Etiologic agents of meningitis were prospectively investigated among patients admitted to Usman Danfodio University Teaching Hospital, Sokoto. Of 1097 cerebrospinal fluid (CSF) samples submitted to the microbiology laboratory from various wards of the hospital, 289 (26%) were microscopically, culturally and/or serologically proven to be bacterial meningitis. The etiologic spectrum was as follows: Neisseria meningitidis (61%), Streptococcus pneumoniae (18%), Haemophilus influenzae (10%), Staphylococcus aureus (6%), Coliform bacilli (3%), Escherichia coli (0.7%), Mycobacterium tuberculosis (0.7%), Listeria monocytogenes (0.4%), Flavobacterium meningosepticum (0.4%) and Pseudomonas putrifasciens (0.4%). Bacterial meningitis was most prevalent (195 or 68%) among children aged 1-9 y, while adults and neonates were least affected. Coliform bacilli caused five of eight neonatal cases. Males were more frequently affected than females (chi2 = 12.50; p < 0.05). Culture and microscopy were comparatively less efficient than the search for bacterial antigens, especially in the diagnosis of Haemophilus meningitis. Antimicrobial susceptibility of N. meningitidis to ampicillin and benzyl penicillin reduced progressively over the years (F = 406.98; p < 0.001). Nineteen (11%) of the isolates (5 Meningococci, 7 Staph. aureus, 1 Haem. influenza and 6 others) showed simultaneous resistance to chloramphenicol, ampicillin and benzyl penicillin.

In an attempt to determine the epidemiology of meningococcal diseases in Sokoto, Nigeria, nasopharyngeal carriage of meningococcus was studied among the groups at the greatest risk of the disease, i.e. children and young adults. Of 726 subjects sampled, 45 (6.2%) carried meningococcus. Sixteen (35.6%) of the 45 isolates belonged to serogroup B. Others were as follows: group A, 8 (17.8%), C, 5 (11.1%), D, 1 (2.2%) and non-groupable 11 (24.4%). Clinical cases encountered during the period were caused by serogroups A (5, 62.5%) and C (3, 37.5%). A male:female carriage ratio of 1.2:1 was recorded for the potential epidemic serogroups, A and C (chi2 = 1.0091; p>0.05), while the clinical case ratio for the genders was 1.8:1 (chi = 16.1619; p<0.001). The 5-9-y-old age group carried meningococci more frequently (8.5%) than other age brackets, and also registered the highest incidence (46.5%) of the cases. Closeness of contact with a clinical case increased the carriage of the strain of the case (chi2 = 33.3940; p<0.001). Rural dwellers carried meningococcus more frequently than urban dwellers (chi2 = 9.5591; p<0.05). The season had no consistent influence on carriage rates, even though it significantly influenced the outbreaks of the disease. Mass vaccination with polysaccharide vaccine and improved living conditions appear to be the most practical ways to control meningococcal diseases in Africa.

Emele FE. Etiologic spectrum and pattern of antimicrobial drug susceptibility in bacterial meningitis in Sokoto, Nigeria. Acta Paediatr 2000; 89: 942-6. Stockholm. ISSN 0803-5253 Etiologic agents of meningitis were prospectively investigated among patients admitted to Usman Danfodio University Teaching Hospital, Sokoto. Of 1097 cerebrospinal fluid (CSF) samples submitted to the microbiology laboratory from various wards of the hospital, 289 (26%) were microscopically, culturally and/or serologically proven to be bacterial meningitis. The etiologic spectrum was as follows: Neisseria meningitidis (61%), Streptococcus pneumoniae (18%), Haemophilus influenzae (10%), Staphylococcus aureus (6%), Coliform bacilli (3%), Escherichia coli (0.7%), Mycobacterium tuberculosis (0.7%), Listeria monocytogenes (0.4%), Flavobacterium meningosepticum (0.4%) and Pseudomonas putrifasciens (0.4%).Bacterial meningitis was most prevalent (195 or 68%) among children aged 1-9 y, while adults and neonates were least affected. Coliform bacilli caused five of eight neonatal cases. Males were more frequently affected than females (w 2 = 12.50; p`0.05). Culture and microscopy were comparatively less efficient than the search for bacterial antigens, especially in the diagnosis of Haemophilus meningitis. Antimicrobial susceptibility of N. meningitidis to ampicillin and benzyl penicillin reduced progressively over the years (F = 406.98; p`0.001). Nineteen (11%) of the isolates (5 Meningococci, 7 Staph. aureus, 1 Haem. influenza and 6 others) showed simultaneous resistance to chloramphenicol, ampicillin and benzyl penicillin.

In an attempt to determine the epidemiology of meningococcal diseases in Sokoto, Nigeria, nasopharyngeal carriage of meningococcus was studied among the groups at the greatest risk of the disease, i.e. children and young adults. Of 726 subjects sampled, 45 (6.2%) carried meningococcus. Sixteen (35.6%) of the 45 isolates belonged to serogroup B. Others were as follows: group A, 8 (17.8%), C, 5 (11.1%), D, 1 (2.2%) and non‐groupable 11 (24.4%). Clinical cases encountered during the period were caused by serogroups A (5, 62.5%) and C (3, 37.5%). A male:female carriage ratio of 1.2:1 was recorded for the potential epidemic serogroups, A and C (χ2= 1.0091; p > 0.05), while the clinical case ratio for the genders was 1.8:1 (χ2= 16.1619; p < 0.001). The 5–9‐y‐old age group carried meningococci more frequently (8.5%) than other age brackets, and also registered the highest incidence (46.5%) of the cases. Closeness of contact with a clinical case increased the carriage of the strain of the case (χ2= 33.3940; p < 0.001). Rural dwellers carried meningococcus more frequently than urban dwellers (χ2= 9.5591; p < 0.05). The season had no consistent influence on carriage rates, even though it significantly influenced the outbreaks of the disease. Mass vaccination with polysaccharide vaccine and improved living conditions appear to be the most practical ways to control meningococcal diseases in Africa.

The prevalence and mode of spread of gonococcal infections was studied among prepubertal children in Nigeria. Of 16 children with symptoms suggestive of sexually transmissible diseases (STD), 9 (56%) had gonorrhoea, while no causative organism was found in 7. The majority (7; 78%) of the gonococcal isolates produced penicillinase. Three of the cases were by child‐to‐child transmission, with female peers as the initiators. Prepubertal children should no longer be ignored as propagators of STD.