Bacterial Meningitis in the Paediatric Emergency Department of CHU Gabriel Touré

Introduction: In Mali, despite the introduction of several vaccines as part of the Expanded Programme on Immunisation, hospitalisations for bacterial meningitis in our department remain frequent. The aim of our work was to study the epidemiological and clinical profile of bacterial meningitis in the paediatric emergency department of the CHU-GT. Patients and Method: We conducted a prospective, cross-sectional, descriptive study over two years (June 1, 2020 to May 31, 2022) of children aged 1 month to 15 years hospitalised in the paediatric emergency department of CHU Gabriel Touré for bacterial meningitis confirmed by bacteriology and/ or cytology. Results: The hospital incidence rate was 4.5%. The 1 to 12 months age group was the most represented (45%), with a predominance of males (sex ratio 1.6). We found that 18.3% of our sample had not received any vaccine. Seizures occurred in 92.2% of patients. These were generalised in 66.9% and focal in 33.1%. A pleicytosis greater than 100 leukocytes/mm3 was noted in 85.6%. The most frequent germs were Streptococcus pneumoniae (25.6%) and Haemophilus influenzae b (14.4%). The case fatality rate was 27.2%, with Streptococcus pneumoniae the most lethal germ (30.4%). The clinical sequelae were axial hypotonia (54.6%) and hydrocephalus (20.5%). Conclusion: Despite vaccination efforts, streptococcus pneumoniae remains the most common bacterial meningitis germ and the most lethal in children.