A prospective study of risk factors for neurological complications in childhood bacterial meningitis

Namani, Sadie; Milenkovic, Zvonko; Koci, Bulëza

doi:10.1016/j.jped.2012.10.001

Cited by 33 publications

(35 citation statements)

References 27 publications

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“…(23) The significantly higher frequency of ME complications among children less than one year of age is consistent with that reported by Gomes et al, (24) who reported that complications were more predominant among Brazilian children aged less than one year of age (71%). On the other hand, the significantly higher frequency of ME complications among exclusively breastfed children in their first six months of life in the present study is in agreement with the finding reported among Sudanese children by Salih et al, (25) who found a relation between the lack of exclusive breastfeeding and high frequency of complications following bacterial ME.…”

Section: Discussionsupporting

confidence: 93%

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Bawazeer¹

2019

YJMS

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Objective: To determine the types and frequencies of complications associated with acute meningoencephalitis (ME) among children admitted to hospitals in Aden, Yemen. Methods: This descriptive cross-sectional study was conducted among 60 children (1 month-14 years of age) admitted to AL-Wahda Teaching Hospital in Aden with acute ME (viral or bacterial) over the period from January to June 2010. Data were collected using a pre-designed questionnaire, and data were presented as frequencies and percentages and analyzed using appropriate statistical tests. Differences or associations between categorical variables were considered statistically significant at P values <0.05. Results: ME complications were significantly higher among children aged less than one year compared to those aged one year or older (58.8% vs. 38.5%, respectively) and among those with bacterial ME compared to those with viral ME (79.2% vs. 30.6%, respectively). The complications were also significantly higher among children with history of illness for three or more days before their admission compared to those having been ill for less than three days (65.8 vs. 22.7%, respectively). In addition, children aged less than two years not exclusively breastfed were more prone to ME complications compared to those exclusively breastfed (93.5% vs. 50.0%, respectively). Increased intracranial pressure (ICP), anemia and hypoglycemia were the three most frequent ME complications among children admitted to Al-Wahda Teaching Hospital, being observed in 53.3%, 50.0% and 43.3% of patients, respectively. Increased ICP was significantly higher among children aged five years or older compared to those aged less than five years (88.9% vs. 47.1%, respectively). In contrast, anemia and hyperglycemia were significantly higher among children aged less than five years (56.9% and 49.0%, respectively) compared to those aged five years or older (11.1% each). Conclusions: ME complications are significantly higher among children aged less than one year, infected with bacterial ME, with history of illness for three or more days before their admission and not exclusively breastfed. Increased ICP, anemia and hypoglycemia are the three most frequent ME complications, particularly among children with bacterial ME in Aden, followed by focal neurological deficits seizures and cranial nerve palsy. Although increased ICP is significantly higher among children aged five years or older, anemia and hyperglycemia are significantly higher among children aged less than five years. Active measures to promote immunization and exclusive breastfeeding along with early diagnosis and proper treatment are highly recommended. Further large-scale studies are required to study the pattern of complications following acute ME among Yemeni children.

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Section: Discussionsupporting

confidence: 93%

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Bawazeer¹

2019

YJMS

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“…If all of these died, the mortality would have actually been 35.9%. Our death rate is higher compared to studies conducted in children from wealthier countries like Kosovo, 2.6% (age one month–16 years) [ 17 ], Iceland, 4.4% (age ≤18.5y) [ 18 ], South Korea, 9.5% (age ≤18y) [ 19 ], and Iran, 10% (5m–10y) [ 20 ]. One comparable study from India reported a 16% death rate in children aged one month–five years [ 21 ].…”

Section: Discussionmentioning

confidence: 55%

Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study

et al. 2022

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Background Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan. Methods We conducted a prospective observational cohort study over one year, February 2020 to January 2021 in a tertiary care hospital in Kandahar, Afghanistan. AMB was diagnosed clinically and on lumbar puncture findings. Binary logistic regression assessed factors for death. Results A total of 393 ABM children of mean age 4.8 years were recruited. Most were males [231 (58.8%)], living in rural areas [267 (67.9%)] and in households of >10 inhabitants [294 (74.8%)]. Only 96 (24.4%) had received against both Haemophilus influenzae type b (Hib) or pneumococcal (PCV) vaccines. Children were treated with combination of ceftriaxone and ampicillin and 169/321 (52.6%) received dexamethasone. Of the 321 children with a known outcome, 69 (21.5%) died. Death was significantly associated with: not receiving dexamethasone [adjusted odds ratio (AOR) 4.9 (95% CI 2.6–9.5, p <0.001)], coma on admission [AOR 4.6 (I 2.3–9.5, p <0.001)], no PCV [AOR 2.8 (1.2–6.6, p = 0.019)] or Hib vaccine [AOR 2.8 (1.2–6.6, p = 0.019)], and being male [AOR 2.7 (1.4–5.5, p = 0.005). Conclusions ABM causes significant morbidity and mortality in Afghan children that may be improved by greater use of PCV and Hib vaccines. Adjunct dexamethasone should be evaluated formally in our setting.

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“…Pediatricians should pay close attention to the children with positive bacterial cultures, because they are more likely to develop hydrocephalus. According to Namani et al, 28 children with bacterial meningitis previously treated with antibiotics do not show an increased incidence of neurologic complications. Initial treatment with 2 antibiotics is considered a risk factor for acute neurologic complications, but adjunctive dexamethasone therapy does not reduce the incidence.…”

Section: Discussionmentioning

confidence: 98%

Clinical Features of and Risk Factors for Hydrocephalus in Childhood Bacterial Meningitis

et al. 2018

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Objective: To explore the clinical characteristics of and analyze the risk factors for hydrocephalus in children with bacterial meningitis. Methods: Retrospective study of a sample of children with bacterial meningitis seen on the pediatric service of Shengjing Hospital of China Medical University between January 1, 2010, and December 31, 2016. Results: Overall, 9.36% (25/267) of patients presented with hydrocephalus. Among patients with hydrocephalus, the age at onset of bacterial meningitis was usually <6 months, 15 patients had confirmed bacterial etiology, and 1 patient died. The most significant results of multivariate analysis for hydrocephalus were a rural living situation, altered level of consciousness, previous treatment with antibiotics, initial cerebrospinal fluid protein >2 g/L, C-reactive protein >100 mg/L, and dexamethasone use. Conclusions: A severe clinical manifestation and significant laboratory index at admission are the most important predictors of hydrocephalus in children with bacterial meningitis.

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A prospective study of risk factors for neurological complications in childhood bacterial meningitis

Abstract: Age < 12 months and severity of clinical presentation at admission were identified as the strongest predictors of neurological complications and may be of value in selecting patients for more intensive care and treatment.

Cited by 33 publications

References 27 publications

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Complications of Acute Meningoencephalitis among Children Admitted to Al-Wahda Teaching Hospital in Aden, Yemen

Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study

Clinical Features of and Risk Factors for Hydrocephalus in Childhood Bacterial Meningitis

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