Meningoencefalitis bacterianas en Cuba

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Abstract

Se describieron algunos aspectos epidemiológicos de las meningoencefalitis bacterianas (MEB) en Cuba entre 1993 y 1998 según datos disponibles en el registro de enfermedades de Declaración Obligatoria del Ministerio de Salud Pública. Fueron reportados 8 348 casos en todo el país durante el período, con un promedio anual de 1 391. Las MEB ocurrieron mayormente en los menores que 5 años (40,8 %). Los agentes más frecuentemente identificados fueron H. Influenzae (9 %) y S. pneumoniae (7 %). Los agentes no identificados constituyeron el 75 % de todas las MEB con la mayor incidencia anual (12,3 casos por 100 000 hab.). Para H. Influenzae y S. pneumoniae la incidencia fluctuó entre 0,2-1,5 casos/100 000 hab. con una tendencia al incremento. Concluimos que los principales agentes causales de MEB fueron: H. Influenzae y S. pneumoniae, especialmente en menores que 5 años, pero aún existe una alta frecuencia de agentes sin identificar. Futuros estudios permitirán profundizar en la epidemiología de estas infecciones.

Translated abstract

Some epidemiological aspects of bacterial meningoencephalitis (BME) in Cuba from 1993 to 1998 were described according to the data available in the Registry of Diseases of Compulsory Declaration of the Ministry of Public Health. 8 348 cases were reported all over the country in this period with an annual average of 1 391. BME occurred mostly in children under 5 (40.8 %). The most frequently identified agents were H. Influenzae (9 %) and S. pneumoniae (7 %). The non-identified agents accounted for 75 % of all BME with the highest annual incidence (12.3 cases per l00 000 inhabitants). For H. Influenzae and S. pneumoniae the incidence ranged between 0.2 and 1.5 per 100 000 inhabitants with a trend to increase. It was concluded that the main causal agents of BME were H. Influenzae and S. pneumoniae, specially in children under 5, and that there is still a high number of agents that have not been identified. Future studies will allow to go deep into the epidemiology of these infections.

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Most cited references 34

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Bacterial meningitis in the United States in 1995. Active Surveillance Team.

Anne Schuchat, Katherine Robinson, Jay Wenger … (1997)

Before the introduction of the conjugate vaccines, Haemophilus influenzae type b was the major cause of bacterial meningitis in the United States, and meningitis was primarily a disease of infants and young children. We describe the epidemiologic features of bacterial meningitis five years after the H. influenzae type b conjugate vaccines were licensed for routine immunization of infants. Data were collected from active, population-based surveillance for culture-confirmed meningitis and other invasive bacterial disease during 1995 in laboratories serving all the acute care hospitals in 22 counties of four states (total population, more than 10 million). The rates were compared with those for 1986 obtained by similar surveillance. On the basis of 248 cases of bacterial meningitis in the surveillance areas, the rates of meningitis (per 100,000) for the major pathogens in 1995 were Streptococcus pneumoniae, 1.1; Neisseria meningitidis, 0.6; group B streptococcus, 0.3; Listeria monocytogenes, 0.2; and H. influenzae, 0.2. Group B streptococcus was the predominant pathogen among newborns, N. meningitidis among children 2 to 18 years old, and S. pneumoniae among adults. Pneumococcal meningitis had the highest case fatality rate (21 percent) and in 36 percent of cases was caused by organisms that were not susceptible to penicillin. From these data, we estimate that 5755 cases of bacterial meningitis were caused by these five pathogens in the United States in 1995, as compared with 12,920 cases in 1986, a reduction of 55 percent. The median age of persons with bacterial meningitis increased greatly, from 15 months in 1986 to 25 years in 1995, largely as a result of a 94 percent reduction in the number of cases of H. influenzae meningitis. Because of the vaccine-related decline in meningitis due to H. influenzae type b, bacterial meningitis in the United States is now a disease predominantly of adults rather than of infants and young children.

