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 ORIGINAL ARTICLE
Year : 2005  |  Volume : 23  |  Issue : 2  |  Page : 95-101

Epidemiological, Clinical and Prognostic Profile of Acute Bacterial Meningitis among Children in Alexandria, Egypt


1 Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
2 Medical Statistics and Clinical Epidemiology Department, Medical Research Institute, Alexandria University, Egypt
3 Microbiology Department, High Institute of Public Health, Alexandria University, Egypt

Correspondence Address:
M M Abdel-Fattah
Medical Statistics and Clinical Epidemiology Department, Medical Research Institute, Alexandria University
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.16047

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Purpose: To address the epidemiological characteristics and clinical indices that may predict the prognostic profile of meningitis among children. Methods: Children admitted to Alexandria fever hospital with clinical diagnosis of meningitis/meningoencephalitis during the period 2002-2003 were recruited for the study. They were subjected to clinical examination as well as CSF bacteriological and serological investigations Results: Three hundred and ten patients (195 males and 115 females) were included. About 65.2% of them were infected with acute bacterial meningitis (ABM) and 34.8% were infected with aseptic meningitis. In this study, ABM was caused by Haemophilus influenzae (21%), Streptococcus pneumoniae (13.9%), Neisseria meningitidis (14.2%) and other undetermined bacteria (16.1%). ABM showed significant association with age group 1-9 years (66.3%), low socio-economic class (96%), working mother (83.2%), more than two smokers in the family (62.9%) and cold seasons(fall 35.1% and winter 48.5%). Aseptic meningitis showed significant association with age group 3-15 months (100%) and previous immunization(81.5%). The overall case fatality rate was 10.3%; 13.9% for ABM and 3.4% for aseptic meningitis. 7.1% of all survivors developed epileptic attacks. Predictors for death or epilepsy events were high WHO meningitis score (> 9), decreased CSF glucose level (<10 mg/dL), more smokers in the family, generalised seizures, infancy (<1year of age) and working mothers. Conclusion: This study highlights the importance of several predictors of the outcome of meningitis in children. It is concluded that quick and simple scoring scales, such as the WHO scale, are not only applicable but valuable prognostic tools for meningitis in children.






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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04