Declines in Pediatric Bacterial Meningitis in the Republic of Benin Following Introduction of Pneumococcal Conjugate Vaccine: Epidemiological and Etiological Findings, 2011-2016.

BACKGROUND: Pediatric bacterial meningitis (PBM) remains an important cause of disease in children in Africa. We describe findings from sentinel site bacterial meningitis surveillance in children <5 years of age in the Republic of Benin, 2011-2016. METHODS: Cerebrospinal fluid (CSF) was collected from children admitted to Parakou, Natitingou, and Tanguieta sentinel hospitals with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus) was performed by rapid diagnostic tests, microbiological culture, and/or polymerase chain reaction; where possible, serotyping/grouping was performed. RESULTS: A total of 10 919 suspected cases of meningitis were admitted to the sentinel hospitals. Most patients were 0-11 months old (4863 [44.5%]) and there were 542 (5.0%) in-hospital deaths. Overall, 4168 CSF samples were screened for pathogens and a total of 194 (4.7%) PBM cases were confirmed, predominantly caused by pneumococcus (98 [50.5%]). Following pneumococcal conjugate vaccine (PCV) introduction in 2011, annual suspected meningitis cases and deaths (case fatality rate) progressively declined from 2534 to 1359 and from 164 (6.5%) to 14 (1.0%) in 2012 and 2016, respectively (P < .001). Additionally, there was a gradual decline in the proportion of meningitis cases caused by pneumococcus, from 77.3% (17/22) in 2011 to 32.4% (11/34) in 2016 (odds ratio, 7.11 [95% confidence interval, 2.08-24.30]). Haemophilus influenzae meningitis fluctuated over the surveillance period and was the predominant pathogen (16/34 [47.1%]) by 2016. CONCLUSIONS: The observed decrease in pneumococcal meningitis after PCV introduction may be indicative of changing patterns of PBM etiology in Benin. Maintaining vigilant and effective surveillance is critical for understanding these changes and their wider public health implications

L'Afrique qualifiée dans la mondialisation

Les mobilités de compétences constituent une des modalités les moins connues des migrations internationales, en dépit de l'ancienneté du phénomène et de l'intérêt qu'il suscite de plus en plus auprès des spécialistes, des états et de certains organismes internationaux. D'après les sources de l'Unesco et de l'OCDE, les étudiants et personnes qualifiées originaires de l'Afrique subsaharienne sont les plus mobiles au monde. Ce dossier couvrira la géographie des pôles de formation en Afrique, les motivations de départ, les destinations de ces flux de compétences, les modes d'insertion dans les sociétés d'accueil, les apports de ces migrations au continent africain. Skill mobility is one of the least known causes of international migrations, regardless of how old this phenomenon is and the growing interest it raises among experts, countries, and a few international agencies. According to the UNESCO and the OECD’s sources, students and qualified people coming from sub-Saharan Africa are the most mobile in the world. This issue will cover the geographical educational pole in Africa, the motivations behind the choice of leaving the country, the destination countries for this flow of expertise, the insertion mode into the host societies and what these migrations contribute to the African continent

Ecriture et migration

Ce nouveau dossier de la revue explore les liens entre écritures et migrations dans une perspective pluridisciplinaire. Les récits des mobilités humaines opèrent des sélections en termes de temporalité, d’expériences vécues, de représentations sociales et constituent autant de mises en scène qu’il y a de protagonistes (enfants, adultes, écrivains, chercheurs, etc.). À travers ces reconstructions sous forme de narrations, les migrations prennent leur sens et véhiculent des identifications multiples qui permettent de questionner de nouveau les catégories des études migratoires. This new issue explores the connections between writing and migration from a multidisciplinary perspective. The accounts of human mobility brings out a selection in terms of temporality, life experiences or social representations, and forms as many set-ups as there are characters - children, adults, writers, scientists and so on. Through these reconstructions by means of narration, the migratory process is giving its full meaning and conveys multiple identifications which allows to again call into question the categories of migration studies