title: Influence of malnutrition on the course of childhood bacterial meningitis.
abstract: BACKGROUND
  Malnutrition may be an important cofactor explaining poor outcome of childhood bacterial meningitis (BM) in developing countries. We examined its effect in Latin American children.
  
  
  METHODS
  The weight-for-age z score was determined for 482 children with BM aged 2 months to 5 years. Normal weight (z score from >-1 to <+1), underweight (z score <-1) and overweight (z score >+1) children were compared on admission, in-hospital and at discharge. Using uni- and multivariate analysis, we sought for associations between malnutrition and 3 different outcomes.
  
  
  RESULTS
  The mean z score was -0.41 +/- 1.54, with a normal distribution. Overall, 260 (54%) patients were of normal weight, 151 (31%) underweight, and 71 (15%) overweight. Compared with others, underweight patients had on admission a lower Glasgow coma score (P = 0.0006) and cerebrospinal fluid glucose concentration (P = 0.03), and a slower capillary filling time (P = 0.02). Their death rate was higher (P = 0.0004) and they survived with more neurological sequelae (P = 0.04), but a similar frequency of hearing impairment (P > 0.05). The odds for death increased 1.98 times by mild (95% confidence interval [CI], 1.03-3.83; P = 0.04), 2.55 times by moderate (95% CI, 1.05-6.17; P = 0.04), and 5.85 times (95% CI, 2.53-13.50; P < 0.0001) by severe underweight. Overweight was not associated with adverse outcomes (P > 0.05).
  
  
  CONCLUSIONS
  Children who are underweight at the time of onset of BM have a substantially increased probability of neurological sequelae and death.
authors.affiliation: Faculty of Health Sciences, University Diego Portales, Santiago, Chile. irmeli.roine@gmail.com
authors.forename: Irmeli
authors.initials: I
authors.lastname: Roine
authors.forename: Gerardo
authors.initials: G
authors.lastname: Weisstaub
authors.forename: Heikki
authors.initials: H
authors.lastname: Peltola
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007843:Latin America; D008297:Male; D044342:Malnutrition / Q000150:complications*; D016920:Meningitis, Bacterial / Q000150:complications* / Q000401:mortality; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome