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Tsolenyanu E, Bancroft RE, Sesay AK, Senghore M, Fiawoo M, Akolly D, Godonou MA, Tsogbale N, Tigossou SD, Tientcheu L, Dagnra A, Atakouma Y, Sylvanus Ndow P, Worwui A, Landoh DE, Mwenda JM, Biey JN, Ntsama B, Kwambana-Adams BA, Antonio M. Etiology of Pediatric Bacterial Meningitis Pre- and Post-PCV13 Introduction Among Children Under 5 Years Old in Lomé, Togo. Clin Infect Dis 2020; 69:S97-S104. [PMID: 31505623 PMCID: PMC6761369 DOI: 10.1093/cid/ciz473] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Pediatric bacterial meningitis (PBM) causes severe morbidity and mortality within Togo. Thus, as a member of the World Health Organization coordinated Invasive Bacterial Vaccine Preventable Diseases network, Togo conducts surveillance targeting Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, at a sentinel hospital within the capital city, Lomé, in the southernmost Maritime region. Methods Cerebrospinal fluid was collected from children <5 years with suspected PBM admitted to the Sylvanus Olympio Teaching Hospital. Phenotypic detection of pneumococcus, meningococcus, and H. influenzae was confirmed through microbiological techniques. Samples were shipped to the Regional Reference Laboratory to corroborate results by species-specific polymerase chain reaction. Results Overall, 3644 suspected PBM cases were reported, and 98 cases (2.7%: 98/3644) were confirmed bacterial meningitis. Pneumococcus was responsible for most infections (67.3%: 66/98), followed by H. influenzae (23.5%: 23/98) and meningococcus (9.2%: 9/98). The number of pneumococcal meningitis cases decreased by 88.1% (52/59) postvaccine introduction with 59 cases from July 2010 to June 2014 and 7 cases from July 2014 to June 2016. However, 5 cases caused by nonvaccine serotypes were observed. Fewer PBM cases caused by vaccine serotypes were observed in infants <1 year compared to children 2–5 years. Conclusions Routine surveillance showed that PCV13 vaccination is effective in preventing pneumococcal meningitis among children <5 years of age in the Maritime region. This complements the MenAfriVac vaccination against meningococcal serogroup A to prevent meningitis outbreaks in the northern region of Togo. Continued surveillance is vital for estimating the prevalence of PBM, determining vaccine impact, and anticipating epidemics in Togo.
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Affiliation(s)
- Enyonam Tsolenyanu
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
- Correspondence: E. Tsolenyanu, Department of Paediatrics Sylvanus Olympio University Hospital Center, National Coordinator for New Vaccines Surveillance, Lomé, Togo ()
| | - Rowan E Bancroft
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Abdul K Sesay
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Madikay Senghore
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Mawouto Fiawoo
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Djatougbe Akolly
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Mawussi A Godonou
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Novissi Tsogbale
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Segla D Tigossou
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Leopold Tientcheu
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Anoumou Dagnra
- Department of Microbiology, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Yawo Atakouma
- Department of Paediatrics, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Peter Sylvanus Ndow
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Archibald Worwui
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | | | - Jason M Mwenda
- WHO Regional Office for Africa WHO/AFRO, Republic of Congo, Brazzaville
| | - Joseph N Biey
