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Meningococcaemia In Children-An Under Recognized Public Health Problem In Pakistan
Saima Bibi1, Syed Yasir Hussain Gilani2, Tahir Saeed Siddiqui1
1Department of Paediatrics, Ayub Medical Teaching Institute, Abbottabad, Pakistan.
Insights
Meningococcaemia is a serious bacterial infection in children, often leading to severe complications like meningitis and septic shock. This study highlights its prevalence and poor outcomes in the pediatric population, emphasizing the need for timely interventions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Bacteriology
Background:
- Meningococcaemia, caused by Neisseria meningitidis, is a severe bacterial illness with significant mortality.
- Limited regional data necessitates a study on disease presentation and outcomes.
Purpose of the Study:
- To describe the clinical manifestations and outcomes of meningococcaemia in a pediatric population.
- To inform the development of targeted interventions for this serious infection.
Main Methods:
- A descriptive study was conducted over 19 months in a pediatric unit.
- Children presenting with fever and characteristic petechial purpuric rash suggestive of meningococcaemia were enrolled.
Main Results:
- 46 pediatric patients were included; 52.2% were male, and 47.8% were aged 1-5 years.
- Major complications included meningitis (84.8%), septic shock (56.5%), and purpura fulminans (26.1%).
- Mortality was 13%, with outcomes significantly associated with age, prolonged PT/APTT, purpura fulminans, and septic shock.
Conclusions:
- Meningococcaemia is prevalent in the pediatric population in this region.
- The disease follows a fulminant course with high rates of complications and mortality, particularly in infants.
Background:
Meningococcaemia is a serious bacterial disease caused by Neisseria meningitidis resulting in septicaemia and meningitis in previously well individuals and is associated with serious consequences including mortality. As the data from our region is scarce, the study was conducted with an aim to highlight the disease manifestations and outcomes so that appropriate interventions are devised.
Method:
A descriptive study was conducted in Paediatrics A Unit from 1st March 2020 to 30th September 2021 after approval of institutional review board. Children admitted with features of meningococcaemia in the form of fever and typical petechial purpuric rash were included in the study.
Results:
A total of 46 patients with meningococcaemia were included in the study. Of these, 24 (52.2%) were male. Majority of the patients 22 (47.8%) were in the age group of 1 year to five years, Major complications were meningitis in 39 (84.8%), septic shock in 26 (56.5%) and purpura fulminans in 12 (26.1%) patients. Mortality was documented in 6 (13%) patients. Outcome was associated with age. (p= 0.039). There was a significant difference in outcome in patients with prolonged PT/APTT (p=0.031), purpura fulminans (p=0.000) and septic shock (p=0.021).
Conclusion:
Meningococcaemia is prevalent in our region in paediatric population. The disease has a fulminant course with a myriad of complications and potentially fatal outcomes especially in children under one year of age.
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