Bacterial meningitis in children in Barbados: a decade later - abstract

ABSTRACT

Forty-eight paediatric patients admitted with bacterial meningitis during a 10-year period, comprising 22 males (46 percent) and 26 females (54 percent), were reviewed. Ages ranged between 7 weeks and 12 years (mean 2.7 years). The mean 10-year incidence was 29/10,000 ward admissions, with a peak incidence of 69/10,000 admissions in 1989. The highest seasonal prevalence occurred during the dry months. Twenty-five patients (52 percent) were less than 2 years of age. Predominant symptoms were fever (85 percent), gastrointestinal (65 percent), and lethargy (40 percent). Frequently associated illnesses included upper respiratory infections in 21 (44 percent), and otitis media in 5(10 percent) of cases. H. influenzae was cultured from the cerebrospinal fluid in 34 cases (71 percent), S. pneumoniae in 4 cases (8 percent), and no organism in 10 cases (21 percent). Thirteen patients (27 percent) had received antibiotic therapy within a week of admission. Initial therapy consisted of parenteral ampicillin and chloramphenicol in 37 cases (77 percent), penicillin and chloramphenicol in 9 cases (19 percent) chlodramphenicol in 1 (2 percent), and trimethoprin/sulfamethoxazole in 1 case (2 percent). These data support a case for routine administration of H. influenzae B vaccine which will lead to the eradication of, or reduction of the overall incidence of bacterial meningitis in childhood (AU)