Bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa: A systematic review of the literature

Abstract

Context and objective. Bacterial meningitis in children is a life-threatening emergency requiring prompt management based on accurate knowledge of causative pathogens and their antibiotic susceptibility patterns. The present systematic review aimed to analyze the bacteriological profile of meningitis in children aged 3 months to 15 years in sub-Saharan Africa. Methods. A systematic search was conducted using open-access databases (PubMed, Cochrane, Medline, Google Scholar, and PMC Free) with French and English keywords. Studies conducted in sub-Saharan Africa, published between 2004 and 2023, and available in full text were included. Of 56 articles initially identified, 11 met the eligibility criteria. Results. Ten studies were analyzed (3 retrospectives, 3 prospective, 3 longitudinal, and 1 cross-sectional). Culture was used in 9 studies, and PCR in 5. Streptococcus pneumoniae was the most frequently isolated organism (8 studies), followed by Haemophilus influenzae (4 studies). Escherichia coli and Neisseria meningitidis were less commonly reported. Third-generation cephalosporins (cefotaxime and ceftriaxone) were the most recommended empirical treatments in 4 studies, with generally high bacterial susceptibility. Conclusion. S. pneumoniae is the leading bacterial cause of pediatric meningitis in sub-Saharan Africa, followed by H. influenzae. E. coli and N. meningitidis were found in lower proportions. Ceftriaxone and cefotaxime remain effective empirical options. Continuous epidemiological surveillance is essential to update the bacteriological profile and guide empirical antibiotic therapy based on local data. Received: January 17th, 2025 Accepted: August 9th, 2025 https://dx.doi.org/10.4314/aamed.v19i1.18