Changes in the Molecular Epidemiology of Pediatric Bacterial Meningitis in Senegal After Pneumococcal Conjugate Vaccine Introduction.

BACKGROUND: Bacterial meningitis is a major cause of mortality among children under 5 years of age. Senegal is part of World Health Organization-coordinated sentinel site surveillance for pediatric bacterial meningitis surveillance. We conducted this analysis to describe the epidemiology and etiology of bacterial meningitis among children less than 5 years in Senegal from 2010 and to 2016. METHODS: Children who met the inclusion criteria for suspected meningitis at the Centre Hospitalier National d'Enfants Albert Royer, Senegal, from 2010 to 2016 were included. Cerebrospinal fluid specimens were collected from suspected cases examined by routine bacteriology and molecular assays. Serotyping, antimicrobial susceptibility testing, and whole-genome sequencing were performed. RESULTS: A total of 1013 children were admitted with suspected meningitis during the surveillance period. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus accounted for 66% (76/115), 25% (29/115), and 9% (10/115) of all confirmed cases, respectively. Most of the suspected cases (63%; 639/1013) and laboratory-confirmed (57%; 66/115) cases occurred during the first year of life. Pneumococcal meningitis case fatality rate was 6-fold higher than that of meningococcal meningitis (28% vs 5%). The predominant pneumococcal lineage causing meningitis was sequence type 618 (n = 7), commonly found among serotype 1 isolates. An ST 2174 lineage that included serotypes 19A and 23F was resistant to trimethoprim-sulfamethoxazole. CONCLUSIONS: There has been a decline in pneumococcal meningitis post-pneumococcal conjugate vaccine introduction in Senegal. However, disease caused by pathogens covered by vaccines in widespread use still persists. There is need for continued effective monitoring of vaccine-preventable meningitis

On multilayer reaction-diffusion problems: A semigroup approach, Part I

We use the theory of semigroups to obtain the existence and uniqueness of solutions for multilayer diffusion models with possibly non linear  reactions terms as well as local non-homogeneous boundary conditions on the rst and the last layers. We also allow the possibility of having Dirichlet,  Newman or mixed type conditions in the rst and the last layers. We express the solutions in terms of variation of constants formula. Our approach  constitutes a rst step in order to deal  with multilayer reaction-diffusion problem with non-local boundary value conditions by using integrated semigroup theory

Spatial distribution of COVID-19 positive cases at district level.

Spatial distribution of COVID-19 positive cases at district level.</p

Univariate and multivariate risk factors analysis according to "symptomatic/asymptomatic" status for Period 2 (from June 26 to October 31^st, 2020).

(DOCX)</p

Univariate and multivariate risk factors analysis according to "uninfected/infected" status for Period 1 (from March 2 to June 25,2020).

(DOCX)</p

Univariate and multivariable factors analysis according to "symptomatic/asymptomatic" status.

Univariate and multivariable factors analysis according to "symptomatic/asymptomatic" status.</p

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(ZIP)</p

Forest plot for COVID-19 associated factors.

A. Forest plot for factors associated with COVID-19 infection. B. Forest plot for factors associated with COVID-19 symptomatic disease. C. Forest plot for factors associated with COVID-19 mortality. Vertical lines (red and blue) represent odds ratio of 1. Red (respectively blue) dots represent crude (respectively adjusted) odds ratio. Red (respectively blue) horizontal lines around dots represent 95% confidence intervals for crude (respectively adjusted) odds ratio.</p

S1 File -

(DOCX)</p

Univariate and multivariate risk factors analysis according to "uninfected/infected" status for Period 2 (from June 26 to October 31^st,2020).

(DOCX)</p