[Childhood bacterial meningitis in the Norwegian county Sør-Trøndelag 1988 - 2007].
BACKGROUND
Bacterial meningitis is a severe and feared disease. We have studied bacterial meningitis in children in Sør-Trøndelag county during a 20-year period from 1988 to 2008.


METHODS
Medical records of children (in-patients) with spinal fluid findings or a clinical diagnosis of bacterial meningitis, at St. Olavs Hospital, were retrospectively reviewed.


RESULTS
112 cases of bacterial meningitis were registered in children below 16 years of age in Sør-Trøndelag county between 1988 and 2008. Children younger than 2 years had the highest occurrence, with a mean annual incidence of 42.3 per 100,000, whereas the incidence among children in the age group 2 to 16 was 5.7 per 100,000. We observed a decline in the occurrence from 19.1 per 100,000 in the period 1988 - 1991, to 6.9 per 100,000 in the period 2003 - 2006. 31 cases of Haemophilus influenzae type B, 26 cases of Neisseria meningitidis group B, 26 of Streptococcus pneumoniae and 19 cases with other pathogens were registered. The occurrence of H influenzae and N meningitidis have declined over the entire period, whereas S pneumoniae has increased. 6/112 children died (5.4 %) and 34 developed sequelae (30.4 %). In a multiple logistic regression analysis, the maximal value of C-reactive protein was associated with an increased risk of developing sequelae, adjusted for age and triggering microbe.


CONCLUSIONS
The incidence of bacterial meningitis among children in Sør-Trøndelag has decreased significantly over the last 20 years, and meningitis is now a rare disease. Bacterial meningitis is most common among children below the age of two, and is still associated with a substantial mortality and risk of long-term neurological sequalae.
Skoe
Øyvind
Ø
oskoe@stud.ntnu.no
Døllner
Henrik
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D034381:Hearing Loss / Q000209:etiology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D008583:Meningitis, Haemophilus / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D008585:Meningitis, Meningococcal / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors