Bacterial meningitis in childhood in an African city. Factors influencing aetiology and outcome.
In a retrospective study of 120 children aged 1 month and above with bacterial meningitis confirmed by positive CSF culture, 88.4% were found to be due to three common organisms: H. influenzae, Str. pneumoniae and N. meinigitidis. Gram-negative enteric organisms accounted for 10% of the infections. Despite intensive antibiotic and ancillary therapy, there has been no significant change in case fatality and sequelae over the past decade in this institution. The present study confirms that factors related to the organism and the host are important in determining the outcome of therapy. H. influenzae and Str. pneumoniae infections are associated with statistically significant rise in case fatality rate and neurologic sequelae at the end of therapy. The presence of neurological abnormality at the time of diagnosis significantly increases case fatality rate while delay in diagnosis appears to primarily influence the frequency of neurological sequelae. Protein-energy malnutrition increases the frequency of neurological sequelae and death from bacterial meningitis without significantly influencing the pattern of bacterial aetiology. The finding of enteric Gram-negative meningitis in association with diarrhoeal disease in the present study adds a new dimension to one of the most prevalent health problems in developing countries and needs to be confirmed.
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004653:Empyema / Q000209:etiology; D005002:Ethiopia; D006801:Humans; D007223:Infant; D008583:Meningitis, Haemophilus / Q000453:epidemiology* / Q000401:mortality; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000401:mortality; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000401:mortality; D009748:Nutrition Disorders / Q000150:complications; D012189:Retrospective Studies; D013353:Subdural Effusion / Q000382:microbiology / Q000401:mortality
D000900:Anti-Bacterial Agents