Acute childhood bacterial meningitis in Luanda, Angola.
Incidence, morbidity and mortality of bacterial meningitis in developing countries are manifold greater than those in the industrialized world. We reviewed retrospectively children with meningitis treated in the paediatric hospital of Luanda in 2004. Among the 555 children, median age 11.0 months, the leading agents were Haemophilus influenzae type b (Hib), pneumococcus, and meningococcus in 60%, 24%, and 10%, respectively. The median length of illness before admission was 7 d. 65% had convulsed. Altered level of consciousness was observed in 61% and blood haemoglobin lower than 8 g/dl in 36% of cases. Case fatality was 35% and, of survivors, 24% were left with severe neurological sequelae. Blood transfusion appeared beneficial since fatality of children with and without transfusion was 23% versus 39% (p=0.003). While awaiting large-scale vaccinations, tools to improve the prognosis of meningitis in Angola comprise generating better awareness to reduce the delay, better fluid treatment and monitoring and active use of blood transfusions.
Pelkonen
Tuula
T
Hospital Pediatrico David Bernardino, Luanda, Angola. tuula.pelkonen@hotmail.com
Roine
Irmeli
I
Monteiro
Lurdes
L
Joao Simoes
Maria
M
Anjos
Elizabete
E
Pelerito
Ana
A
Pitkaranta
Anne
A
Bernardino
Luis
L
Peltola
Heikki
H
D000810:Angola / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008583:Meningitis, Haemophilus / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D010100:Oxygen / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010100:Oxygen