Perfil Clínico e Laboratorial de Indivíduos (0-5anos) Suspeitos de Meningite em Moçambique, 2013

Abstract

Bacterial infections are among the leading causes of childhood morbidity and mortality worldwide. In this context, *Haemophilus influenzae* type b (Hib) is one of the most significant bacteria. In developing countries, it accounts for up to 30% of culture-positive meningitis cases and 20% to 60% of bacterial meningitis cases, with a case-fatality rate reaching as high as 40%.

A descriptive cross-sectional study was conducted from January to December 2013 at the Microbiology Reference Laboratory of the National Institute of Health (INS) to analyze data quality regarding children with suspected meningitis and to assess the role of *Haemophilus influenzae* type b (Hib) as a major pathogen, particularly during the first two years of life. Data were sourced from the National Meningitis Surveillance (ViNaMe) database and analyzed using SPSS software (version 21). The study was authorized by the INS Surveillance Department.

The samples underwent macroscopic, microscopic, cytochemical, and biochemical examinations, as well as testing for *Cryptococcus neoformans*, Gram staining, culture, and latex agglutination for serotyping. The following microorganisms were isolated: *Haemophilus influenzae* (6; 2.8%), *Streptococcus pneumoniae* (198; 92.5%), *Neisseria meningitidis* (1; 0.5%), and other microorganisms (9; 4.2%); the most affected age group was 0–24 months, and the male sex was the most affected.

It is concluded that there is over-reporting of meningitis cases in some regions of the country; *Streptococcus pneumoniae* is the most prevalent microorganism, and Nampula Central Hospital, located in the northern zone of the country, was the health facility that reported the highest number of cases.

It is recommended to reinforce and maintain the sentinel surveillance site at Nampula 

Central Hospital; improve database registration and notification procedures; introduce CIE (counter-immunoelectrophoresis) and blood culture testing to enhance laboratory diagnostic quality; provide training for laboratory technicians and clinicians on meningitis diagnosis; improve the availability of CSF biochemical tests; conduct mass vaccination against Hib and *Streptococcus pneumoniae* for all children aged 0–59 months; maintain ventilated home and workplace environments; and educate the population on personal and environmental hygiene.