[Comparative study of neonatal bacterial meningitis in Lomé, Bobo-Dioulasso, Casablanca and Lyon].
Bacterial meningitis in new-borns remains a serious event because of its high mortality and morbidity rates in Africa.


OBJECTIVE
To identify the clinical and bacteriological epidemiology and the outcome of neonatal bacterial meningitis in three African cities.


METHODS
We have analysed and compared three hospital studies done in humid tropical, Sahelian, and desert Africa with a European study.


RESULTS
Compared with the European study this African study is characterized by a high mean frequency of neonatal meningitis (6 cases per year against 1.4), more important risk factors linked to pregnancy and childbirth (50% against 33%), high rates of death (61 to 68% against 5%) and sequelae (25 to 40% against 30%), rarity of Streptococcus agalactiae (7 to 15% against 38%) and absence of Listeria. Enterobacteriaceae were predominant both in African (50 to 68%) and European (43%) studies. E. coli appeared as the most frequent germ in both European and African studies and Salmonella as more frequent in Sub-Saharan Africa than in occidental countries.


CONCLUSIONS
The epidemiological, bacteriological and evolutional aspects of the neonatal meningitis were identical in the three African cities. The African studies were different from the European only by their high incidence, the rarity of S. agalactiae and Listeria and the difficulties of bacterial diagnosis and management, all might explain the high rates of death and sequelae. An epidemiological survey and adequate antimicrobial therapy according to antibiotic susceptibility may improve the outcome.
Balaka
B
B
Service de pédiatrie, CHU de Lomé, Togo. agbere_abdou@hotmail.com
Bonkoungou
P
P
Sqalli
M
M
Bambara
M
M
Millogo
A
A
Agbèrè
A D
AD
D002050:Burkina Faso / Q000453:epidemiology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003889:Desert Climate; D024881:Drug Resistance, Bacterial; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D009017:Morbidity; D009018:Morocco / Q000453:epidemiology; D011159:Population Surveillance; D011379:Prognosis; D012307:Risk Factors; D014037:Togo / Q000453:epidemiology; D016896:Treatment Outcome; D014330:Tropical Medicine; D014504:Urban Health / Q000706:statistics & numerical data