- WHO Intercountry Support Team West Africa, Ouagadougou, Burkina Faso
| | - Bernard Ntsama
- WHO Intercountry Support Team West Africa, Ouagadougou, Burkina Faso
| | - Brenda A Kwambana-Adams
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
| | - Martin Antonio
- World Health Organization (WHO) Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul
- Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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2
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Mounkoro D, Nikiema CS, Maman I, Sakandé S, Bozio CH, Tall H, Sadji AY, Njanpop-Lafourcade BM, Sibabe A, Landoh DE, Abodji EO, Kodjo A, Tamekloe TA, Essoh TA, Maba DW, Gessner BD, Moïsi JC. Neisseria meningitidis Serogroup W Meningitis Epidemic in Togo, 2016. J Infect Dis 2019; 220:S216-S224. [PMID: 31671438 PMCID: PMC6822970 DOI: 10.1093/infdis/jiz330] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND During 2014, 4 regions in Togo within the African meningitis belt implemented vaccination campaigns with meningococcal serogroup A conjugate vaccine (MACV). From January to July 2016, Togo experienced its first major Neisseria meningitidis serogroup W (NmW) outbreak. We describe the epidemiology, response, and management of the outbreak. METHODS Suspected, probable, and confirmed cases were identified using World Health Organization case definitions. Through case-based surveillance, epidemiologic and laboratory data were collected for each case. Cerebrospinal fluid specimens were analyzed by polymerase chain reaction, culture, or latex agglutination. Vaccination campaigns were conducted in affected districts. RESULTS From January 11 to July 5, 2016, 1995 suspected meningitis cases were reported, with 128 deaths. Among them, 479 (24.0%) were confirmed by laboratory testing, and 94 (4.7%) and 1422 (71.3%) remained as probable and suspected cases, respectively. Seven epidemic districts had cumulative attack rates greater than 100 per 100 000 population. Of the confirmed cases, 91.5% were NmW; 39 of 40 available NmW isolates were sequence type-11/clonal complex-11. CONCLUSIONS This outbreak demonstrates that, although high coverage with MACV has reduced serogroup A outbreaks, large meningococcal meningitis outbreaks due to other serogroups may continue to occur; effective multivalent meningococcal conjugate vaccines could improve meningococcal disease prevention within meningitis belt populations.
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Affiliation(s)
| | | | | | | | - Catherine H Bozio
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Haoua Tall
- Agence de Médecine Préventive, Ouagadougou, Burkina Faso
| | | | | | - Agoro Sibabe
- Ministère de la Santé et de l’Hygiène Publique, Togo
| | - Dadja E Landoh
- Organisation Mondiale de la Santé, Bureau Pays, Lomé, Togo
| | | | | | | | | | - Détèma W Maba
- Ministère de la Santé et de l’Hygiène Publique, Togo
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3
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Nikiema Pessinaba C, Landoh DE, Dossim S, Bidjada B, Kere-Banla A, Tamekloe TA, Doumbia T, Douti K, Bakonde BV, Segbena AY. Screening for extended-spectrum beta-lactamase-producing Enterobacteriaceae intestinal carriage among children aged under five in Lomé, Togo. Med Mal Infect 2018; 48:551-554. [PMID: 30190161 DOI: 10.1016/j.medmal.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/05/2018] [Accepted: 07/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- C Nikiema Pessinaba
- Division de la surveillance intégrée des urgences sanitaires et de la riposte, Lomé Togo
| | - D E Landoh
- Programme élargie de vaccination, OMS, 53, QAD, rue Adame B.P 1504, Lome, Togo
| | - S Dossim
- Services des laboratoires, centre hospitalier universitaire Campus, université de Lomé, Lomé, Togo.
