Related Experiment Videos
Changes in bacterial meningitis
P E Carter1, S M Barclay, W H Galloway
1Royal Aberdeen Children's Hospital, Foresterhill.
Abstract:
In 1964, one of us (WHG) undertook a retrospective study of bacterial meningitis in childhood in the north east of Scotland during the period 1946-61. We have recently carried out a similar review of cases occurring during 1971-86, to compare the incidence, mortality, and bacteriological patterns. During the earlier period 285 cases occurred, a total incidence of 16.9/100,000 children per year. In the later period 274 children were affected, an annual incidence of 17.8/100,000. The overall mortality rate fell dramatically from 11.9% to 1.8%, the latter figure comparing favourably with recent published studies from Scandinavia and the United States. There was a change in the bacteriological profile in the second period with a significant rise in cases due to Haemophilus influenzae at all ages. A fall in cases of meningococcal meningitis was significant in infants under 1 year of age only. Possible reasons for the change in the bacteriological pattern are discussed.
Insights
Childhood bacterial meningitis incidence remained stable, but mortality rates significantly decreased. A notable shift occurred in causative bacteria, with a rise in Haemophilus influenzae infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bacterial meningitis remains a significant cause of childhood morbidity and mortality.
- Understanding trends in incidence, mortality, and causative pathogens is crucial for public health strategies.
- Previous studies in North East Scotland (1946-1961) established a baseline for childhood bacterial meningitis.
Purpose of the Study:
- To compare the incidence, mortality, and bacteriological patterns of childhood bacterial meningitis in North East Scotland between two distinct periods: 1946-1961 and 1971-1986.
- To identify changes in the epidemiology and causative agents of bacterial meningitis over a 40-year interval.
Main Methods:
- Retrospective review of childhood bacterial meningitis cases in North East Scotland.
- Data collection and analysis for incidence rates (per 100,000 children per year).
- Mortality rate calculation and comparison between the two study periods.
- Analysis of bacteriological profiles, identifying causative organisms (e.g., Haemophilus influenzae, Neisseria meningitidis).
Main Results:
- Overall incidence of childhood bacterial meningitis remained similar between the periods (16.9/100,000 vs. 17.8/100,000 children per year).
- A dramatic reduction in overall mortality rate was observed, falling from 11.9% to 1.8%.
- A significant shift in bacteriology was noted, with a marked increase in Haemophilus influenzae cases across all age groups and a decrease in meningococcal meningitis, particularly in infants.
Conclusions:
- Childhood bacterial meningitis incidence in North East Scotland has remained relatively constant.
- Significant improvements in treatment or prevention have led to a dramatic decrease in mortality rates.
- The changing bacteriological landscape, particularly the rise of Haemophilus influenzae, necessitates ongoing surveillance and adaptation of treatment protocols.