Empiric Treatment of Acute Meningitis Syndrome in a Resource-Limited Setting: Clinical Outcomes and Predictors of Survival or Death

Birkneh Tilahun Tadesse, Byron (Alex) Foster, Mulugeta Sitot Shibeshi, Henok Tadele Dangiso

Research output: Contribution to journalArticle

Abstract

Background: Bacterial meningitis is a significant cause of morbidity and mortality in the developing world. However, limited research has focused on the diagnosis and management of meningitis in resource-limited settings.

Methods: We designed a prospective case series of children admitted to a large, academic referral hospital with acute meningitis syndrome. Data were collected on age, time of presentation, prior antibiotics, cerebrospinal fluid (CSF) parameters, antibiotic and steroid prescription, and clinical outcome.

Results: Data on 99 patients were collected and analyzed. Most of the patients were males, n=69 (70%), and were from a rural area, n=83 (84%). Incomplete vaccination was common, n=36 (36%) and many have evidence of malnutrition, n=25 (38%). Most patients, n=64 (72%), had received antibiotics prior to admission with a mean duration of symptoms of 4.9 days prior to admission. The CSF white blood cell (WBC) count was higher in those who had not received prior antibiotics though it was elevated in both groups. The CSF WBC count was not associated with survival; malnutrition and length of symptoms prior to admission were both associated with decreased survival.

Conclusions: While use of antibiotics prior to obtaining CSF in patients with acute meningitis syndrome may decrease their CSF WBC count, it is not clinically significant. Many patients had a significant delay in presentation that had an effect on survival, This is a potentially modifiable risk factor despite the resourcelimited setting.

Original languageEnglish (US)
Pages (from-to)581-588
Number of pages8
JournalEthiopian journal of health sciences
Volume27
Issue number6
StatePublished - Nov 1 2017

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Meningitis
Cerebrospinal Fluid
Anti-Bacterial Agents
Leukocyte Count
Survival
Malnutrition
Therapeutics
Bacterial Meningitides
Prescriptions
Vaccination
Referral and Consultation
Steroids
Morbidity
Mortality
Research

Keywords

  • antibiotics
  • bacterial meningitis
  • children
  • glucocorticoids

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Empiric Treatment of Acute Meningitis Syndrome in a Resource-Limited Setting : Clinical Outcomes and Predictors of Survival or Death. / Tadesse, Birkneh Tilahun; Foster, Byron (Alex); Shibeshi, Mulugeta Sitot; Dangiso, Henok Tadele.

In: Ethiopian journal of health sciences, Vol. 27, No. 6, 01.11.2017, p. 581-588.

Research output: Contribution to journalArticle

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