| | - B Bidjada
- Institut national d'hygiène, QAD 01 BP1396, Lomé Togo
| | - A Kere-Banla
- Institut national d'hygiène, QAD 01 BP1396, Lomé Togo
| | - T A Tamekloe
- Division de la surveillance intégrée des urgences sanitaires et de la riposte, Lomé Togo
| | | | - K Douti
- Service de pédiatrie, centre hospitalier universitaire Campus, 03 BP 30284 Lomé, Togo
| | - B V Bakonde
- Service de pédiatrie, centre hospitalier universitaire Campus, 03 BP 30284 Lomé, Togo
| | - A Y Segbena
- Services des laboratoires, centre hospitalier universitaire Campus, université de Lomé, Lomé, Togo
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Ekouevi DK, Gbeasor-Komlanvi FA, Yaya I, Zida-Compaore WI, Boko A, Sewu E, Lacle A, Ndibu N, Toke Y, Landoh DE. Incomplete immunization among children aged 12-23 months in Togo: a multilevel analysis of individual and contextual factors. BMC Public Health 2018; 18:952. [PMID: 30071824 PMCID: PMC6090752 DOI: 10.1186/s12889-018-5881-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/24/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Inadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized in 2013. This study aimed to estimate the immunization coverage among children aged 12-23 months, and to identify factors associated with incomplete immunization status in Togo. METHODS A cross-sectional survey was conducted in the six health regions of Togo. Children aged 12 to 23 months who were living with one of their parents or guardians from selected households were recruited for the study. Data was collected using a pre-tested questionnaire through face-to-face interviews. Multilevel logistic regression analyses were performed to assess factors associated with incomplete immunization coverage. RESULTS A total of 1261 households were included. Respondents were predominantly women (91.9%) and 22.8% had secondary or higher education level. Immunization cards were available for 85.3% of children. Complete immunization coverage was 72.3%, 95% confidence interval (CI): [69.7-74.8]). After controlling for both individual and contextual level variables, children whose mothers attended secondary school or above were 33% (adjusted Odds Ratio (aOR) = 0.67, CI [0.47-0.94]) less likely to have an incomplete immunization coverage compared to those with no education. The likelihood of incomplete immunization in children decreased with the increase in household's income (aOR = 0.73, 95% CI [0.58-0.93]), children who did not have an immunization card (aOR = 13.41, 95% CI [9.19-19.57]) and those whose parents did not know that children immunization was free of charge (aOR = 1.82, 95% CI [1.00-3.30]) were more likely to have an incomplete immunization. Finally, children whose parents had to walk half an hour to one hour to reach a healthcare center were 57% (aOR = 1.57, 95% CI [1.15-2.13]) more likely to have an incomplete immunization coverage than those whose parents had to walk less than half an hour. CONCLUSION The goal of 90% coverage at the national level has not been achieved in 2017. Innovative strategies such as using electronic cards and strengthening sensitization activities must be initiated in order to attain a complete immunization coverage in Togo.
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Affiliation(s)
- Didier K. Ekouevi
- Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
- ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France
| | - Fifonsi A. Gbeasor-Komlanvi
- Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Issifou Yaya
- Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale (SESSTIM), Aix Marseille Université, Marseille, France
| | | | - Amevegbé Boko
- Programme Elargi de Vaccination, Ministère de la Santé et de la Protection Sociale, Lomé, Togo
| | - Essèboe Sewu
- Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo
| | - Anani Lacle
- Programme Elargi de Vaccination, Ministère de la Santé et de la Protection Sociale, Lomé, Togo
| | | | - Yaovi Toke
- UNICEF, country office of Togo, Lomé, Togo
| | - Dadja E. Landoh
- World Health Organization, country office of Togo, Lomé, Togo
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Nadri J, Sauvageot D, Njanpop-Lafourcade BM, Baltazar CS, Banla Kere A, Bwire G, Coulibaly D, Kacou N’Douba A, Kagirita A, Keita S, Koivogui L, Landoh DE, Langa JP, Miwanda BN, Mutombo Ndongala G, Mwakapeje ER, Mwambeta JL, Mengel MA, Gessner BD. Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa. Am J Trop Med Hyg 2018; 98:1021-1030. [PMID: 29488455 PMCID: PMC5928804 DOI: 10.4269/ajtmh.16-0523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/20/2017] [Indexed: 11/07/2022] Open
Abstract
During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.
