{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:13:49Z","timestamp":1774548829104,"version":"3.50.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["14-202"],"award-info":[{"award-number":["14-202"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["19-307"],"award-info":[{"award-number":["19-307"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Acute bacterial meningitis (ABM) is a serious health issue in Yemen where civil war, which continues unabated, has crippled the healthcare system. We conducted a nationwide retrospective observational study in Yemeni sentinel hospitals to identify the prevalence, aetiology, vaccination coverage and spatio-temporal pattern of ABM in children aged &amp;lt;5\u2009years before and during the civil war, 2014\u201320.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cerebrospinal fluid samples were collected from hospitalized children and were analysed macroscopically for appearance and microscopically by Gram stain and white blood cell count. Culture and latex agglutination tests were performed. Data on the prevalence of and vaccination coverage for ABM were obtained from the Ministry of Health. Joinpoint regression was used to assess the annual percent change (APC) of ABM prevalence and vaccination coverage. Pearson's correlation was used to evaluate the association between ABM prevalence and vaccination coverage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 11\u00a0339 hospitalized children had suspected cases of ABM (prevalence, 40.07\/100\u00a0000 of the whole Yemeni population) and 2.6% (293\/11\u00a0339) of suspected ABM cases were confirmed (prevalence, 1.04\/100\u00a0000 of the whole Yemeni population). The dominant pathogens were Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b (Hib). The civil war reduced the Hib and pneumococcal vaccination coverage (APC\u2009=\u2009\u20131.92), reaching its lowest (79.5%) in 2018. The prevalence of suspected ABM increased (APC\u2009=\u20093.46), reaching its maximum (6.08\/100\u00a0000 of the whole Yemeni population) in 2019. The conflict inversely correlated with the ABM prevalence and vaccination coverage (Pearson correlation coefficient (r), \u20130.69 to \u20130.53). Ta'izz region, which was severely affected by the civil war, had the highest prevalence of suspected ABM (120.90\/100\u00a0000 of the whole Yemeni population) and lowest vaccination coverage (60%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The civil war had a negative impact on vaccination coverage and coincided with increasing prevalence of ABM in Yemen. Streptococcus pneumoniae is the dominant causative pathogen.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyad047","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T08:06:16Z","timestamp":1683014776000},"page":"1175-1186","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence, aetiology, vaccination coverage and spatio-temporal pattern among patients admitted with acute bacterial meningitis to the sentinel hospital surveillance network in Yemen, 2014\u201320, before and during the civil war"],"prefix":"10.1093","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-5572","authenticated-orcid":false,"given":"Galal A","family":"Al-Samhari","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region , P.R. China"},{"name":"Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University , Dhamar, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaber M","family":"Al-Mushiki","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region , P.R. China"},{"name":"Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University , Dhamar, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashi","family":"Tamrakar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Internal Medicine, The First Affiliated Hospital of Guangxi Medical University , Nanning, Guangxi, P.\u00a0R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue-Dong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region , P.R. China"},{"name":"Acute Infectious Disease Prevention and Control Branch, Xiamen Center for Disease Control and Prevention , Xiamen, Fujian, P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6842-7121","authenticated-orcid":false,"given":"Fadhl","family":"Al-Shaebi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medicine and Health Sciences, Thamar University , Dhamar, Yemen"},{"name":"Department of Immunology & Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University , Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A","family":"Akroot","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Program for Bacterial Meningitis Investigation, Dhamar General Hospital , Dhamar, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saddam A","family":"Al-Nahari","sequence":"additional","affiliation":[{"name":"Department of Central Supervision, Expanded Program on Immunization, Ministry of Public Health Population , San'a, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4636-8532","authenticated-orcid":false,"given":"Guan-Jie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Medicine, Prince of Songkla University , Hat Yai, Songkhla, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xian-Yan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region , P.R. 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