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The epidemiology of bacterial meningitis occurring in a Pacific Island population
Abstract:
During a 36-month period 83 cases of bacterial meningitis were seen, giving an overall annual incidence rate of 134 per 10(5) population. The highest incidence was seen in infants (930 per 10(5) infants) and 59% of the patients were 0-5 years of age (incidence rate 207 per 10(5) children). Pathogens were successfully identified in 80% of the cases, by employing a combination of microscopy and antigen detection using a commercially available latex agglutination kit. Neisseria meningitidis was identified in 58%, Streptococcus pneumoniae in 29%, Haemophilus influenzae type b in 11% and dual infection with H. influenzae type b and S. pneumoniae in 3% of the cases. Serogrouping was successfully performed on cerebrospinal fluid (CSF) deposits from 8 cases of meningococcal meningitis; 7 belonged to serogroup C and 1 to serogroup Y. There was a significant difference in the geometric mean age of meningitis caused by the three organisms. There was no seasonal or geographical clustering of cases caused by N. meningitidis. Although admissions for severe pneumonia in children less than 5 years of age peaked during the cold dry season (July-October), this was not associated with a similar peak in meningitis admissions caused by H. influenzae or S. pneumoniae. The overall case fatality rate was 15.7%, and the highest case fatality rate was found in infants (28%). Meningitis caused by H. influenzae was associated with the highest case fatality rate (29%) and N. meningitidis with the lowest (8%), but the difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Bacterial meningitis is most common in infants, with Neisseria meningitidis and Streptococcus pneumoniae as leading causes. The overall case fatality rate is 15.7%, highlighting the need for effective prevention and treatment strategies.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis remains a significant public health concern, particularly in young children.
- Understanding the incidence, causative agents, and outcomes of bacterial meningitis is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence, identify common pathogens, and assess the case fatality rate of bacterial meningitis over a 36-month period.
- To investigate potential seasonal or geographical patterns and differences in outcomes based on causative organisms.
Main Methods:
- Retrospective analysis of 83 bacterial meningitis cases over 36 months.
- Pathogen identification using microscopy and latex agglutination assays.
- Serogrouping of Neisseria meningitidis isolates.
Main Results:
- Overall annual incidence was 134 per 10(5) population, highest in infants (930 per 10(5)).
- Neisseria meningitidis (58%) and Streptococcus pneumoniae (29%) were the most frequent pathogens.
- Case fatality rate was 15.7% overall, with infants experiencing the highest rate (28%).
Conclusions:
- Bacterial meningitis predominantly affects young children, with N. meningitidis and S. pneumoniae being key etiological agents.
- While H. influenzae meningitis had a higher fatality rate, differences were not statistically significant.
- No clear seasonal or geographical clustering was observed for N. meningitidis meningitis.