Epidemiological, clinical and biological profile of meningitis in Settat province-Morocco, 2008-2018.

  • Vaccine preventable diseases
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Background:
Meningitis disease is a serious illness that causes ~1.2 million cases of meningitis Worldwide. In Morocco, meningitis occurs in sporadic, endemic or epidemic status. The national incidence of all types of meningitis was 2.85/100,000 inhabitants in 2016, and the incidence of meningococcal meningitis was 1.8/100,000 inhabitants. The objective of this study is to describe the epidemiological, clinical and biological profile of meningitis in the province of Settat between 2008-2018.

Methods:
We performed a descriptive analysis of a case series of all forms of meningitis reported by the provincial epidemiological surveillance system for meningitis between 2008 and 2018. We reviewed the reports of meningitis cases reported by attending physicians and the laboratory‘s registry of meningitis cases. The laboratory reported all the results of analysis of patients suspected of meningitis who have undergone a lumbar puncture. Data analysis was performed by Epi-Info 7 at a 95% confidence level.

Results:
A total of 403 cases were analyzed. The median age was 6.5 years, with an interquartile range [2-18]. The 5-15years age group was the most affected, accounting for 29% of age groups. These age ranges: under 3 months, 3 months-2 years, 2-5 years, 15-40 years and 40-65 years are represented respectively: 9.75%, 14.75%, 16.50%, 19.50%, 10.50%. The sex ratio M/F was 1.6: 1. Meningococcal meningitis accounted for 48% of cases. The average annual number of cases was 36.63 with a stable overall temporal trend. The incidence rate of all forms of meningitis was 6 per 100,000 populations. We observed seasonal variability in the distribution of meningitis cases. The main clinical signs in our series are fever (94.30%), vomiting (79%), headache (70.35%) and seizures (29%), neck stiffness (77%). A purpura is found in 14% of cases. The biological confirmation rate was 29% including Neisseria meningitidis (10%), Streptococcus pneumoniae (15%) and Haemophilus influenzae (1%). Case Fatality Ratio was 10.42%.

Conclusion:
The high incidence of meningitis in Settat suggests population immunization is either not done or not preventing transmission to unvaccinated persons. These findings highlight the importance of strengthening provincial surveillance and building sustained laboratory diagnostic capacity for with a biological confirmation.

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