Risk factors for death and severe sequelae in Malawian children with bacterial meningitis, 1997-2010.
Pediatr Infect Dis J
; 32(2): e54-61, 2013 Feb.
Article
en En
| MEDLINE
| ID: mdl-22914560
ABSTRACT
BACKGROUND:
Acute bacterial meningitis (ABM) causes significant death and disability in children worldwide, with HIV recognized as an established risk factor for infection and negative outcomes. However, additional major risk factors for death and disability in pediatric ABM remain unclear.METHODS:
We conducted a retrospective analysis of case data from 3 departmental studies of ABM involving 1784 children <15 years old who attended Queen Elizabeth Central Hospital in Blantyre, Malawi during 1997 to 2010. Univariate and multivariate logistic regression models were used to estimate the effects of HIV seropositivity, impaired consciousness and causative organism on death and severe sequelae.RESULTS:
Impaired consciousness or coma at the time of admission was strongly associated with death (coma odds ratio [OR] = 14.4, 95% confidence interval [CI] 9.42, 22.1) and severe sequelae (Coma OR = 3.27, 95% CI 2.02, 5.29) in multivariate logistic regression models. HIV seropositivity was significantly associated with increased odds of death (OR = 1.65, 95% CI 1.20, 2.26) but not with developing severe sequelae (OR = 0.88, 95% CI 0.56, 1.38). After adjustment, infection with Salmonella spp. was associated with increased odds of death (OR = 2.11, 95% CI 1.06, 4.08) and pneumococcal meningitis was associated with increased odds of severe sequelae (OR = 1.84, 95% CI 1.03, 3.29).CONCLUSIONS:
Impaired consciousness and HIV infection increased the odds of death from ABM in Malawian children. Use of pneumococcal conjugate vaccine could greatly reduce the burden of ABM in Malawi.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Meningitis Bacterianas
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Región como asunto:
Africa
Idioma:
En
Revista:
Pediatr Infect Dis J
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos