For longer than a century, the “meningitis belt” of sub-Saharan Africa has experienced the largest-ever global meningitis epidemic. Whereas HIV-associated immunosuppression drives higher susceptibility to environmental infectious organisms with tropism for the central nervous system (CNS), most diagnostic laboratories in the belt stick to N. meningitidis, H. influenzae, and S. pneumoniae. Cryptococcus neoformans has been the leading cause of death (incidence, 89%; death, 75%). To establish whether diagnostic services target geographically important pathogens, there is a need to know the current spectrum of etiology. Given Africa’s agro-silvo-pastoralism, the One Health diagnostic approach is recommended. Considering multipathogen detection capacity, needed speed for corticosteroid therapy decision, and susceptibility/resistance to antimicrobials with improved CNS penetration, proposed laboratory categorization will help neurologists to choose suitable services.

中文翻译：

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优化撒哈拉以南非洲脑膜炎带传染性脑膜炎的实验室诊断服务。

一个多世纪以来，撒哈拉以南非洲的“脑膜炎带”经历了有史以来最大的全球脑膜炎流行。与HIV相关的免疫抑制对中枢神经系统（CNS）具有嗜性的环境感染性生物产生更高的敏感性，而该带中的大多数诊断实验室都坚持 脑膜炎奈瑟氏菌，流感嗜血杆菌和肺炎链球菌。新型隐球菌一直是主要的死亡原因（发生率，占89％；死亡，占75％）。为了确定诊断服务是否针对地理上重要的病原体，需要了解当前的病因谱。考虑到非洲的农林牧民主义，建议采用“一种健康”诊断方法。考虑到多病原体的检测能力，皮质类固醇治疗决策所需的速度以及对具有改善的中枢神经系统渗透性的抗生素的敏感性/耐药性，建议的实验室分类将有助于神经科医生选择合适的服务。