title: Mobile microbiological laboratory support for evaluation of a meningitis epidemic in Northern Benin.
abstract: BACKGROUND
  Fixed laboratory capacity in Africa may be inadequate; mobile microbiological laboratories may address this issue but their utility has seldom been evaluated.
  
  
  METHODS
  During 2012, the Benin Ministry of Health requested mobile microbiological laboratory (LaboMobil®) support following the failure of polysaccharide meningococcal A+C vaccine to prevent an epidemic in five Northern districts. Within four days, the intervention was initiated. A fixed site in Northern Togo, Pasteur Institutes in Côte d'Ivoire and France, and a research laboratory in Burkina Faso provided additional laboratory support.
  
  
  RESULTS
  Local laboratories initially reported most cases to have Gram-positive diplococci suggestive of pneumococcal meningitis. The LaboMobil® evaluated 200 cerebrospinal fluid (CSF) samples and 59 stored isolates collected from 149 individuals. Of the 74 individuals with etiologic confirmation, 60 (81%) had NmW135 and 11 (15%) NmX identified; no pneumococci were identified. Testing in France on 30 NmW135 and 3 NmX confirmed the etiology in all cases. All five districts had crossed the epidemic threshold (10 cases per 100,000 per week), all had NmW135 identified and four had NmX identified. NmX were identified as X:ST-181:ccST-181:5-1:10-1:F1-31 and NmW135 as W:ST-11: ccST-11:5:2:F1-1.
  
  
  CONCLUSIONS
  In an area with limited local laboratory capacity, a mobile microbiology laboratory intervention occurred in four days through the cooperation of four African and one European country. Results were different from those reported by local laboratories. Despite the introduction of serogroup A meningococcal and 13-valent pneumococcal conjugate vaccines, endemic and epidemic meningitis will continue in the region, emphasizing the usefulness of the LaboMobil® in the short and medium term.
authors.affiliation: Agence de Médecine Préventive, Paris, France.
authors.forename: Berthe-Marie
authors.initials: BM
authors.lastname: Njanpop-Lafourcade
authors.forename: Stéphane
authors.initials: S
authors.lastname: Hugonnet
authors.forename: Honoré
authors.initials: H
authors.lastname: Djogbe
authors.forename: Agbenoko
authors.initials: A
authors.lastname: Kodjo
authors.forename: Adèle Kacou
authors.initials: AK
authors.lastname: N'douba
authors.forename: Muhamed-Kheir
authors.initials: MK
authors.lastname: Taha
authors.forename: Philippe
authors.initials: P
authors.lastname: Stoeckel
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
mesh_terms: D001541:Benin / Q000453:epidemiology; D002050:Burkina Faso; D064790:Clinical Laboratory Services; D007560:Cote d'Ivoire; D058872:Epidemics / Q000517:prevention & control*; D005602:France; D006801:Humans; D007391:International Cooperation; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology; D022401:Meningococcal Vaccines / Q000276:immunology; D018986:Motor Vehicles; D009345:Neisseria meningitidis / Q000145:classification / Q000276:immunology; D011634:Public Health / Q000379:methods; D015203:Reproducibility of Results; D012703:Serotyping; D013997:Time Factors; D014037:Togo
chemical_list: D022401:Meningococcal Vaccines