Jayasinghe, James D. Kellner, Jackie Kleynhans, Mirjam J. Knol, Jana Kozakova, Karl Gústaf Kristinsson, Shamez N. Ladhani, Claudia S. Lara, Maria Eugenia León, Tiia Lepp, Grant A. Mackenzie, Lucia Mad’arová, Allison McGeer, Tuya Mungun, Jason M. Mwenda, J. Pekka Nuorti, Néhémie Nzoyikorera, Kazunori Oishi, Lucia Helena De Oliveira, Metka Paragi, Tamara Pilishvili, Rodrigo Puentes, Eric Rafai, Samir K. Saha, Larisa Savrasova, Camelia Savulescu, J. Anthony Scott, Kevin J. Scott, Fatima Serhan, Lena Petrova Setchanova, Nadja Sinkovec Zorko, Anna Skoczyńska, Todd D. Swarthout, Palle Valentiner-Branth, Mark van der Linden, Didrik F. Vestrheim, Anne von Gottberg, Inci Yildirim, Kyla Hayford and the PSERENADE Teamadd Show full author list remove Hide full author list
Microorganisms 2021, 9(4), 742; https://doi.org/10.3390/microorganisms9040742 - 02 Apr 2021
Cited by 27 | Viewed by 9272
Abstract
Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by [...] Read more.
Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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21 pages, 1356 KiB  
Article
Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10/13 Period: Findings from the PSERENADE Project
by Maria Garcia Quesada, Yangyupei Yang, Julia C. Bennett, Kyla Hayford, Scott L. Zeger, Daniel R. Feikin, Meagan E. Peterson, Adam L. Cohen, Samanta C. G. Almeida, Krow Ampofo, Michelle Ang, Naor Bar-Zeev, Michael G. Bruce, Romina Camilli, Grettel Chanto Chacón, Pilar Ciruela, Cheryl Cohen, Mary Corcoran, Ron Dagan, Philippe De Wals, Stefanie Desmet, Idrissa Diawara, Ryan Gierke, Marcela Guevara, Laura L. Hammitt, Markus Hilty, Pak-Leung Ho, Sanjay Jayasinghe, Jackie Kleynhans, Karl G. Kristinsson, Shamez N. Ladhani, Allison McGeer, Jason M. Mwenda, J. Pekka Nuorti, Kazunori Oishi, Leah J. Ricketson, Juan Carlos Sanz, Larisa Savrasova, Lena Petrova Setchanova, Andrew Smith, Palle Valentiner-Branth, Maria Teresa Valenzuela, Mark van der Linden, Nina M. van Sorge, Emmanuelle Varon, Brita A. Winje, Inci Yildirim, Jonathan Zintgraff, Maria Deloria Knoll and the PSERENADE Teamadd Show full author list remove Hide full author list
Microorganisms 2021, 9(4), 738; https://doi.org/10.3390/microorganisms9040738 - 01 Apr 2021
Cited by 31 | Viewed by 5765
Abstract
Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5–7 years with primary series uptake above 70%. The distribution [...] Read more.
Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5–7 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases <5 years of age and 15% among ≥5 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases <5 years and 37% ≥5 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in <5 and 26% in ≥5 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (≤26% across all ages) than pre-PCV (≥70% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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23 pages, 1767 KiB  
Article
Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project
by Julia C. Bennett, Marissa K. Hetrich, Maria Garcia Quesada, Jenna N. Sinkevitch, Maria Deloria Knoll, Daniel R. Feikin, Scott L. Zeger, Eunice W. Kagucia, Adam L. Cohen, Krow Ampofo, Maria-Cristina C. Brandileone, Dana Bruden, Romina Camilli, Jesús Castilla, Guanhao Chan, Heather Cook, Jennifer E. Cornick, Ron Dagan, Tine Dalby, Kostas Danis, Sara de Miguel, Philippe De Wals, Stefanie Desmet, Theano Georgakopoulou, Charlotte Gilkison, Marta Grgic-Vitek, Laura L. Hammitt, Markus Hilty, Pak-Leung Ho, Sanjay Jayasinghe, James D. Kellner, Jackie Kleynhans, Mirjam J. Knol, Jana Kozakova, Karl G. Kristinsson, Shamez N. Ladhani, Laura MacDonald, Grant A. Mackenzie, Lucia Mad’arová, Allison McGeer, Jolita Mereckiene, Eva Morfeldt, Tuya Mungun, Carmen Muñoz-Almagro, J. Pekka Nuorti, Metka Paragi, Tamara Pilishvili, Rodrigo Puentes, Samir K. Saha, Aalisha Sahu Khan, Larisa Savrasova, J. Anthony Scott, Anna Skoczyńska, Shigeru Suga, Mark van der Linden, Jennifer R. Verani, Anne von Gottberg, Brita A. Winje, Inci Yildirim, Khalid Zerouali, Kyla Hayford and the PSERENADE Teamadd Show full author list remove Hide full author list
Microorganisms 2021, 9(4), 696; https://doi.org/10.3390/microorganisms9040696 - 27 Mar 2021
Cited by 9 | Viewed by 6530
Abstract
Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally [...] Read more.
Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3 + 0 schedule constrains generalizability and data from these settings are needed. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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11 pages, 1143 KiB  
Article
The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital
by Timothy A. Erickson, Flor M. Munoz, Catherine L. Troisi, Melissa S. Nolan, Rodrigo Hasbun, Eric L. Brown and Kristy O. Murray
Microorganisms 2021, 9(3), 526; https://doi.org/10.3390/microorganisms9030526 - 04 Mar 2021
Cited by 10 | Viewed by 7156
Abstract
Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National [...] Read more.
Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis. Results: Among 694 infants with meningitis, the most common etiology was viral (n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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Graphical abstract

13 pages, 2217 KiB  
Article
Understanding the Role of Duration of Vaccine Protection with MenAfriVac: Simulating Alternative Vaccination Strategies
by Andromachi Karachaliou Prasinou, Andrew J. K. Conlan and Caroline L. Trotter
Microorganisms 2021, 9(2), 461; https://doi.org/10.3390/microorganisms9020461 - 23 Feb 2021
Cited by 2 | Viewed by 1963
Abstract
We previously developed a transmission dynamic model of Neisseria meningitidis serogroup A (NmA) with the aim of forecasting the relative benefits of different immunisation strategies with MenAfriVac. Our findings suggested that the most effective strategy in maintaining disease control was the introduction of [...] Read more.
We previously developed a transmission dynamic model of Neisseria meningitidis serogroup A (NmA) with the aim of forecasting the relative benefits of different immunisation strategies with MenAfriVac. Our findings suggested that the most effective strategy in maintaining disease control was the introduction of MenAfriVac into the Expanded Programme on Immunisation (EPI). This strategy is currently being followed by the countries of the meningitis belt. Since then, the persistence of vaccine-induced antibodies has been further studied and new data suggest that immune response is influenced by the age at vaccination. Here, we aim to investigate the influence of both the duration and age-specificity of vaccine-induced protection on our model predictions and explore how the optimal vaccination strategy may change in the long-term. We adapted our previous model and considered plausible alternative immunization strategies, including the addition of a booster dose to the current schedule, as well as the routine vaccination of school-aged children for a range of different assumptions regarding the duration of protection. To allow for a comparison between the different strategies, we use several metrics, including the median age of infection, the number of people needed to vaccinate (NNV) to prevent one case, the age distribution of cases for each strategy, as well as the time it takes for the number of cases to start increasing after the honeymoon period (resurgence). None of the strategies explored in this work is superior in all respects. This is especially true when vaccine-induced protection is the same regardless of the age at vaccination. Uncertainty in the duration of protection is important. For duration of protection lasting for an average of 18 years or longer, the model predicts elimination of NmA cases. Assuming that vaccine protection is more durable for individuals vaccinated after the age of 5 years, routine immunization of older children would be more efficient in reducing disease incidence and would also result in a fewer number of doses necessary to prevent one case. Assuming that elimination does not occur, adding a booster dose is likely to prevent most cases but the caveat will be a more costly intervention. These results can be used to understand important sources of uncertainty around MenAfriVac and support decisions by policymakers. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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16 pages, 2285 KiB  
Article
The Global Burden of Meningitis in Children: Challenges with Interpreting Global Health Estimates
by Claire Wright, Natacha Blake, Linda Glennie, Vinny Smith, Rose Bender, Hmwe Kyu, Han Yong Wunrow, Li Liu, Diana Yeung, Maria Deloria Knoll, Brian Wahl, James M. Stuart and Caroline Trotter
Microorganisms 2021, 9(2), 377; https://doi.org/10.3390/microorganisms9020377 - 13 Feb 2021
Cited by 22 | Viewed by 6390
Abstract
The World Health Organization (WHO) has developed a global roadmap to defeat meningitis by 2030. To advocate for and track progress of the roadmap, the burden of meningitis as a syndrome and by pathogen must be accurately defined. Three major global health models [...] Read more.
The World Health Organization (WHO) has developed a global roadmap to defeat meningitis by 2030. To advocate for and track progress of the roadmap, the burden of meningitis as a syndrome and by pathogen must be accurately defined. Three major global health models estimating meningitis mortality as a syndrome and/or by causative pathogen were identified and compared for the baseline year 2015. Two models, (1) the WHO and the Johns Hopkins Bloomberg School of Public Health’s Maternal and Child Epidemiology Estimation (MCEE) group’s Child Mortality Estimation (WHO-MCEE) and (2) the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease Study (GBD 2017), identified meningitis, encephalitis and neonatal sepsis, collectively, to be the second and third largest infectious killers of children under five years, respectively. Global meningitis/encephalitis and neonatal sepsis mortality estimates differed more substantially between models than mortality estimates for selected infectious causes of death and all causes of death combined. Estimates at national level and by pathogen also differed markedly between models. Aligning modelled estimates with additional data sources, such as national or sentinel surveillance, could more accurately define the global burden of meningitis and help track progress against the WHO roadmap. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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Review

Jump to: Editorial, Research

10 pages, 895 KiB  
Review
The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review
by Nicoline Schiess, Nora E. Groce and Tarun Dua
Microorganisms 2021, 9(5), 900; https://doi.org/10.3390/microorganisms9050900 - 22 Apr 2021
Cited by 25 | Viewed by 4277
Abstract
The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with over 2.5 million new cases of [...] Read more.
The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with over 2.5 million new cases of bacterial meningitis and over 236,000 deaths worldwide in 2019 alone. Up to 30% of survivors have some type of neurological or neuro-behavioural sequelae. These include seizures, hearing and vision loss, cognitive impairment, neuromotor disability and memory or behaviour changes. Few studies have documented the long-term (greater than five years) consequences or have parsed out whether the age at time of meningitis contributes to poor outcome. Knowledge of the socioeconomic impact and demand for medical follow-up services among these patients and their caregivers is also lacking, especially in low- and middle-income countries (LMICs). Within resource-limited settings, the costs incurred by patients and their families can be very high. This review summarises the available evidence to better understand the impact and burden of the neurological sequelae and disabling consequences of bacterial meningitis, with particular focus on identifying existing gaps in LMICs. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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15 pages, 352 KiB  
Review
Long Term Impact of Conjugate Vaccines on Haemophilus influenzae Meningitis: Narrative Review
by Mary Paulina Elizabeth Slack
Microorganisms 2021, 9(5), 886; https://doi.org/10.3390/microorganisms9050886 - 21 Apr 2021
Cited by 14 | Viewed by 2639
Abstract
H. influenzae serotype b (Hib) used to be the commonest cause of bacterial meningitis in young children. The widespread use of Hib conjugate vaccine has profoundly altered the epidemiology of H. influenzae meningitis. This short review reports on the spectrum of H. influenzae [...] Read more.
