Clinico-epidemiological Characteristics of Children with Infectious Meningitis at Nishtar Medical Hospital

Abstract

Objective:

This study aims to determine the common Clinico-epidemiological Characteristics of Patients suffering from infectious meningitis presenting at Nishtar medical university hospital Multan, Pakistan.

Study design:

Descriptive cross-sectional study

Place and duration of study:

Pediatric department, Nishtar Hospital Multan the duration of the study was February 01, 2016 to January 31, 2017.

Method

The study comprised of 172 patients. All the children of age 1 month to 12 years with suspected meningitis presenting to Pediatric Department Nishtar Hospital, Multan were included in our study. The patients who were critically ill or immune compromised were not included in the study. The cases in which the parents did not give consent were also excluded. The written informed consent was taken from the parents. All these cases were evaluated by detailed history, thorough physical examination and the necessary investigations. All the demographic data and other variables related to clinico-epidemiological features were measured and recorded using a specifically designed performa. The data were analyzed by using computer program SPSS 21 version.

Result

Of the 154 patients included in the final analysis, 98 (63.6%) were females and 56 (36.4%) males. The age ranged from 1 month to 12 years with a median of 31 months (6.00 - 72.50). Seventy-five percent of them were below 5 years. On the basis of investigations, bacterial meningitis was diagnosed in 91, viral meningitis in 27, tuberculous meningitis in 21 and cryptococcal meningitis in 15 patients. The most common clinical presentations of meningitis were fever, vomiting, headache, irritability, neck stiffness and altered level of consciousness. While the photophobia and fits were less common. The GCS score was more than 13 in 109 patients (70.8%) while less than eight GCS score was observed in 45 children (29.2%). Most of the complications were observed in the initial 36 hours of admission. The commonly observed complications were an altered level of sensorium, seizure, and shock. The minimum length of hospitalization was one day and the maximum was 36 days with median (IQR) of 12 days (4-15). The mortality was observed in 22 patients (14.3%) of Pediatric Medicine Department.

Conclusion

Meningitis is a highly morbific and fatal central nervous system infection in children population. It is associated with life-threatening complications and exhibits highly diverse clinical course with a very non-specific sign and symptoms. Younger children of rural areas are highly prone to fall a victim to this lethal disease. By vaccinating the children population against causative agents of meningitis, we can reduce the burden of disease.

Keywords: Meningitis.  Children. Clinico-epidemiological features.