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Haemophilus influenzae invasive disease in the United States, 1994-1995: near disappearance of a vaccine-preventable childhood disease.

K M Bisgard, A. Kao, J Leake … (1998)

We analyzed national Haemophilus influenzae (Hi) surveillance data from 1994 and 1995 to describe the epidemiology of Hi invasive disease among persons of all ages. Serotype data were available for 376 (56%) of 669 reported Hi cases among children aged 4 years or younger; 184 (49%) were H. influenzae type b (Hib). Among children aged 4 or younger, incidence (per 100,000) of all Hi invasive disease was 1.8 in 1994 and 1.6 (p < 0.05) in 1995. Children aged 5 months or younger had the highest average annual incidence rate of Hib invasive disease (2.2 per 100,000); children aged 6 to 11 months had the next highest rate (1.2 per 100,000)(p < 0.05). Of 181 children with Hib invasive disease whose age in months was known, 85 (47%) were too young (aged 5 months or younger) to have completed a primary series with an Hib-containing vaccine. Of the 83 children with known vaccination status who were eligible to receive a primary series (aged 6 months or older), 52 (63%) were undervaccinated, and the remaining 31 (37%) had completed a primary series in which vaccine failed. Among persons aged 5 years or older with Hi invasive disease, the lowest average annual incidence was among those 20 to 39 years of age (0.15 per 100,000), and the highest was among those aged 80 years or older (2.26 per 100,000). Among persons aged 5 years or older, serotype data were available for 1,372 (71%) of the 1,940 Hi invasive disease cases; 159 (28%) of the 568 Hi cases with known serotype were due to Hib.

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The Epidemiological Impact of Antimeningococcal B Vaccination in Cuba

Antonio Rodríguez, Félix Dickinson, Alberto Baly … (1999)

The incidence of invasive meningococcal disease (IMD) before (1984-1988) and after (1989-1994), a nationwide intervention with VA-MENGOC-BC vaccination started in 1989, was compared. The prevaccination period incidence density (ID> 8.8/ 105 year-person) was higher than the postvaccination ID (ID< 6.5/ 105 year-person). The percentage proportional differences from the start to the end of each period of ID in the vaccinal period was higher (87%) than the prevaccinal (37%) with significant differences among vaccinated groups (< 25 years old). A break-point (Chow test) was confirmed by the decrease in the ID between 1989 and 1990 in children under 1 year old, 5-9, 10-14, 15-19 and 50-54 years. Comparison of ID using maps showed a decrease in IMD in all municipalities during the postvaccination period. These findings support the epidemiological impact of VA-MENGOC-BC vaccination in the reduction of IMD morbidity.

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Author and article information

Contributors

Félix Orlando Dickinson Meneses: Role: ND

Antonio Esteban Pérez Rodríguez: Role: ND

Journal

Journal ID (publisher): hie

Title: Revista Cubana de Higiene y Epidemiología

Abbreviated Title: Rev Cubana Hig Epidemiol

Publisher: Editorial Ciencias Médicas (Ciudad de la Habana )

ISSN: 1561-3003

Publication date (Print): August 2001

Volume: 39

Issue: 2

Pages: 86-94

Affiliations

[1 ] Universidade Estadual de Maringá Brazil

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Publisher ID: S1561-30032001000200003

SO-VID: a8fc5e4c-d318-47d9-8457-5bb7aa41297c

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http://creativecommons.org/licenses/by/4.0/

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SciELO Cuba

Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1561-3003&lng=en

Meningoencefalitis bacterianas en Cuba

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Most cited references 34

Bacterial meningitis in the United States in 1995. Active Surveillance Team.

Haemophilus influenzae invasive disease in the United States, 1994-1995: near disappearance of a vaccine-preventable childhood disease.

The Epidemiological Impact of Antimeningococcal B Vaccination in Cuba

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