Endemic bacterial meningitis in Sudanese children: aetiology, clinical findings, treatment and short-term outcome.
During the period April 1985 to November 1986 (18 months), 196 children (of age greater than 1 month) admitted to the Children's Emergency Hospital in Khartoum, Sudan, with clinical suspicion of meningitis/meningoencephalitis were followed up prospectively. Bacterial meningitis was diagnosed by culture, direct microscopy and/or antigen-detecting assays (co-agglutination and enzyme immunoassay) in 44 infants (25 Haemophilus influenzae type b, 8 Neisseria meningitidis, 7 Streptococcus pneumoniae, 3 enterobacteria and one mixed infection), aseptic meningitis in 52, cerebral malaria in 4 and febrile convulsions in 96. The majority of cases of bacterial meningitis were boys and 57% of those in whom H. influenzae was the commonest isolate were less than 1 year old. The presenting signs and symptoms are described as well as the transient and permanent short-term sequelae. The total mortality from bacterial meningitis was 19%, permanent neurological sequelae were seen in 26% of survivors. Prospective follow-up, including audiometry, of 35 children 1-2 months after discharge showed that 11% had hemiplegia and 20% had hearing impairment. The potential impact of vaccination against invasive H. influenzae infections is discussed.
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Sudan.
M A
MA
Salih
A I
AI
el Hag
H
H
Sid Ahmed
M
M
Bushara
I
I
Yasin
M I
MI
Omer
Y
Y
Hofvander
P
P
Olcen
D001424:Bacterial Infections / Q000134:cerebrospinal fluid / Q000150:complications / Q000453:epidemiology*; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D005260:Female; D006193:Haemophilus influenzae; D006311:Hearing Disorders / Q000209:etiology; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000150:complications / Q000453:epidemiology*; D008582:Meningitis, Aseptic / Q000453:epidemiology; D008583:Meningitis, Haemophilus / Q000453:epidemiology; D008585:Meningitis, Meningococcal / Q000453:epidemiology; D008586:Meningitis, Pneumococcal / Q000453:epidemiology; D013397:Sudan / Q000453:epidemiology
D001428:Bacterial Vaccines