Only northern Cameroon is situated within the African "meningitis belt." The FSP Meningitis project has allowed for support of the annex of the Pasteur Centre in Cameroon situated in Garoua (PCPAG), in the north of the country, regarding microbiological surveillance activities for meningitis. After being neglected for years, meningitis surveillance was thus reintroduced to northern Cameroon in 2007. A portion of each CSF (cerebrospinal fluid) sample collected at the regional laboratory is sent to the CPCAG laboratory (turbidity, Gram, soluble antigens, rapid tests for N. meningitidis serogroups A, C, W135 and Y, culture).
Overall, 409 CSF samples were tested at the CPCAG from January 2007 to June 2008, of which 144 (35.2%) presented a leucocyte number suggesting bacterial meningitis. In all, 24 S. pneumoniae, 23 H. influenzae and 57 N. meningitidis were identified by culture or detection of soluble antigens.
Fiften meningococci grew in culture, representing 28.3% of the CSF that tested positive for soluble antigens. The frequent use of presumptive antibiotic therapy, as well as the poor conditions for transporting the CSF samples, may explain the low success rates for culture techniques. All the meningococci identified belonged to the serogroup W135. The serogroup A seems to have disappeared following the reintroduction of microbiological surveillance of meningitis in northern Cameroon in February 2007. Nine of the 15 strains of N. meningitidis were genotyped at the WHO Collaborating Centre in Marseilles. Eight were sequence type (ST-) ST-2881 and 1 was ST-11. To date, ST-2881 has only been associated with sporadic cases or minor epidemics, unlike ST-11, which cause a major epidemic in 2002 in Burkina Faso. All strains of N. meningitidis were sensitive to beta-lactams and chloramphenicol.
