Predictors of Bacterial Meningitis among Paediatric Patients Aged 0 - 5 Years at Kenyatta Hospital, Kenya

Abstract

Introduction: Meningitis remains a common and serious problem in children worldwide. One million instances of meningitis are assessed to happen in children worldwide each year. In Africa, where outbreaks are common 70% of meningitis cases are diagnosed in children under the age of five (5) years. Though in most cases, doctors diagnose early and adequate treatment started, 5% to 10% of patients still succumb during the 24 -48 hours after onset of clinical features. In 2009, the mortality rate in Africa was four thousand deaths. Study Objective: This study describes the predictors of bacterial meningitis among children aged 0 -5 years admitted at Kenyatta National Hospital (K.N.H.) paediatric wards. Methodology: The study adopted a descriptive cross-sectional design. It was carried out in K.N.H. paediatric wards. Data were obtained from consenting parent or guardian and healthcare workers (nurses and registrars). Study participants were selected by convenient sampling method. A total of 104 study participants were included in the study sample. In-depth interviews of key informants were conducted on 7 health workers; 5 nurses from the paediatric wards and paediatric emergency unit and 2 paediatric registrars. Ethical consideration included full disclosure to participants, confidentiality, security of health records and informed consent. Data were collected by use of researcher administered semi-structured questionnaire and desk reviews of patients' files were also used. Qualitative data from the interviews were audio-taped. Logistic regression analysis was used for data analysis. Quantitative data were cleaned, entered and analysed using Statistical Package for Social Sciences (SPSS) version 23. Results were displayed by utilization of tables, pie charts. Qualitative data were transcribed, grouped in themes and analysed manually. Study Results: The majority of the children (55.8%) were female. The highest percentage of the children (53.8%) was aged less than one year. The highest proportion of the parents (39.4%) was within the age group of 26 -30 years. Neonatal sepsis (37.5%), neonatal jaundice (25.0%) and for observation (25.0%) were the common reasons for admission to NBU. Children admitted and managed in the nursery unit were significantly 2.7 times more likely to have bacterial meningitis compared to those children never admitted to the nursery [OR = 2.75; 95% CI = 1.08 -7.00; P = 0.031]. Streptococcus pneumonia was the main (51.2%) causative agent of bacterial meningitis among the children. Children who were taken to hospital in delay after illness were 1.740 times more likely to exhibit meningitis than those taken to hospital immediately. Children whose parents had higher levels of income were two times less likely to exhibit meningitis than those with lower. Majority (62.5%) resided in mid urban and slum areas. Most lived in a one (1) bed-roomed house and most houses (60.6%) had more than five people living in it. The main co-existing illnesses among the children were pneumonia (53.8%) and heart di...

Identified Bacteria and Virus in the Cerebrospinal Fluid of under Five Years Hospitalized Children for Clinical Meningitis at Panzi Hospital in the Eastern Part of DRC

“…Our results revealed that Streptococcus pneumoniae (n = 14) followed by Haemophilus influenzae (n = 6) were the most prevalent bacteria detected in the CSF of ours under five years children hospitalized for meningitis, similar results has been reported in Namibia in 2013 [12], in Mozambique [13], in Kenya at Kenyatta Hospital where streptococcus pneumonia was about 51.2% [14]. A study done in Manhiça, a rural area in Southern Mozambique has reported Streptotoccus pneumoniae (n = 31) as the most prevalent bacteria in the CSF of children with meningitis followed by, Haemophilus influenzae (n = 13) and Open Journal of Pediatrics Neisseria meningitis (n = 8) [15].…”

Parental Refusal to Lumbar Puncture: Effects on Treatment, Hospital Stay and Leave Against Medical Advice

“…These patients who discharge against advice following parental refusal to LP are a great concern because diagnosis and management of serious conditions such meningitis might be further delayed, and could lead to grave consequences including death [7,10,11]. LAMA is associated with a higher risk of death, complications, and readmissions, as proposed by studies done by Serem et al and Glasgow et al, which revealed a statistically significant association between LAMA and 30-day mortality and readmission rate [12,13].…”