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1. Serogroup W135 Meningococcal Disease, The Gambia, 2012

Author

M. Jahangir Hossain, Anna Roca, Grant A. Mackenzie, Momodou Jasseh, Mohammad Ilias Hossain, Shah Muhammad, Manjang Ahmed, Osuorah Donatus Chidiebere, Ndiaye Malick, S.M. Bilquees, Usman N. Ikumapayi, Baba Jeng, Baba Njie, Mamady Cham, Beate Kampmann, Tumani Corrah, Stephen Howie, and Umberto D’Alessandro more...

Subjects
Neisseria meningitidis, serogroup W135, meningitis, Gambia, epidemic, outbreak, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

In 2012, an outbreak of Neisseria meningitidis serogroup W135 occurred in The Gambia. The attack rate was highest among young children. The associated risk factors were male sex, contact with meningitis patients, and difficult breathing. Enhanced surveillance facilitates early epidemic detection, and multiserogroup conjugate vaccine could reduce meningococcal epidemics in The Gambia. more...

Published
2013
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2. Child Mortality after Discharge from a Health Facility following Suspected Pneumonia, Meningitis or Septicaemia in Rural Gambia: A Cohort Study.

Author

Aakash Varun Chhibber, Philip C Hill, James Jafali, Momodou Jasseh, Mohammad Ilias Hossain, Malick Ndiaye, Jayani C Pathirana, Brian Greenwood, and Grant A Mackenzie

Subjects
Medicine, Science
Abstract

OBJECTIVE:To measure mortality and its risk factors among children discharged from a health centre in rural Gambia. METHODS:We conducted a cohort study between 12 May 2008 and 11 May 2012. Children aged 2-59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary and secondary care facilities, were followed for 180 days after discharge. We developed models associating post-discharge mortality with clinical syndrome on admission and clinical risk factors. FINDINGS:One hundred and five of 3755 (2.8%) children died, 80% within 3 months of discharge. Among children aged 2-11 and 12-59 months, there were 30 and 29 deaths per 1000 children per 180 days respectively, compared to 11 and 5 respectively in the resident population. Children with suspected pneumonia unaccompanied by clinically severe malnutrition (CSM) had the lowest risk of post-discharge mortality. Mortality increased in children with suspected meningitis or septicaemia without CSM (hazard ratio [HR] 2.6 and 2.2 respectively). The risk of mortality greatly increased with CSM on admission: CSM with suspected pneumonia (HR 8.1; 95% confidence interval (CI) 4.4 to 15), suspected sepsis (HR 18.4; 95% CI 11.3 to 30), or suspected meningitis (HR 13.7; 95% CI 4.2 to 45). Independent associations with mortality were: mid-upper arm circumference (MUAC) of 11.5-13.0 cm compared to >13.0 cm (HR 7.2; 95% CI 3.0 to 17.0), MUAC 10.5-11.4 cm (HR 24; 95% CI 9.4 to 62), and MUAC more...

Published
2015
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3. Serogroup W135 Meningococcal Disease, The Gambia, 2012

Author

Momodou Jasseh, Baba Njie, Osuorah Donatus Chidiebere, M. Jahangir Hossain, Mohammad Ilias Hossain, Baba Jeng, Grant A. Mackenzie, Mamady Cham, S.M. Bilquees, Stephen R. C. Howie, Shah Muhammad, Anna Roca, Umberto D'Alessandro, Ndiaye Malick, Tumani Corrah, Beate Kampmann, Manjang Ahmed, and Usman N. Ikumapayi more...

Subjects
Male, Microbiology (medical), Epidemiology, Attack rate, lcsh:Medicine, Meningitis, Meningococcal, Neisseria meningitidis, Meningococcal disease, medicine.disease_cause, epidemic, Disease Outbreaks, lcsh:Infectious and parasitic diseases, Sex Factors, Neisseria meningitidis, Serogroup W-135, Risk Factors, Conjugate vaccine, Odds Ratio, medicine, Humans, lcsh:RC109-216, bacteria, the Gambia, serogroup W135, outbreak, business.industry, Incidence, Incidence (epidemiology), lcsh:R, Dispatch, Infant, Outbreak, meningitis, medicine.disease, Virology, Infectious Diseases, Case-Control Studies, Child, Preschool, Female, Serogroup W135, Gambia, Seasons, business, Meningitis
Abstract

In 2012, an outbreak of Neisseria meningitidis serogroup W135 occurred in The Gambia. The attack rate was highest among young children. The associated risk factors were male sex, contact with meningitis patients, and difficult breathing. Enhanced surveillance facilitates early epidemic detection, and multiserogroup conjugate vaccine could reduce meningococcal epidemics in The Gambia. more...

Published
2013

4. Child Mortality after Discharge from a Health Facility following Suspected Pneumonia, Meningitis or Septicaemia in Rural Gambia: A Cohort Study

Author

Philip C. Hill, James Jafali, Jayani Pathirana, Momodou Jasseh, Grant A. Mackenzie, Brian Greenwood, Malick Ndiaye, Mohammad Ilias Hossain, and Aakash Varun Chhibber

Subjects
Male, Rural Population, Pediatrics, medicine.medical_specialty, Population, lcsh:Medicine, Child Nutrition Disorders, Cohort Studies, Sepsis, medicine, Risk of mortality, Humans, Meningitis, lcsh:Science, education, Child, Neck stiffness, education.field_of_study, Multidisciplinary, business.industry, Mortality rate, lcsh:R, Hazard ratio, Infant, Pneumonia, medicine.disease, Patient Discharge, Hospitalization, Child, Preschool, Child Mortality, lcsh:Q, Female, Gambia, business, Cohort study, Research Article
Abstract

OBJECTIVE: To measure mortality and its risk factors among children discharged from a health centre in rural Gambia. METHODS: We conducted a cohort study between 12 May 2008 and 11 May 2012. Children aged 2-59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary and secondary care facilities, were followed for 180 days after discharge. We developed models associating post-discharge mortality with clinical syndrome on admission and clinical risk factors. FINDINGS: One hundred and five of 3755 (2.8%) children died, 80% within 3 months of discharge. Among children aged 2-11 and 12-59 months, there were 30 and 29 deaths per 1000 children per 180 days respectively, compared to 11 and 5 respectively in the resident population. Children with suspected pneumonia unaccompanied by clinically severe malnutrition (CSM) had the lowest risk of post-discharge mortality. Mortality increased in children with suspected meningitis or septicaemia without CSM (hazard ratio [HR] 2.6 and 2.2 respectively). The risk of mortality greatly increased with CSM on admission: CSM with suspected pneumonia (HR 8.1; 95% confidence interval (CI) 4.4 to 15), suspected sepsis (HR 18.4; 95% CI 11.3 to 30), or suspected meningitis (HR 13.7; 95% CI 4.2 to 45). Independent associations with mortality were: mid-upper arm circumference (MUAC) of 11.5-13.0 cm compared to >13.0 cm (HR 7.2; 95% CI 3.0 to 17.0), MUAC 10.5-11.4 cm (HR 24; 95% CI 9.4 to 62), and MUAC more...

Published
2015