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Childhood bacterial meningitis in Southwestern Greece: a population-based study
G A Syrogiannopoulos1, C J Mitselos, N G Beratis
1Department of Pediatrics, University of Patras, Greece.
Abstract:
During the 5-year period from 1990 through 1994, we investigated the incidence of childhood bacterial meningitis (beyond the neonatal period) in southwestern Greece. Thirty-seven cases of bacterial meningitis were identified. Fifty-one percent of the cases were caused by Neisseria meningitidis, 41% by Haemophilus influenzae type b (Hib), and 8% by Streptococcus pneumoniae. Fifty-eight percent and 73% of cases of meningococcal and Hib meningitis, respectively, involved children younger than 2 years of age. The average yearly incidences of meningococcal and Hib meningitis were 9.7 and 8 cases, respectively, per 100,000 children < 5 years of age. The main difference between findings in this study and those in other studies in Western European countries is the lower incidence of Hib meningitis observed in our area. This low incidence of Hib meningitis cannot be attributed to the use of vaccine because the Hib vaccine was first introduced in May 1994 and used infrequently through December 1994.
Insights
This study found Neisseria meningitidis and Haemophilus influenzae type b (Hib) were the main causes of bacterial meningitis in young children in Greece. Hib meningitis incidence was notably lower than in other Western European countries.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Bacterial meningitis poses a significant threat to children globally.
- Understanding regional incidence patterns is crucial for public health interventions.
- Previous data from Western Europe highlighted high rates of Haemophilus influenzae type b (Hib) meningitis.
Purpose of the Study:
- To determine the incidence and causative agents of childhood bacterial meningitis in southwestern Greece between 1990-1994.
- To compare the observed incidence rates with those reported in other Western European regions.
Main Methods:
- A retrospective study was conducted over a 5-year period (1990-1994).
- Cases of bacterial meningitis beyond the neonatal period were identified and analyzed.
- Causative pathogens including Neisseria meningitidis, Haemophilus influenzae type b (Hib), and Streptococcus pneumoniae were identified.
Main Results:
- Thirty-seven cases of bacterial meningitis were identified.
- Neisseria meningitidis (51%) and Haemophilus influenzae type b (Hib) (41%) were the predominant pathogens.
- Children under 2 years old accounted for the majority of meningococcal and Hib meningitis cases.
- The average yearly incidence was 9.7/100,000 for meningococcal and 8/100,000 for Hib meningitis in children <5 years.
- A lower incidence of Hib meningitis was observed compared to other Western European countries.
- The low Hib incidence could not be attributed to vaccination, as the vaccine was introduced late and infrequently used during the study period.
Conclusions:
- Neisseria meningitidis and Hib are key pathogens in childhood bacterial meningitis in southwestern Greece.
- The incidence of Hib meningitis in this region was lower than in Western Europe during 1990-1994.
- This lower incidence predates widespread Hib vaccination, suggesting other epidemiological factors may be at play.