H. influenzae serotype b (Hib) used to be the commonest cause of bacterial meningitis in young children. The widespread use of Hib conjugate vaccine has profoundly altered the epidemiology of H. influenzae meningitis. This short review reports on the spectrum of H. influenzae meningitis thirty years after Hib conjugate vaccine was first introduced into a National Immunization Program (NIP). Hib meningitis is now uncommon, but meningitis caused by other capsulated serotypes of H. influenzae and non-typeable strains (NTHi) should be considered. H. influenzae serotype a (Hia) has emerged as a significant cause of meningitis in Indigenous children in North America, which may necessitate a Hia conjugate vaccine. Cases of Hie, Hif, and NTHi meningitis are predominantly seen in young children and less common in older age groups. This short review reports on the spectrum of H. influenzae meningitis thirty years after Hib conjugate vaccine was first introduced into a NIP. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
18 pages, 306 KiB  
Review
Defeating Paediatric Tuberculous Meningitis: Applying the WHO “Defeating Meningitis by 2030: Global Roadmap”
by Robindra Basu Roy, Sabrina Bakeera-Kitaka, Chishala Chabala, Diana M Gibb, Julie Huynh, Hilda Mujuru, Naveen Sankhyan, James A Seddon, Suvasini Sharma, Varinder Singh, Eric Wobudeya and Suzanne T Anderson
Microorganisms 2021, 9(4), 857; https://doi.org/10.3390/microorganisms9040857 - 16 Apr 2021
Cited by 12 | Viewed by 3242
Abstract
Children affected by tuberculous meningitis (TBM), as well as their families, have needs that lie at the intersections between the tuberculosis and meningitis clinical, research, and policy spheres. There is therefore a substantial risk that these needs are not fully met by either [...] Read more.
Children affected by tuberculous meningitis (TBM), as well as their families, have needs that lie at the intersections between the tuberculosis and meningitis clinical, research, and policy spheres. There is therefore a substantial risk that these needs are not fully met by either programme. In this narrative review article, we use the World Health Organization (WHO) “Defeating Meningitis by 2030: global roadmap” as a starting point to consider key goals and activities to specifically defeat TBM in children. We apply the five pillars outlined in the roadmap to describe how this approach can be adapted to serve children affected by TBM. The pillars are (i) prevention; (ii) diagnosis and treatment; (iii) surveillance; (iv) support and care for people affected by meningitis; and (v) advocacy and engagement. We conclude by calling for greater integration between meningitis and TB programmes at WHO and at national levels. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
20 pages, 341 KiB  
Review
Vaccines to Prevent Meningitis: Historical Perspectives and Future Directions
by Mark R. Alderson, Jo Anne Welsch, Katie Regan, Lauren Newhouse, Niranjan Bhat and Anthony A. Marfin
Microorganisms 2021, 9(4), 771; https://doi.org/10.3390/microorganisms9040771 - 07 Apr 2021
Cited by 7 | Viewed by 3768
Abstract
Despite advances in the development and introduction of vaccines against the major bacterial causes of meningitis, the disease and its long-term after-effects remain a problem globally. The Global Roadmap to Defeat Meningitis by 2030 aims to accelerate progress through visionary and strategic goals [...] Read more.
Despite advances in the development and introduction of vaccines against the major bacterial causes of meningitis, the disease and its long-term after-effects remain a problem globally. The Global Roadmap to Defeat Meningitis by 2030 aims to accelerate progress through visionary and strategic goals that place a major emphasis on preventing meningitis via vaccination. Global vaccination against Haemophilus influenzae type B (Hib) is the most advanced, such that successful and low-cost combination vaccines incorporating Hib are broadly available. More affordable pneumococcal conjugate vaccines are becoming increasingly available, although countries ineligible for donor support still face access challenges and global serotype coverage is incomplete with existing licensed vaccines. Meningococcal disease control in Africa has progressed with the successful deployment of a low-cost serogroup A conjugate vaccine, but other serogroups still cause outbreaks in regions of the world where broadly protective and affordable vaccines have not been introduced into routine immunization programs. Progress has lagged for prevention of neonatal meningitis and although maternal vaccination against the leading cause, group B streptococcus (GBS), has progressed into clinical trials, no GBS vaccine has thus far reached Phase 3 evaluation. This article examines current and future efforts to control meningitis through vaccination. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
12 pages, 625 KiB  
Review
Bacterial Meningitis in Children: Neurological Complications, Associated Risk Factors, and Prevention
by Abdulwahed Zainel, Hana Mitchell and Manish Sadarangani
Microorganisms 2021, 9(3), 535; https://doi.org/10.3390/microorganisms9030535 - 05 Mar 2021
Cited by 39 | Viewed by 18971
Abstract
Bacterial meningitis is a devastating infection, with a case fatality rate of up to 30% and 50% of survivors developing neurological complications. These include short-term complications such as focal neurological deficit and subdural effusion, and long-term complications such as hearing loss, seizures, cognitive [...] Read more.
Bacterial meningitis is a devastating infection, with a case fatality rate of up to 30% and 50% of survivors developing neurological complications. These include short-term complications such as focal neurological deficit and subdural effusion, and long-term complications such as hearing loss, seizures, cognitive impairment and hydrocephalus. Complications develop due to bacterial toxin release and the host immune response, which lead to neuronal damage. Factors associated with increased risk of developing neurological complications include young age, delayed presentation and Streptococcus pneumoniae as an etiologic agent. Vaccination is the primary method of preventing bacterial meningitis and therefore its complications. There are three vaccine preventable causes: Haemophilus influenzae type b (Hib), S. pneumoniae, and Neisseria meningitidis. Starting antibiotics without delay is also critical to reduce the risk of neurological complications. Additionally, early adjuvant corticosteroid use in Hib meningitis reduces the risk of hearing loss and severe neurological complications. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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16 pages, 1129 KiB  
Review
A Narrative Review of the W, X, Y, E, and NG of Meningococcal Disease: Emerging Capsular Groups, Pathotypes, and Global Control
by Yih-Ling Tzeng and David S. Stephens
Microorganisms 2021, 9(3), 519; https://doi.org/10.3390/microorganisms9030519 - 03 Mar 2021
Cited by 19 | Viewed by 3620
Abstract
Neisseria meningitidis, carried in the human nasopharynx asymptomatically by ~10% of the population, remains a leading cause of meningitis and rapidly fatal sepsis, usually in otherwise healthy individuals. The epidemiology of invasive meningococcal disease (IMD) varies substantially by geography and over time [...] Read more.
Neisseria meningitidis, carried in the human nasopharynx asymptomatically by ~10% of the population, remains a leading cause of meningitis and rapidly fatal sepsis, usually in otherwise healthy individuals. The epidemiology of invasive meningococcal disease (IMD) varies substantially by geography and over time and is now influenced by meningococcal vaccines and in 2020–2021 by COVID-19 pandemic containment measures. While 12 capsular groups, defined by capsular polysaccharide structures, can be expressed by N. meningitidis, groups A, B, and C historically caused most IMD. However, the use of mono-, bi-, and quadrivalent-polysaccharide-conjugate vaccines, the introduction of protein-based vaccines for group B, natural disease fluctuations, new drugs (e.g., eculizumab) that increase meningococcal susceptibility, changing transmission dynamics and meningococcal evolution are impacting the incidence of the capsular groups causing IMD. While the ability to spread and cause illness vary considerably, capsular groups W, X, and Y now cause significant IMD. In addition, group E and nongroupable meningococci have appeared as a cause of invasive disease, and a nongroupable N. meningitidis pathotype of the hypervirulent clonal complex 11 is causing sexually transmitted urethritis cases and outbreaks. Carriage and IMD of the previously “minor” N. meningitidis are reviewed and the need for polyvalent meningococcal vaccines emphasized. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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17 pages, 338 KiB  
Review
Invasive Bacterial Infections in Subjects with Genetic and Acquired Susceptibility and Impacts on Recommendations for Vaccination: A Narrative Review
by Ala-Eddine Deghmane and Muhamed-Kheir Taha
Microorganisms 2021, 9(3), 467; https://doi.org/10.3390/microorganisms9030467 - 24 Feb 2021
Cited by 5 | Viewed by 2616
Abstract
The WHO recently endorsed an ambitious plan, “Defeating Meningitis by 2030”, that aims to control/eradicate invasive bacterial infection epidemics by 2030. Vaccination is one of the pillars of this road map, with the goal to reduce the number of cases and deaths due [...] Read more.
