title: Epidemiologic pattern of meningococcal meningitis in northern Cameroon in 2007-2010: contribution of PCR-enhanced surveillance.
abstract: OBJECTIVE
  Monitoring acute bacterial meningitis in northern Cameroon.
  
  
  METHODS
  Health professionals collected cerebrospinal fluid (CSF) specimens from patients presenting with clinical symptoms of meningitis. Specimens were tested using gram stain, latex agglutination  test, and culture. A PCR assay completed the diagnostic testing. Multilocus sequence typing (MLST) was performed on some Neisseria meningitidis (Nm) isolates.
  
  
  RESULTS
  From 2007 through 2010, of the 1429 CSF specimens tested, 292 (20·4%) were positive, either for Nm  (205), Streptococcus pneumoniae (Sp) (57), or Haemophilus influenzae (Hi) (30). From 2007 through 2009, the serogroup W135 represented 98·8% of 164 case isolates. Until 2008, most serogroup W135 isolates presented the sequence-type ST-2881 usually associated with sporadic  cases. Since 2009, the ST-11 (an epidemic-associated clone) became predominant, although no epidemic occurred. Serogroup A ST-7 was observed in 2010 and caused a localized epidemic. Using the detection PCR on turbid CSF, a 2·7-fold increase in cases with etiologic diagnosis was obtained,  compared to culture. All tested meningococcal isolates (42) were susceptible to ampicillin, chloramphenicol, and cefotaxim.
  
  
  CONCLUSIONS
  Resurgence of serogroup A and recent increase in ST-11 among serogroup W135 isolates were worrying when considered with the epidemic wave of serogroup  A meningitis, which affected neighboring countries and the serogroup W135 epidemic in Niger in 2009-2010.
authors: Centre Pasteur of Cameroon-Annexe of Garoua/Réseau International des Instituts Pasteur, Garoua, Cameroon. denis.massenet@yahoo.fr
authors: Denis
authors: D
authors: Massenet
authors: Jacques
authors: J
authors: Birguel
authors: François
authors: F
authors: Azowé
authors: Clifford
authors: C
authors: Ebong
authors: Bouba
authors: B
authors: Gake
authors: Jean-Pierre
authors: JP
authors: Lombart
authors: Pascal
authors: P
authors: Boisier
mesh_terms: D015373:Bacterial Typing Techniques; D002163:Cameroon / Q000453:epidemiology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D006801:Humans; D008585:Meningitis, Meningococcal / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D018571:Sentinel Surveillance