Bacterial Meningitis Epidemiology in Burkina Faso and Niger—High-Risk Countries in the Meningitis Belt of Sub-Saharan Africa, 2015–2023

BACKGROUND: Burkina Faso and Niger experience hyperendemic meningitis. We describe their bacterial meningitis epidemiology during 2015-2023, after meningococcal A and prior to meningococcal ACWYX (Men5CV) conjugate vaccine introductions. METHODS: Case-based surveillance included demographics, clinical information, and cerebrospinal fluid (CSF) specimens from suspected meningitis cases. CSF specimens were tested by real-time polymerase chain reaction (rt-PCR) and culture to detect Neisseria meningitidis (Nm), Streptococcus pneumoniae (Sp), or Haemophilus influenzae (Hi). Nm serogroup (A, C, W, Y, X, B, or indeterminate) was established by rt-PCR or slide agglutination. Annual incidences were calculated using country census estimates as population denominators. RESULTS: During 2015-2023, 20 538 suspected cases were reported in Burkina Faso and 18 047 in Niger. In Burkina Faso, 3722 of 16 350 CSF specimens tested were positive; 2357 (64%) were Sp and 512 (14%) Nm serogroup W; Hi and Nm serogroups A, C, X, and indeterminate were also detected (