Etiology Agents and Antibiotic Susceptibility profile of Cerebrospinal Meningitis: Retrospective Description of Surveillance Data in Rwanda

Background: Cerebrospinal meningitis is an important cause of morbidity and mortality globally, but its highest burden is in sub-Saharan Africa. Surveillance is critical to assess the burden of the disease and provide the necessary information to mitigate the impact. The aim of this study is to assess the cases of Cerebrospinal meningitis occurring across the Rwanda in order to determine where the burden of illness lies, the causative agents and effective treatments.Method: A retrospective study was carried out from January 2010 to December 2016. 173 cerebrospinal fluid samples from 25 Districts Hospitals in Rwanda were collected from patients suspected of meningitis. Demographic characteristics, region and season, etiological agents, antimicrobial susceptibility variables were analyzed with SPSS, version 22.Results: Out of 173 suspected cases, 68 were positive for cerebrospinal meningitis. Of the positive cases 35 (56.1% were male) and 17 (25%) were under 5 years of age. The majority of cases 27 (37.5%) occurred between June and September and 22 (32%) were found in the eastern region. In this sample 32 (47.1%) of the confirmed cases were caused by Streptococcus pneumonia, followed by Neisseria meningitidis 17 (x/y; 25.1%) and E. coli with 3 (4.5%). Two different fungi, Cryptococcus neoformans and Candida albicans represented 3 (4.4%) of causative agents. The most common treatment was Ceftriaxone which was the most active/sensitive to all bacterial agents.Conclusion: Children under 5 years of age are the most affected, and the higher prevalence occurs during the dry season in the eastern region. Streptococcus pneumoniae was the leading cause of meningitis, and ceftriaxone antibiotic was the most active to the majority of identified bacteria.