Observational studyThe Journal of infection2024
Etiologies and comorbidities of meningitis deaths in children under 5 years in high-mortality settings: Insights from the CHAMPS Network in the post-pneumococcal vaccine era.
Observational study in The Journal of infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Long-Term Outcomes Following Bacterial Meningitis in Childhood: A Systematic Review and Meta-Analysis.Journal of paediatrics and child health · 2026Pooled it
- Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia - Child Health and Mortality Prevention Surveillance, Seven Countries, 2016-2024.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2026Article
- Infectious pathogens associated with stillbirth and under-five mortality by sickle cell disease in Western Kenya: a cross-sectional study.BMC infectious diseases · 2026Article
- Protecting Newborns from Multidrug-Resistant Infections: The Emerging Role of Bacteriophages.Viruses · 2026Review
- Trends in Meningitis Burden and Projections to 2040: A Secondary Analysis of the Global Burden of Disease Study 2023.Health science reports · 2026Article
- Rationale and Design of the MIA Trial: A Proof-of-Concept Study of Minimally Invasive Autopsy in an Infectious Cause of Death in a Scandinavian ICU Setting.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2026Review
- Investigating the Role of Cytomegalovirus as a Cause of Stillbirths and Child Deaths in Low- and Middle-Income Countries Through Postmortem Minimally Invasive Tissue Sampling.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Klebsiella vaccine research and development in Africa: a rapid scoping review of current evidence and future priorities.BMJ public health · 2026Article
- Implementation of India's largest sentinel surveillance for meningitis: an exploratory qualitative analysis of the facilitators and challenges in this sentinel site network.Frontiers in public health · 2026Article
- Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal diseases in Africa and Bangladesh.PLOS global public health · 2025Article
- Article
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Authors and funding
40 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of meningitis in causing deaths and in children under 5 is unclear, especially since widespread use of vaccines to prevent common causes of meningitis. Child Health and Mortality Prevention Surveillance (CHAMPS) uses post-mortem minimally invasive tissue sampling (MITS) and ante-mortem data to explore death causes. We aimed to assess meningitis's contribution to mortality and identify causative pathogens in children under 5 within CHAMPS Network sites.
methodIn this observational study, we analyzed deaths in live-born children <5 years of age that occurred between December 16, 2016, and December 31, 2023, in CHAMPS catchments in six sub-Saharan African countries (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, South Africa) and Bangladesh. MITS was conducted within 24-72 h of death, including blood and cerebrospinal fluid (CSF) culture, multi-organism targeted nucleic acid amplification tests on blood, CSF and lung tissue, and histopathology of lung, liver and brain. Expert panels at each site reviewed data to attribute causes of death following ICD-10 standards.
resultMeningitis was in the causal pathway for 7.0% (270/3857) of deaths; in 4.8% (13/270) meningitis was considered the underlying condition. Neonates accounted for 65.9% (178/270) and infants or children 34.1% (92/270). Among neonatal meningitis deaths, 55.6% (99/178) occurred ≥72 h post-hospital admission; and common pathogens were Acinetobacter baumannii (49.5%, 49/99; mainly from South Africa) and Klebsiella pneumoniae (40.4%, 40/99). Forty-four percent (79/178) of neonatal meningitis deaths were community-associated, primarily due to K. pneumoniae (35.4%, 28/79) and Escherichia coli (13.9%, 11/79). Among infant and child meningitis deaths, 43.5% (40/92) occurred ≥72 h post-admission; and common pathogens were K. pneumoniae (42.5%,17/40) and A. baumannii (17.5%, 7/40). Among community-associated meningitis deaths in infants and children (56.5%, 52/92), Streptococcus pneumoniae (34.6%, 18/52) and K. pneumoniae (19.2%, 10/52) were common pathogens. Pathogen prevalence varied by region.
conclusionOur study highlights meningitis as a significant contributor to under-5 mortality in low-middle-income countries. The prominent role of K. pneumoniae and A. baumannii, particularly in healthcare settings and specific regions, highlights the need for better infection control, targeted interventions, and more effective treatment strategies.
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