• Impact on infant mortality: Bacterial meningitis remains a major cause of death in children under five in Niger, despite advances in vaccination. • Epidemiological evolution: Following the introduction of the vaccine against serogroup A, Neisseria meningitidis (including other serogroups) has become the dominant pathogen, illustrating a phenomenon of strain replacement. • Critical seasonality: The disease burden peaks during the dry season, confirming the persistent vulnerability of populations in the African "meningitis belt." • Prognostic factors: Delayed hospitalization is identified as the critical determinant of worsening clinical problems and increased case fatality rates. Bacterial meningitis remains a major public health problem in Niger. Despite vaccination campaigns, the disease persists and continues to cause high morbidity and mortality in the pediatric population. This study aimed to describe the epidemiological and evolutionary characteristics of bacterial meningitis in children in two tertiary hospitals in Niamey. This was a retrospective, descriptive, and analytical cross-sectional study conducted over a 22-month period (2023-2024). The study population included all children aged 0 to 59 months hospitalized for suspected or confirmed bacterial meningitis. Data were collected exhaustively from patient records. Variables associated with mortality in bivariate analysis were included in a multivariable logistic regression model. Pearson's chi-squared test at a significance level of 5% was used to determine factors associated with death by multivariate analysis. Of a total of 220 suspected cases of meningitis, 105 (47.7%) were confirmed. The mean age was 24.2 ± 16.9 months, with a male-to-female ratio of 1.5. Fever (98.2%) and seizures (74.1%) were the main reasons for consultation. Neisseria meningitidis was the predominant pathogen (80.9% of cultures), with a majority of serogroup W135 identified by PCR (60%). The overall case fatality rate was alarming, reaching 50.9%, and 6.4% of survivors had sequelae. The main risk factors for death were age ≤ 24 months (OR=2.81), short duration of corticosteroid therapy (OR=11.48), and antibiotic monotherapy. Pediatric bacterial meningitis in Niamey is characterized by high mortality and the predominance of Neisseria meningitidis. These results call for an urgent review of national treatment protocols, the strengthening of diagnostic capacities, and the accelerated introduction of multivalent conjugate vaccines to cover emerging serogroups.
Sahada et al. (Wed,) studied this question.