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Pneumococcal meningitis in Jamaican children.
H Trotman1, O Olugbuyi, M Barton
1Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies, Kingston 7, Jamaica. helen.trotmanedwards@uwimona.edu.jm
The West Indian Medical Journal
|June 30, 2010
Summary
Pneumococcal meningitis is a significant threat to Jamaican children, especially those with sickle cell disease. Urgent vaccine strategies are needed to reduce mortality and hearing loss.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pneumococcal meningitis poses a serious health risk to children.
- Understanding its clinical features and outcomes in specific populations is crucial for public health.
- Jamaican children are particularly vulnerable to invasive pneumococcal disease.
Purpose of the Study:
- To describe the clinical features and outcomes of pneumococcal meningitis in Jamaican children.
- To identify risk factors and complications associated with pneumococcal meningitis.
- To inform national vaccine policy and intervention strategies.
Main Methods:
- Retrospective study of children admitted to Bustamante Hospital for Children (1995-1999).
- Inclusion criteria: isolation of Streptococcus pneumoniae from cerebrospinal fluid (CSF) or blood, with CSF pleocytosis.
- Data collected: demographic, clinical, and laboratory information.
Main Results:
- 23% of pneumococcal infections presented as meningitis.
- Median age of affected children was 8 months.
- Children with sickle cell disease had a 53-fold increased risk; 12% mortality rate, primarily in infants under 1 year.
- 36% experienced poor outcomes, including hearing loss in 38% of evaluated survivors.
Conclusions:
- Pneumococcal meningitis is a common and severe manifestation of invasive pneumococcal disease in Jamaican children.
- High morbidity and mortality underscore the need for local seroepidemiological data to guide vaccine decisions.
- A risk-based vaccination strategy, prioritizing children with sickle cell disease, is recommended as an interim measure.
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