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Salmonella meningitis in children in Blantyre, Malawi, 1996-1999

E M Molyneux1, A L Walsh, G Malenga

  • 1Department of Paediatrics, College of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi. emolyneux@malawi.net

Annals of Tropical Paediatrics
|May 29, 2000
PubMed

Insights

Salmonella meningitis in children increased significantly, with a high mortality rate despite chloramphenicol treatment. This suggests a need for new antibiotic strategies for bacterial meningitis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Salmonella meningitis is a severe form of bacterial meningitis.
  • An increase in Salmonella meningitis cases was observed between 1996 and 1999 compared to 1982.
  • This rise may be linked to the increasing prevalence of Human Immunodeficiency Virus (HIV) infection and subsequent Salmonella septicemia.

Purpose of the Study:

  • To analyze the incidence, clinical features, and outcomes of Salmonella meningitis in children.
  • To evaluate the effectiveness of current treatment protocols.

Main Methods:

  • Retrospective review of 61 cases of Salmonella meningitis from February 1996 to January 1999.
  • Analysis of patient demographics, nutritional status, clinical presentation, treatment, and outcomes.
  • In vitro susceptibility testing of Salmonella isolates to chloramphenicol.

Main Results:

  • Salmonella meningitis constituted 6.8% of acute bacterial meningitis cases during the study period.
  • The majority of affected children were under 2 years old, malnourished, and anemic.
  • Mortality was high (58%), with significant morbidity in survivors.
  • Relapse occurred in two patients, one of whom died.
  • All isolates were sensitive in vitro to chloramphenicol.

Conclusions:

  • The high mortality and morbidity associated with Salmonella meningitis underscore its severity.
  • Current treatment with chloramphenicol appears inadequate, despite in vitro sensitivity.
  • An alternative antibiotic policy is urgently needed to improve outcomes for children with Salmonella meningitis.

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