{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:38:58Z","timestamp":1780619938102,"version":"3.54.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Acute bacterial meningitis remains a major cause of childhood mortality in sub-Saharan Africa. We document findings from hospital-based sentinel surveillance of bacterial meningitis among children &lt;5 years of age in The Gambia, from 2010 to 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cerebrospinal fluid (CSF) was collected from children admitted to the Edward Francis Small Teaching Hospital with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae was performed by microbiological culture and\/or polymerase chain reaction where possible. Whole genome sequencing was performed on pneumococcal isolates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 438 children were admitted with suspected meningitis during the surveillance period. The median age of the patients was 13 (interquartile range, 3\u201330) months. Bacterial meningitis was confirmed in 21.4% (69\/323) of all CSF samples analyzed. Pneumococcus, meningococcus, and H. influenzae accounted for 52.2%, 31.9%, and 16.0% of confirmed cases, respectively. There was a significant reduction of pneumococcal conjugate vaccine (PCV) serotypes, from 44.4% in 2011 to 0.0% in 2014, 5 years after PCV implementation. The majority of serotyped meningococcus and H. influenzae belonged to meningococcus serogroup W (45.5%) and H. influenzae type b (54.5%), respectively. Meningitis pathogens were more frequently isolated during the dry dusty season of the year. Reduced susceptibility to tetracycline, trimethoprim-sulfamethoxazole, and chloramphenicol was observed. No resistance to penicillin was found.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The proportion of meningitis cases due to pneumococcus declined in the post-PCV era. However, the persistence of vaccine-preventable meningitis in children aged &lt;5 years is a major concern and demonstrates the need for sustained high-quality surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz505","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T03:13:27Z","timestamp":1565147607000},"page":"S126-S132","source":"Crossref","is-referenced-by-count":11,"title":["Declining Trends of Pneumococcal Meningitis in Gambian Children After the Introduction of Pneumococcal Conjugate Vaccines"],"prefix":"10.1093","volume":"69","author":[{"given":"Bakary","family":"Sanneh","sequence":"first","affiliation":[{"name":"National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Okoi","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Collaborating Center for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul"},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Grey-Johnson","sequence":"additional","affiliation":[{"name":"Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haddy","family":"Bah-Camara","sequence":"additional","affiliation":[{"name":"National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu"},{"name":"Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baba","family":"Kunta Fofana","sequence":"additional","affiliation":[{"name":"National Public Health Laboratories, Ministry of Health and Social Welfare, 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Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadou","family":"Samateh","sequence":"additional","affiliation":[{"name":"National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu"},{"name":"Edward Francis Small Teaching Hospital, Ministry of Health and Social Welfare, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Effua","family":"Usuf","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Collaborating Center for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Sylvanus","family":"Ndow","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Collaborating Center for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madikay","family":"Senghore","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Collaborating Center for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archibald","family":"Worwui","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Collaborating Center for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, Banjul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M","family":"Mwenda","sequence":"additional","affiliation":[{"name":"Immunization, Vaccines and Development, WHO Regional Office for Africa, Brazzaville, Republic of 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