Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020.
Complications
Haemophilus influenzae
Meningitis
Mortality
Neisseria meningitidis
Streptococcus pneumoniae
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
17
05
2022
revised:
26
07
2022
accepted:
26
07
2022
pubmed:
8
8
2022
medline:
9
9
2022
entrez:
7
8
2022
Statut:
ppublish
Résumé
Providing country-specific estimates of case fatality and sequelae from bacterial meningitis (BM) is important to evaluate and monitor progress toward the World Health Organization's roadmap to "defeating meningitis by 2030". From 2016-2020, GERMS-SA conducted enhanced surveillance at 26 hospitals across South Africa. Episodes of laboratory-confirmed BM due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis were included. Risk factors for in-hospital death and sequelae at hospital discharge among survivors were analyzed. Of 12,717 invasive bacterial infections reported nationally, 39% (4980) were from enhanced surveillance sites, including 4159 pneumococcal, 640 H. influenzae, and 181 meningococcal infections. BM accounted for 32% (1319/4159) of pneumococcal, 21% (136/640) of H. influenzae, and 83% (151/181) of meningococcal invasive diseases. Clinical data were available for 91% (1455/1606) of BM: 26% (376/1455) were aged <5 years, 50% (726/1455) were female, and 62% (723/1171) with known HIV results, were HIV-infected. In-hospital case fatality was 37% (534/1455), and 24% (222/921) of survivors had adverse sequelae. Risk factors for death included altered mental status, HIV infection, and comorbidities. Risk factors for adverse sequelae included altered mental status and antimicrobial nonsusceptibility. BM in South Africa has a high case fatality, and adverse sequelae frequently occur among survivors. Those with comorbidities (including HIV) are at the highest risk.
Identifiants
pubmed: 35934172
pii: S1201-9712(22)00463-5
doi: 10.1016/j.ijid.2022.07.068
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1056-1066Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing interest Susan Meiring reports a grant from Sanofi Pasteur for research outside the submitted work. Anne von Gottberg and Cheryl Cohen report grants from US CDC, PATH, Wellcome Trust, Sanofi, and from South African MRC, outside the submitted work. All other authors declare that they have no commercial or other associations that may pose a conflict of interest.