title: Etiologies of bacterial meningitis in Bangladesh: results from a hospital-based study.
abstract: We conducted a study at four hospitals from June 2003 to July 2005 to investigate the etiologies of bacterial meningitis in Bangladesh. A total of 2,609 patients met the clinical case definition, and 766 had cerebrospinal fluid tested by at least one of the following methods: latex agglutination, 16S rRNA gene sequencing, or real-time polymerase chain reaction for Neisseria meningitidis A and C, Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib); culture results were noted from patient records. In total, 189 patients (24%) of those tested, representing all age groups, were diagnosed with bacterial meningitis; 136 (18%) had meningococcal, 23 (3%) had pneumococcal, and 25 (3%) had Hib infection. Twenty percent of patients with Hib meningitis (5/25) were > 15 years old. Case-fatality ratios were 10% for N. meningitidis, 22% for S. pneumoniae, and 24% for Hib. Bacterial meningitis from vaccine-preventable pathogens causes significant morbidity and mortality in Bangladesh in adults and children.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. egurley@icddrb.org
authors.forename: Emily S
authors.initials: ES
authors.lastname: Gurley
authors.forename: M Jahangir
authors.initials: MJ
authors.lastname: Hossain
authors.forename: Susan P
authors.initials: SP
authors.lastname: Montgomery
authors.forename: Lyle R
authors.initials: LR
authors.lastname: Petersen
authors.forename: James J
authors.initials: JJ
authors.lastname: Sejvar
authors.forename: Leonard W
authors.initials: LW
authors.lastname: Mayer
authors.forename: Anne
authors.initials: A
authors.lastname: Whitney
authors.forename: Peter
authors.initials: P
authors.lastname: Dull
authors.forename: Nazmun
authors.initials: N
authors.lastname: Nahar
authors.forename: A K M Rafique
authors.initials: AK
authors.lastname: Uddin
authors.forename: M Ekhlasur
authors.initials: ME
authors.lastname: Rahman
authors.forename: A R M Saifuddin
authors.initials: AR
authors.lastname: Ekram
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008583:Meningitis, Haemophilus / Q000453:epidemiology* / Q000382:microbiology; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D055815:Young Adult