Abstract

ACUTE BACTERIAL MENINGITIS: FOCUSED UPDATE ON PATHOPHYSIOLOGY AND TREATMENT AMONG ADULTS IN "AFRICAN MENINGITIS BELT" OF NORTH-WESTERN NIGERIA

Balarabe S.A.*

ABSTRACT

Background: Cerebrospinal meningitis (CSM) is inflammation of the leptomeninges and underlying sub-arachnoid cerebrospinal fluid, (CSF) usually caused by bacterial infection. Several pathogenic microorganisms have been implicated in the etiology of cerebrospinal meningitis; among these, Neisseria Meningitides serogroup A (but now serogroup C) is the most common cause of outbreak of bacterial meningitis in the "African Meningitis belt". The disease is highly transmissible, with seasonal epidemics in many African countries located within the belt. "African meningitis belt" is a region of twenty five sub-Saharan countries stretching from Senegal in the west to Ethiopia in the east, with a total population of about five hundred million (500million) people. Since the introduction of the Men A conjugate vaccine (MenAfrivac), which protects against the most prevalent type of Neisseria Meningitides (serogroup A) by the government of Nigeria, with support from the Global Alliance for Vaccine Initiative (GAVI ), occurrence of the disease has reduced significantly in all states at risk, including North-Western states. However, Despite overall decrease in serotype A meningococcal infections, the risk of other types of Neisseria meningitides persists, as evidenced by the Laboratory tests that confirmed the predominance of Neisseria meningitidis serogroup C, in the ongoing outbreak of meningococcal meningitis in Nigeria. This update tends to shed light on the current literature, with specific focus on pathophysiology and treatment of cerebrospinal meningitis among adult, in the "meningitis belt" of North-Western Nigeria.

Keywords: "African meningitis Belt" Meningococcemia, Cerebrospinal Meningitis, Cerebrospinal fluid, Serogroup.