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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bacterial meningitis in children in Antananarivo, Madagascar
Archives de Pediatrie, Volume 9, No. 9, Year 2002
Notification
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Description
Objective. - To determine the bacterial causal agents of meningitis and their pattern of resistance, in children more than one month to 14 years of age. Methods. - A 2 years, prospective study (June 1998 to June 2000) on bacterial meningitis in children was carried out in the main hospitals in Antananarivo. The enrollment criteria upon admission were fever with symptoms of meningitis and/or convulsions and/or coma. A lumbar puncture was systematically performed in each child. The aspect of the cerebrospinal fluid was described, the level of protein and glucose estimated, soluble antigens measured. Following the examination of a Gram straining, an aliquot of the fluid was cultured on specific medium. Antimicrobial sensitivity testing of isolated pathogens was performed. Results. - Bacterial meningitis was confirmed in 119 children: 95 (80%) and 111 (93%) were less than 12 and 24 months of age, respectively. The sex distribution was 1:1. Three predominant microorganisms were identified: Streptococcus pneumoniae (45%), Haemophilus influenzae b (43%) and Neisseria meningitidis (10%) of which ten of 12 cases were belonging to serogroup B. The other microorganisms isolated were E. coli (2%). S. pneumoniae were found to be sensitive to penicilin G and H. influenzae were found to be sensitive to the third generation cephalosporins. Seven percent of the S. pneumoniae strains were mildly resistant (R+I) to chloramphenicol and between 29 and 50% to aminoglucosides. A moderate resistance against gentamicin and amoxicillin was found in 22-29 % of the H. influenzae strains. The mortality rate was high (31%) and among the surviving children 30% presented with neurosensitive disorders. Conclusion. - According to these data we may recommend the inclusion of vaccination against H. influenzae in the children immunization program in Madagascar. The early diagnosis and treatment with appropriate antibiotics, such as third generation of cephalosporins, are other critical measures to be taken in order to reduce the risk of developing severe complications associated to bacterial meningitis. © 2002 Éditions scientifiques et médicales Elsevier SAS. All rights reserved.
Authors & Co-Authors
Migliani, R.
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Clouzeau, J.
Madagascar, Antananarivo
Centre Hospitalier Soavinandriana
Decousser, Jean Winoc
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Ravelomanana, Noeline
Madagascar, Antananarivo
Hopital Mere Enfant de Tsaralalana
Rasamoelisoa, J.
Madagascar, Antananarivo
Centre Hospitalier Universitaire D'antananarivo - Hôpital Joseph Ravoahangy Andrianavalona
Rabijaona, H.
Madagascar, Antananarivo
Centre Hospitalier Universitaire D'antananarivo - Hôpital Joseph Ravoahangy Andrianavalona
Dromigny, Jacques Albert
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Pfister, P.
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Roux, Jean Felix
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Statistics
Citations: 9
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.1016/S0929-693X(02)00018-0
ISSN:
0929693X
Research Areas
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Madagascar