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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sequelae due to bacterial meningitis among African children: A systematic literature review
BMC Medicine, Volume 7, Article 47, Year 2009
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Description
Background: African children have some of the highest rates of bacterial meningitis in the world. Bacterial meningitis in Africa is associated with high case fatality and frequent neuropsychological sequelae. The objective of this study is to present a comprehensive review of data on bacterial meningitis sequelae in children from the African continent. Methods: We conducted a systematic literature search to identify studies from Africa focusing on children aged between 1 month to 15 years with laboratory-confirmed bacterial meningitis. We extracted data on neuropsychological sequelae (hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delay/impairment, and seizures) and mortality, by pathogen. Results: A total of 37 articles were included in the final analysis representing 21 African countries and 6,029 children with confirmed meningitis. In these studies, nearly one fifth of bacterial meningitis survivors experienced in-hospital sequelae (median = 18%, interquartile range (IQR) = 13% to 27%). About a quarter of children surviving pneumococcal meningitis and Haemophilus influenzae type b (Hib) meningitis had neuropsychological sequelae by the time of hospital discharge, a risk higher than in meningococcal meningitis cases (median = 7%). The highest in-hospital case fatality ratios observed were for pneumococcal meningitis (median = 35%) and Hib meningitis (median = 25%) compared to meningococcal meningitis (median = 4%). The 10 post-discharge studies of children surviving bacterial meningitis were of varying quality. In these studies, 10% of children followed-up post discharge died (range = 0% to 18%) and a quarter of survivors had neuropsychological sequelae (range = 3% to 47%) during an average follow-up period of 3 to 60 months. Conclusion: Bacterial meningitis in Africa is associated with high mortality and risk of neuropsychological sequelae. Pneumococcal and Hib meningitis kill approximately one third of affected children and cause clinically evident sequelae in a quarter of survivors prior to hospital discharge. The three leading causes of bacterial meningitis are vaccine preventable, and routine use of conjugate vaccines could provide substantial health and economic benefits through the prevention of childhood meningitis cases, deaths and disability. © 2009 Ramakrishnan et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2759956/bin/1741-7015-7-47-S1.doc
Authors & Co-Authors
Ramakrishnan, Meenakshi
Unknown Affiliation
Ulland, Aaron J.
United States, Washington, D.c.
Sabin Vaccine Institute
Steinhardt, Laura C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Moïsi, Jennifer C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Were, Fred Nabwire
Kenya, Nairobi
Kenya Paediatric Association
Levine, Orin S.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 183
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1186/1741-7015-7-47
e-ISSN:
17417015
Research Areas
Disability
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Systematic review