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Changing pattern of acute bacterial meningitis in Enugu, Nigeria
1Department of Medical Microbiology, University of Nigeria Teaching Hospital, Enugu.
Abstract:
A retrospective analysis of the records of 76 children with culture proven acute bacterial meningitis at UNTH, Enugu over a four year period (1 April 1989 through 30 March 1993), has revealed a striking change in the pattern of the disease especially in the causative organisms, age distribution, morbidity and mortality. Gram negative organisms accounted for 52.63% of all isolates, with coliforms being the most predominant (34.21% of total isolates). However, in a previous study by others in the same locality, gram positive organisms were more predominant, accounting for 81.2% of all isolates. In both series, Streptococcus pneumoniae was the single most predominant organism although there was a decrease in the percentage of the organism in the present study. Morbidity and mortality rates were 23.68% and 28.95% respectively, compared with 19.6% and 20.6% in the previous study. The University of Nigeria Teaching Hospital (UNTH), Enugu is the only teaching hospital in the State.
Insights
A study of childhood bacterial meningitis in Enugu shows a shift towards Gram-negative bacteria, including coliforms, as the primary cause. This change is associated with increased morbidity and mortality rates compared to previous findings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute bacterial meningitis remains a significant cause of childhood morbidity and mortality globally.
- Previous studies in Enugu indicated a predominance of Gram-positive organisms in pediatric bacterial meningitis.
- Understanding shifts in causative pathogens is crucial for effective treatment and prevention strategies.
Purpose of the Study:
- To analyze the changing patterns of causative organisms, age distribution, morbidity, and mortality in childhood acute bacterial meningitis.
- To compare current findings with historical data from the same locality.
Main Methods:
- A retrospective analysis of medical records of 76 children diagnosed with acute bacterial meningitis.
- Data collected from the University of Nigeria Teaching Hospital (UNTH), Enugu, over a four-year period (1989-1993).
- Microbiological culture results were analyzed to identify causative bacterial agents.
Main Results:
- Gram-negative organisms were identified as the predominant pathogens (52.63%), with coliforms being the most frequent (34.21%).
- This contrasts with earlier studies where Gram-positive organisms predominated (81.2%).
- Morbidity and mortality rates were 23.68% and 28.95%, respectively, showing an increase from previous reports.
Conclusions:
- There has been a significant epidemiological shift in the causative agents of childhood bacterial meningitis in Enugu, with Gram-negative bacteria now being more prevalent.
- The observed increase in morbidity and mortality warrants further investigation and potential adjustments in clinical management and public health interventions.
- Continuous surveillance of bacterial meningitis patterns is essential for adapting treatment protocols.