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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Risk factors for death and severe sequelae in malawian children with bacterial meningitis, 1997-2010
Pediatric Infectious Disease Journal, Volume 32, No. 2, Year 2013
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Description
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. Copyright © 2013 by Lippincott Williams &Wilkins.
Authors & Co-Authors
McCormick, David W.
United States, Ann Arbor
University of Michigan, Ann Arbor
Wilson, Mark Lee
United States, Ann Arbor
University of Michigan, Ann Arbor
Mankhambo, Limangeni A.
Malawi, Zomba
University of Malawi
Phiri, Ajib I.
Malawi, Zomba
University of Malawi
Chimalizeni, Yamikani Fg
Malawi, Zomba
University of Malawi
Kawaza, Kondwani M.
Malawi, Zomba
University of Malawi
Denis, Brigitte B.
Malawi, Zomba
University of Malawi
Carrol, Enitan D.
Malawi, Zomba
University of Malawi
United Kingdom, Liverpool
University of Liverpool
Molyneux, Elizabeth M.
Malawi, Zomba
University of Malawi
Statistics
Citations: 9
Authors: 9
Affiliations: 3
Identifiers
Doi:
10.1097/INF.0b013e31826faf5a
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Disability
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Study Locations
Malawi