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A study of bacterial meningitis in Kumasi, Ghana
E J Mackie1, P Shears, E Frimpong
1School of Medical Sciences, University of Science and Technology, Kumasi, Ghana.
Abstract:
A prospective study of acute bacterial meningitis in infants and children in Kumasi, Ghana identified 69 cases by culture or antigen detection. Of these, 50.7% (n = 35) were S. pneumoniae, 34.8% (n = 24) N. meningitidis and 14.5% (n = 10) H. influenzae. The mortality for each pathogen was 36.4%, 17.4% and 30%, respectively, showing no significant difference. In pneumococcal meningitis, the most significant clinical factor associated with an increased mortality rate or subsequent neurological sequelae was a lowered level of consciousness at admission (chi 2 = 8.66, d.f. = 1, p = 0.003). Antibiotic susceptibilities were determined in the 40 positive isolates. Six cases of N. meningitidis and two of S. pneumoniae were penicillin-resistant, and there was a single case of chloramphenicol-resistant S. pneumoniae.
Insights
Bacterial meningitis in Ghanaian children is primarily caused by Streptococcus pneumoniae and Neisseria meningitidis. Lowered consciousness at admission significantly increases mortality risk in pneumococcal meningitis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis remains a significant cause of mortality and morbidity in infants and children globally.
- Understanding the etiological agents and their resistance patterns is crucial for effective treatment and public health strategies.
Purpose of the Study:
- To identify the causative pathogens of acute bacterial meningitis in children in Kumasi, Ghana.
- To determine the mortality rates associated with different pathogens.
- To investigate clinical factors influencing outcomes and assess antibiotic resistance.
Main Methods:
- A prospective study was conducted on infants and children diagnosed with acute bacterial meningitis.
- Pathogen identification was performed using culture or antigen detection methods.
- Clinical data, including consciousness levels, and antibiotic susceptibility testing were analyzed.
Main Results:
- 69 cases were identified, with Streptococcus pneumoniae (50.7%), Neisseria meningitidis (34.8%), and Haemophilus influenzae (14.5%) being the predominant pathogens.
- Mortality rates were 36.4% for S. pneumoniae, 17.4% for N. meningitidis, and 30% for H. influenzae.
- Lowered consciousness at admission was significantly associated with increased mortality or neurological sequelae in pneumococcal meningitis.
- Antibiotic resistance was observed, including penicillin resistance in N. meningitidis and S. pneumoniae, and chloramphenicol resistance in S. pneumoniae.
Conclusions:
- Streptococcus pneumoniae and Neisseria meningitidis are major causes of bacterial meningitis in Ghanaian children.
- Prompt assessment of consciousness level is vital for predicting outcomes in pneumococcal meningitis.
- The emergence of antibiotic resistance necessitates ongoing surveillance and adaptation of treatment guidelines.