Causes and outcome of bacterial meningitis in Malawian children

Em, Molyneux; Walsh, Alissa; Forsyth, Hope; Tembo, Madalitso; Mwenechanya, James; Kayira, K; Bwanaisa, Lloyd; Njobvu, Alfred; Malenga, Grace

doi:10.4314/mmj.v15i2.10775

Cited by 6 publications

(7 citation statements)

References 7 publications

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“…Chloramphenicol treatment for meningitis has been associated with slow responses, frequent complications and high mortality of up to 60-80%. 12 It has a low therapeutic index and variable pharmacokinetics. The CSF levels vary with individuals and are reduced by drugs such as phenobarbitone which is commonly given to control seizures in severe meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…9 Our study supports previously reported findings from a number of African countries that invasive NTS infections are common, that they are seasonal and that they are associated with anaemia and malnutrition. [1][2][3][4][5][6]11,12 Invasive NTS infections are more common in the rainy season when malaria, malnutrition and anaemia are also at their peak. 3,4,7 In several national guidelines, chloramphenicol and benzyl penicillin are recommended as standard first-line antibiotic treatments for invasive NTS illness, including meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…7 A later series in 1997-2001 reported a similar mortality and a high incidence of sequelae with 67% of survivors neurologically impaired, including 40% with hearing impairment. 12 At this time, resistance to chloramphenicol was increasing and antibiotic treatment was changed to ceftriaxone as first-line antibiotic therapy for Gram-negative bacillary meningitis.…”

Section: Introductionmentioning

confidence: 99%

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The outcome of non-typhoidal salmonella meningitis in Malawian children, 1997–2006

Molyneux

Mankhambo²,

Graham³

et al. 2009

Annals of Tropical Paediatrics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The outcome of non-typhoidal salmonella meningitis in Malawian children, 1997–2006

Molyneux

Mankhambo²,

Graham³

et al. 2009

Annals of Tropical Paediatrics

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“…They are also the second-commonest cause of neonatal meningitis, the third-most-common cause of bacterial meningitis in children over 2 months of age in Malawi (Molyneux et al, 2003), and an important cause of septic arthritis (Lepage et al, 1990) and neonatal sepsis (Milledge et al, 2005). It is estimated that the minimum incidence of communityacquired NTS in rural and urban populations of children may be as high as 166 per 100 000 per year for children under 5 years of age (Berkley et al, 2005;Mwangi et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa: zoonotic or anthroponotic transmission?

Kariuki

Govind

Kariuki

et al. 2006

Journal of Medical Microbiology

194

178

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In Africa, multidrug-resistant non-typhoidal salmonellae (NTS) are one of the leading causes of morbidity and high mortality in children under 5 years of age, second in importance only to pneumococcal disease. The authors studied NTS isolates from paediatric admissions at two hospitals in Nairobi, Kenya, and followed the index cases to their homes, where rectal swabs and stools from parents and siblings, and from animals in close contact, were obtained. The majority of NTS obtained from cases were Salmonella enterica serotype Typhimurium (106 out of 193; 54?9 %) and Salmonella enterica serotype Enteritidis (64; 33?2 %), a significant proportion (34?2 %) of which were multiply resistant to three or more antibiotics, including ampicillin, tetracycline, cotrimoxazole and chloramphenicol. Only 23?4 % of NTS were fully susceptible to all 10 antibiotics tested. Of the 32 NTS obtained from contacts (nine adults and 23 children) at the homes of index cases, 21 (65?6 %) isolates were similar by antibiotic-susceptibility profiles and plasmid content, and their XbaI-and SpeI-digested chromosomal DNA patterns were indistinguishable from those of the corresponding index cases. Only three out of 180 (1?7 %) samples from environmental sources, including animals, soil, sewers and food, contained NTS matching those from corresponding index cases. The carriage of NTS in an asymptomatic population was represented by 6?9 % of human contacts from 27 out of 127 homes sampled. This population of carriers may represent an important reservoir of NTS that would play a significant role in the epidemiology of community-acquired NTS bacteraemia in children.

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“…A paediatrician in Malawi who spoke the local language treated a child with sudden seizures who died due to meningitis 2. The mother thought her next door neighbour had cast a spell.…”

mentioning

confidence: 99%

Learning from low income countries: what are the lessons?: Health is a dynamic process

Das¹

2004

BMJ

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Causes and outcome of bacterial meningitis in Malawian children

Cited by 6 publications

References 7 publications

The outcome of non-typhoidal salmonella meningitis in Malawian children, 1997–2006

The outcome of non-typhoidal salmonella meningitis in Malawian children, 1997–2006

Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa: zoonotic or anthroponotic transmission?

Learning from low income countries: what are the lessons?: Health is a dynamic process

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