Pneumococci in the African meningitis belt: meningitis incidence and carriage prevalence in children and adults.

Abstract

BackgroundThe development of optimal vaccination strategies for pneumococcal conjugate vaccines requires serotype-specific data on disease incidence and carriage prevalence. This information is lacking for the African meningitis belt.MethodsWe conducted hospital-based surveillance of acute bacterial meningitis in an urban and rural population of Burkina Faso during 2007-09. Cerebrospinal fluid was evaluated by polymerase chain reaction for species and serotype. In 2008, nasopharyngeal swabs were obtained from a representative population sample (1 month to 39 years; N = 519) and additional oropharyngeal swabs from 145 participants. Swabs were evaluated by culture.ResultsAnnual pneumococcal meningitis incidence rates were highest among ConclusionsSerotype 1 causes the majority of cases with a relatively constant age-specific incidence. Pneumococcal carriage is common in all age groups including adults. Vaccination programs in this region may need to include older target age groups for optimal impact on disease burden.