Pediatric Bacterial Meningitis Surveillance in Nigeria From 2010 to 2016, Prior to and During the Phased Introduction of the 10-Valent Pneumococcal Conjugate Vaccine

Background: Historically, Nigeria has experienced large bacterial meningitis outbreaks with high mortality in children. Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae are major causes of this invasive disease. In collaboration with the World Health Organization, we conducted longitudinal surveillance in sentinel hospitals within Nigeria to establish the burden of pediatric bacterial meningitis (PBM). Methods: From 2010 to 2016, cerebrospinal fluid was collected from children <5 years of age, admitted to 5 sentinel hospitals in 5 Nigerian states. Microbiological and latex agglutination techniques were performed to detect the presence of pneumococcus, meningococcus, and H. influenzae. Species-specific polymerase chain reaction and serotyping/grouping were conducted to determine specific causative agents of PBM. Results: A total of 5134 children with suspected meningitis were enrolled at the participating hospitals; of these 153 (2.9%) were confirmed PBM cases. The mortality rate for those infected was 15.0% (23/153). The dominant pathogen was pneumococcus (46.4%: 71/153) followed by meningococcus (34.6%: 53/153) and H. influenzae (19.0%: 29/153). Nearly half the pneumococcal meningitis cases successfully serotyped (46.4%: 13/28) were caused by serotypes that are included in the 10-valent pneumococcal conjugate vaccine. The most prevalent meningococcal and H. influenzae strains were serogroup W and serotype b, respectively. Conclusions: Vaccine-type bacterial meningitis continues to be common among children <5 years in Nigeria. Challenges with vaccine introduction and coverage may explain some of these finding. Continued surveillance is needed to determine the distribution of serotypes/groups of meningeal pathogens across Nigeria and help inform and sustain vaccination policies in the countr

In vivo Anti-Inflammatory Effect of Zapoteca portoricensis (Jacq) HM Hernández

Purpose: To evaluate the anti-inflammatory activity of the root extracts and fractions of Zapoteca portoricensis. Methods: The root of Z. portoricensis was extracted with methanol and the extract (ME) subjected to activity-guided fractionation to obtain chloroform (CF), ethyl acetate (EF) and methanol (MF) fractions. CF was further separated into four column fractions (CF1-CF4). The crude methanol extract and all the fractions were screened for anti-inflammatory activity using eggalbumin induced rat paw edema as a model of inflammation. Results: The crude methanol extract (200 mg/kg) exhibited a significant (P&lt;0.01) anti-inflammatory effect with edema inhibition of 71.9 % at 3 h. At 200 mg/kg, CF exhibited high and significant (P &lt; 0.01) inhibition of edema (59.9 % at 3 h). EF (200 mg/kg) exhibited moderate inhibition of edema (29.8 % at 3 h) while MF (200 mg/kg) did not show any edema inhibition at 3 h. The column fractions CF1, CF3 and CF4 showed high and significant (P &lt; 0.01) inhibition of edema (62.3, 60.9 and 66.7 %) respectively. The activities of these fractions are significantly higher than that of acetyl 100 mg/kg salycilic acid (45.6 % at 3 h). These column fractions on phytochemical analysis were shown to contain mainly terpenoids and steroids. Conclusion: Zapoteca portoricensis possesses significant anti-inflammatory activity in acute inflammation in rats. The terpenoids and steroids present in the column fractions may be responsible for the activity.Keywords: Zapoteca portoricensis; Anti-inflammatory, Egg albumeninduced edema, Terpenoids; Steroids