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Epidemiology of post-neonatal bacterial meningitis in Cape Town children

G Hussey1, H Schaaf, D Hanslo

  • 1Department of Paediatrics and Child Health, University of Cape Town.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|January 1, 1997
PubMed

Insights

Bacterial meningitis poses a significant threat to children in Cape Town, with Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae being the primary pathogens. Incidence rates were highest in black infants, highlighting a critical public health concern.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Bacterial meningitis is a leading cause of childhood illness and death in South Africa.
  • A lack of comprehensive epidemiological data hinders effective public health interventions for childhood bacterial meningitis.
  • This study addresses the need for regional data on childhood bacterial meningitis in Cape Town.

Purpose of the Study:

  • To determine the scope of childhood bacterial meningitis in Cape Town.
  • To identify the causative agents and incidence rates of bacterial meningitis in children.
  • To analyze age-specific and demographic variations in disease occurrence.

Main Methods:

  • A 1-year prospective study (August 1991-July 1992) included all children (1 month to 14 years) with confirmed bacterial meningitis in Cape Town.
  • Data collection involved all metropolitan hospitals.
  • Causative pathogens, incidence rates, age distributions, and outcomes were analyzed.

Main Results:

  • 201 cases of bacterial meningitis were identified.
  • Neisseria meningitidis (50.2%), Haemophilus influenzae (36.8%), and Streptococcus pneumoniae (12.9%) were the main pathogens.
  • Overall incidence rates were 34/100,000 (all children <14), 76/100,000 (<5 years), and 257/100,000 (<1 year). Black infants had the highest rate (416/100,000). Median age was 10 months, with meningococcal meningitis cases being older.
  • The case fatality rate was 5%, and 12.9% of survivors experienced neurological sequelae.

Conclusions:

  • Childhood bacterial meningitis is a significant public health problem in Cape Town, with distinct etiological profiles and age-related incidence.
  • The high incidence in black infants underscores disparities and the need for targeted interventions.
  • The study provides crucial epidemiological data for public health planning and resource allocation.

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