{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:22Z","timestamp":1772169142701,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.14868.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T00:00:00Z","timestamp":1553817600000}}],"reference-count":25,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T00:00:00Z","timestamp":1553817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008196","name":"M\u00e9decins Sans Fronti\u00e8res","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["106698"],"award-info":[{"award-number":["106698"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    A high incidence of bacterial meningitis was observed in the Central African Republic\u00a0(CAR) from December 2015 to May 2017 in three hospitals in the northwest of\u00a0the country that are within the African meningitis belt. The majority of cases were caused by\n                    <ns4:italic>Streptococcus pneumoniae<\/ns4:italic>\n                    (249\/328; 75.9%), which occurred disproportionately\u00a0during the dry season (November-April) with a high case-fatality ratio\u00a0of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt have typically been caused by\n                    <ns4:italic>Neisseria\u00a0meningitidis<\/ns4:italic>\n                    (meningococcal meningitis), and our observations suggest that the\u00a0risk of contracting\n                    <ns4:italic>S. pneumoniae<\/ns4:italic>\n                    (pneumococcal) meningitis is increased by the\u00a0same environmental factors. Cases of meningococcal meningitis (67\/328; 20.4%)\u00a0observed over the same period were predominantly group W and had a lower case\u00a0fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing\u00a0medical facilities, it is likely that the reported cases represented only a\u00a0small proportion of the overall burden. Nationwide vaccination campaigns\u00a0in the CAR against meningitis have been limited to the use of MenAfriVac, which\u00a0targets only meningococcal meningitis group A. We therefore highlight the need for\u00a0expanded vaccine coverage to prevent additional causes of seasonal outbreaks.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.14868.2","type":"journal-article","created":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T08:20:14Z","timestamp":1553847614000},"page":"134","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Seasonal upsurge of pneumococcal meningitis in the Central African Republic"],"prefix":"10.12688","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2934-1063","authenticated-orcid":false,"given":"Thomas","family":"Crellen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. Bhargavi","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turid","family":"Piening","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joke","family":"Zeydner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9638-594X","authenticated-orcid":false,"given":"M. Ruby","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2019,3,29]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"242-249","DOI":"10.1016\/S0035-9203(02)90089-1","article-title":"Where is the meningitis belt? 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Pasteur Institute of Bangui, Bangui, Central African Republic, 23 Apr 2019, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/3-134\/v2#referee-response-35168","order":2,"name":"referee-response-35168","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research was conducted as part of routine MSF surveillance, therefore data collection and the provision of medical care was funded by MSF. T.C. performed the analysis while an employee of the Mahidol Oxford Tropical Medicine Research Unit, funded by the Wellcome Trust (106698). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}