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Epidemiology of bacterial meningitis in children: Aichi Prefecture, Japan, 1984-1993
T Ishikawa1, Y Asano, T Morishima
1Department of Pediatrics, Nagoya City University Medical School, Japan.
Abstract:
The details of 328 patients with bacterial meningitis, admitted from 1984 through 1993, were obtained from 46 departments of pediatrics of large hospitals through questionnaires. The incidence rate per 100,000 child-years was 2.32, being higher in children aged 0-4 years (rate, 7.22) than 5-15 years (rate, 0.49). The disease in the 274 (84%) etiologically diagnosed patients was due to Haemophilus influenzae (95), Streptococcus pneumoniae (56), Group B streptococci (GBS) (41), Escherichia coli (27), and other agents (55), including 7 patients with Mycobacterium tuberculosis infection. The short-term outcome (mean length of follow-up, 2 years, 11 months) of meningitis was death in 26 patients (8.2%) and sequelae in 49 (16.0%), including 26 children with multiple residual impairment. Tuberculous, pneumococcal, and GBS meningitis with a poor outcome increased during the late period (1989-1993) of the 10-year study. The annual infant mortality rate for purulent meningitis decreased from 3.7 to 1.4 per 100,000 population between 1984 and 1993. The incidence of a poor outcome (death and sequelae) in newborns decreased by half during the late period.
Insights
Bacterial meningitis incidence was higher in young children. While overall infant mortality decreased, severe outcomes from tuberculous, pneumococcal, and Group B streptococci meningitis increased in the later study period.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of meningitis
- Bacterial meningitis pathogens
Background:
- Bacterial meningitis remains a significant pediatric health concern.
- Understanding incidence, causative agents, and outcomes is crucial for public health.
- Longitudinal data collection is vital for tracking disease trends.
Purpose of the Study:
- To analyze the incidence, etiology, and short-term outcomes of bacterial meningitis in children.
- To identify trends in specific pathogens and their associated outcomes over a decade.
- To evaluate changes in mortality and sequelae rates during the study period.
Main Methods:
- Retrospective analysis of 328 pediatric bacterial meningitis cases admitted between 1984 and 1993.
- Data collected via questionnaires from 46 large hospital pediatric departments.
- Etiological diagnosis and outcome assessment (death, sequelae) were key parameters.
Main Results:
- Overall incidence rate was 2.32 per 100,000 child-years, significantly higher in 0-4 year olds (7.22).
- Common pathogens included Haemophilus influenzae, Streptococcus pneumoniae, Group B streptococci (GBS), and Escherichia coli.
- Poor outcomes (death/sequelae) increased for tuberculous, pneumococcal, and GBS meningitis in the later study period (1989-1993), despite a decrease in infant mortality for purulent meningitis.
Conclusions:
- Bacterial meningitis predominantly affects young children, with varying etiological profiles.
- While overall infant mortality declined, specific meningitis types showed concerning trends in poor outcomes.
- Continued surveillance and targeted interventions are necessary to combat severe pediatric meningitis.