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Haemophilus influenzae meningitis: a 5-year study in Ibadan, Nigeria
Insights
Haemophilus influenzae meningitis predominantly affects children under two years old, with high mortality and morbidity rates. Further research is exploring the link between sickle cell disease and this severe infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Haemophilus influenzae meningitis is a serious infection in children.
- Malnutrition, specifically marasmus, was prevalent in the studied population.
- The study observed a seasonal pattern in meningitis incidence, peaking in the dry season.
Purpose of the Study:
- To analyze the clinical characteristics, outcomes, and risk factors of Haemophilus influenzae meningitis in children.
- To investigate the potential association between sickle cell disease and Haemophilus influenzae meningitis.
- To evaluate the effectiveness of different antibiotic treatment regimens.
Main Methods:
- A retrospective study of 131 children diagnosed with Haemophilus influenzae meningitis over five years.
- Analysis of patient demographics, clinical presentation, treatment protocols, and outcomes (mortality and morbidity).
- Hemoglobin electrophoresis was performed on a subset of patients to assess for Hb SS (sickle cell disease).
Main Results:
- Mortality rate was 26%, with 94% of deaths occurring in children aged two years or younger.
- Morbidity among survivors was 36%.
- A higher incidence of Hb SS was observed in patients compared to the general population, suggesting a potential link.
Conclusions:
- Haemophilus influenzae meningitis poses a significant threat to young children, particularly those under two.
- The co-occurrence of sickle cell disease warrants further investigation.
- Combination therapy with penicillin and chloramphenicol is recommended for initial treatment due to bacterial susceptibility patterns.
Abstract:
A total of 131 children with Haemophilus influenzae meningitis was studied over a period of 5 years. Of these, 92% and of those who died from this disease, 94% were 2 years old or less. Mortality was 26% and morbidity among the survivors was 36%. Most of the children studied were marasmic. The seasonal incidence is discussed since incidence peaked mainly in the dry season with a secondary peak in the rainy season. Haemoglobin (H6) electrophoresis, done in respect of a few children, showed a significantly higher incidence of Hb SS among patients than in the general population. This relationship is being studied further. The prognosis did not appear to be significantly affected by the choice between a combination of penicillin and chloramphenicol on the one hand and ampicillin alone on the other. A combination of penicillin and chloramphenicol is preferred to chloramphenicol alone in initiating therapy because 100% of strains of H. influenzae isolated in our laboratory are susceptible to chloramphenicol but only 75% of strains of Streptococcus pneumoniae are susceptible to this drug.