The WHO recently endorsed an ambitious plan, “Defeating Meningitis by 2030”, that aims to control/eradicate invasive bacterial infection epidemics by 2030. Vaccination is one of the pillars of this road map, with the goal to reduce the number of cases and deaths due to Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus agalactiae. The risk of developing invasive bacterial infections (IBI) due to these bacterial species includes genetic and acquired factors that favor repeated and/or severe invasive infections. We searched the PubMed database to identify host risk factors that increase the susceptibility to these bacterial species. Here, we describe a number of inherited and acquired risk factors associated with increased susceptibility to invasive bacterial infections. The burden of these factors is expected to increase due to the anticipated decrease in cases in the general population upon the implementation of vaccination strategies. Therefore, detection and exploration of these patients are important as vaccination may differ among subjects with these risk factors and specific strategies for vaccination are required. The aim of this narrative review is to provide information about these factors as well as their impact on vaccination against the four bacterial species. Awareness of risk factors for IBI may facilitate early recognition and treatment of the disease. Preventive measures including vaccination, when available, in individuals with increased risk for IBI may prevent and reduce the number of cases. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
19 pages, 781 KiB  
Review
A Narrative Review of the Molecular Epidemiology and Laboratory Surveillance of Vaccine Preventable Bacterial Meningitis Agents: Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae and Streptococcus agalactiae
by Raymond S. W. Tsang
Microorganisms 2021, 9(2), 449; https://doi.org/10.3390/microorganisms9020449 - 22 Feb 2021
Cited by 15 | Viewed by 4417
Abstract
This narrative review describes the public health importance of four most common bacterial meningitis agents, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and S. agalactiae (group B Streptococcus). Three of them are strict human pathogens that normally colonize the nasopharynx [...] Read more.
This narrative review describes the public health importance of four most common bacterial meningitis agents, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and S. agalactiae (group B Streptococcus). Three of them are strict human pathogens that normally colonize the nasopharynx and may invade the blood stream to cause systemic infections and meningitis. S. agalactiae colonizes the genito-gastrointestinal tract and is an important meningitis agent in newborns, but also causes invasive infections in infants or adults. These four bacteria have polysaccharide capsules that protect them against the host complement defense. Currently licensed conjugate vaccines (against S. pneumoniae, H. influenza, and N. meningitidis only but not S. agalactiae) can induce protective serum antibodies in infants as young as two months old offering protection to the most vulnerable groups, and the ability to eliminate carriage of homologous serotype strains in vaccinated subjects lending further protection to those not vaccinated through herd immunity. However, the serotype-specific nature of these vaccines have driven the bacteria to adapt by mechanisms that affect the capsule antigens through either capsule switching or capsule replacement in addition to the possibility of unmasking of strains or serotypes not covered by the vaccines. The post-vaccine molecular epidemiology of vaccine-preventable bacterial meningitis is discussed based on findings obtained with newer genomic laboratory surveillance methods. Full article
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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