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Affiliation(s)
| | | | | | | | - Abiba Banla Kere
- Institut National d’Hygiène, Lomé, Togo
- Ministry of Health, Lomé, Togo
| | - Godfrey Bwire
- Control of Diarrheal Diseases, Community Health Department, Ministry of Health, Kampala, Uganda
| | | | | | - Atek Kagirita
- Central Public Health Laboratory, Ministry of Health, Kampala, Uganda
| | - Sakoba Keita
- Division Prévention et Lutte contre la Maladie, Ministry of Health, Conakry, Guinea
| | | | | | - Jose P. Langa
- Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique
| | - Berthe N. Miwanda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | - Guy Mutombo Ndongala
- Division Provinciale de la Santé du Nord Kivu, Goma, Democratic Republic of Congo
| | - Elibariki R. Mwakapeje
- Epidemiology and Diseases Control Section, Preventive Department, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
| | - Jacob L. Mwambeta
- Curative Department, National Health Laboratory Quality Assurance and Training Center, Ministry of Health, Community Development, Gender, Elderly and Children, Dar es Salaam, Tanzania
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Archer BN, Thomas J, Weyer J, Cengimbo A, Landoh DE, Jacobs C, Ntuli S, Modise M, Mathonsi M, Mashishi MS, Leman PA, le Roux C, Jansen van Vuren P, Kemp A, Paweska JT, Blumberg L. Epidemiologic Investigations into Outbreaks of Rift Valley Fever in Humans, South Africa, 2008-2011. Emerg Infect Dis 2013; 19. [PMID: 29360021 PMCID: PMC3840856 DOI: 10.3201/eid1912.121527] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Rift Valley fever continues to pose a notable public health threat to humans. Rift Valley fever (RVF) is an emerging zoonosis posing a public health threat to humans in Africa. During sporadic RVF outbreaks in 2008–2009 and widespread epidemics in 2010–2011, 302 laboratory-confirmed human infections, including 25 deaths (case-fatality rate, 8%) were identified. Incidence peaked in late summer to early autumn each year, which coincided with incidence rate patterns in livestock. Most case-patients were adults (median age 43 years), men (262; 87%), who worked in farming, animal health or meat-related industries (83%). Most case-patients reported direct contact with animal tissues, blood, or other body fluids before onset of illness (89%); mosquitoes likely played a limited role in transmission of disease to humans. Close partnership with animal health and agriculture sectors allowed early recognition of human cases and appropriate preventive health messaging.
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7
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Saka B, Landoh DE, Kobara B, Djadou KE, Yaya I, Yékplé KB, Piten E, Balaka A, Akakpo S, Kombaté K, Mouhari-Toure A, Kanassoua K, Pitché P. [Profile of Buruli ulcer treated at the National Reference Centre of Togo: a study of 119 cases]. ACTA ACUST UNITED AC 2012; 106:32-6. [PMID: 22923363 DOI: 10.1007/s13149-012-0241-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 03/27/2012] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to describe the epidemiological, clinical, therapeutic profile and the outcome of Buruli ulcer (BU) in the National Reference Center for Buruli ulcer treatment (NRCBUT) in Togo. It was a retrospective and descriptive study of records of patients treated for BU in the NRCBUT between June 2007 and December 2010. During the study period, 119 patients (56.3% males) were treated in the NRCBUT for BU. The median age of patients was 14 years. The proportion of children (< 15 years) was 56.3%. On admission, 85 patients were at ulcer stage and 34 patients at the pre-ulcer stage. BU wounds were mainly located on lower limbs (50.4%), followed by upper limbs (32.6%) and trunk (13.3%). The location of the wounds on the lower limbs were more frequent in patients older than 15 years (P < 0.001), while those on the upper limbs (P = 0.002) and trunk (P = 0.03) were more frequent in patients aged less than 15 years. All patients had received medical treatment which was based on rifampicin-streptomycin combination for eight weeks. This treatment was coupled to surgery in 30 cases. The outcome was punctuated by complications in 7 patients, limb amputation in 3 patients, and sequels in 10 patients. This study confirmed that the BU is the prerogative of young subjects and the exposed areas in the skin facilitates transmission. Apart from these classic features, some unique aspects including the age-dependent distribution are related to the pathogenesis of this disease.
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Affiliation(s)
- B Saka
- Service de dermatologie, Université de Lomé, Lomé, Togo.
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