[Purulent meningitis in children: special considerations for developing countries].

Bacterial meningitis is frequent in tropical zones as a result of recurring epidemics, meningococcal meningitis and near-total absence of anti-haemophilus type b vaccination. Recently the situation has been further complicated by the unexplained appearance of meningococcal W135 epidemics in Burkina-Faso. With regard to pneumococcal meningitis, the appearance of antibiotic strains is a worldwide phenomenon that has greatly increased the cost of antimicrobial treatment. Hopefully in the future children in tropical areas will be able to benefit from immunization using a conjugate vaccine combining anti-haemophilus b, meningococcal type a and W135 vaccination. In this regard the currently available 7 valence pneumococcal vaccine is poorly suited to tropical epidemiology and that an additional 4 serotypes would be needed to achieve 85% coverage.