1.

Penulis

:
BARAFF, LARRY J., SIDNEY I. LEE, and DAVID L.
SCHRIGER

2.

Judul

:
"Outcomes of bacterial meningitis in children: a
meta-analysis."

3.

Penerbit

4.

Tahun Publish

5.

Situs

The Pediatric infectious disease journal

1993
http://journals.lww.com/pidj/Abstract/1993/05000/Outc
omes_of_bacterial_meningitis_in_children__a.8.aspx
6.

Tanggal akses

7.

Isi

3 oktober 2015
ABSTRACT
We abstracted the results of all English language reports of the outcomes of
bacterial meningitis published after 1955. We used hierarchical Bayesian metaanalysis to determine the overall and organism-specific frequencies of death and
persistent neurologic sequelae in children 2 months to 19 years of age. A total of
4920 children with acute bacterial meningitis were included in 45 reports that met
the inclusion criteria. Children described in the 19 reports of prospectively
enrolled cohorts from developed countries had lower mortality (4.8% vs. 8.1%)
and were more likely to have no sequelae (82.5% vs. 73.9%). In these 19 studies
1602 children were evaluated for at least 1 sequela after hospital discharge. The
mean probabilities of these sequelae were: deafness, 10.5%; bilateral severe or
profound deafness, 5.1%; mental retardation, 4.2%; spasticity and/or paresis,
3.5%; seizure disorder, 4.2%; and no detectable sequelae, 83.6%. Mean
probabilities of outcomes varied significantly by etiologic bacteria, e.g. mortality:
Haemophilus influenzae, 3.8%; Neisseria meningitidis, 7.5%; Streptococcus
pneumoniae, 15.3%.

1.

Nama

:
Bonsu, Bema K., and Marvin B. Harper

2.

Judul

:
"Fever interval before diagnosis, prior antibiotic
treatment, and clinical outcome for young children
with bacterial
meningitis."

3.

Penerbit

4.

Tahun Publish

5.

Situs

6.

Tanggal akses

7.

Isi

Clinical infectious diseases

2001
http://cid.oxfordjournals.org/content/32/4/566.short
3 oktober 2015
ABSTRACT
In young children, meningitis due to Streptococcus pneumoniae is preceded by a
long interval from onset of fever to diagnosis of bacterial meningitis (hereafter
known as fever interval), during which time the patient frequently contacts a
clinician. By means of retrospective chart review, we compared the fever interval
that preceded diagnosis with the complication rate among 288 young children
(age, 336 months) who had bacterial meningitis (19841996), as stratified by
causative organism and prior antibiotic treatment. Pathogens included S.
pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis.
Pneumococcusspecies were associated with the longest fever interval prior to
diagnosis of meningitis, the highest frequency of contact with a clinician before
hospitalization, and the highest rate of documented morbidity or mortality. For S.
pneumoniae, there was an association between antibiotic treatment received at
prior meetings with a clinician and a reduced rate of meningitis-related
complications (odds ratio, 0.14; P = .02). Antibiotic treatment during such
meetings is associated with a substantial reduction in disease-related sequelae.

1.

Penulis :
GIRGIS, NABIL I

2.

Judul

:
"Dexamethasone treatment for bacterial meningitis in
children and adults."

3.

Penerbit

:
The Pediatric infectious disease journal

4.

Tahun Publish

:
1989

5.

Situs

:
http://journals.lww.com/pidj/abstract/1989/12000/dexa
methaso ne_treatment_for_bacterial_meningitis.4.aspx

6.

Tanggal akses

7.

Isi

3 oktober 2015
ABSTRACT
Four hundred twenty-nine patients with bacterial meningitis were
assigned on a nonselective alternating basis into one of two therapeutic regimens.
Patients in Group I received dexamethasone in addition to standard antibacterial
chemotherapy of ampicillin and chloramphenicol whereas those in Group II
received antibacterial chemotherapy alone. Dexamethasone was given
intramuscularly (8 mg to children younger than 12 years and 12 mg to adults
every 12 hours for 3 days). Both treatment groups were comparable with regard
to age, sex, duration of symptoms and state of consciousness at the time of
hospitalization.
A significant reduction in the case fatality rate (P < 0.01) was observed in patients
with pneumococcal meningitis receiving dexamethasone; only 7 of 52 patients
died compared with 22 of 54 patients not receiving dexamethasone. A reduction
in the overall neurologic sequelae (hearing impairment and paresis) was observed
in patients receiving dexamethasone. This reduction was significant only in
patients with Streptococcus pneumoniae meningitis; none of the 45 surviving
patients receiving steroids had hearing loss whereas 4 of 32 patients not receiving
dexamethasone had severe hearing loss (P < 0.05). No significant difference was
observed between the two groups with regard to time for patients to become
afebrile or to regain consciousness or in the mean admission and 24- to 36-hour
cerebrospinal fluid leukocyte count, glucose or protein content.

1.

Nama

:
Odio, Carla M

2.

Judul

:
"The beneficial effects of early dexamethasone
administration in infants
and children with
bacterial meningitis."

3.

Penerbit

4.

Tahun Publish

5.

Situs

New England Journal of Medicine

1991
http://www.nejm.org/doi/full/10.1056/NEJM19910530
3242201
6.

Tanggal akses

7.

Isi

3 oktober 2015
ABSTRACT
Considerable attention has recently been focused on the molecular
pathophysiology of bacterial meningitis in an attempt to elucidate the
mechanisms of meningeal inflammation and the ways they can be regulated to
improve outcome for patients with the disease. It is believed that the cytokines
interleukin-1 and tumor necrosis factor (TNF-) have a seminal role in the
initial events of meningeal inflammation that eventually result in alterations in
the bloodbrain barrier, cerebrovascular autoregulation, cerebrospinal fluid
dynamics, and brain metabolism.Therapeutic interventions to modulate cytokine
production have been assessed in experimental models of meningitisand in two
recently reported clinical trials of adjunctive dexamethasone therapy in infants
and children with bacterial meningitis. The results of the latter studies indicated
that steroid therapy significantly reduced the degree of meningeal inflammation
at 24 hours and improved outcome. In those two trials dexamethasone was
administered from approximately 30 minutes to many hours after the first
parenteral dose of the antibiotic.
In experimentally induced Haemophilus influenzae meningitis, a single dose of
ceftriaxone given intravenously resulted in a 40-fold to 600-fold increase in
free H. influenzae lipo-oligosaccharide concentrations in the cerebrospinal fluid
two hours later, as compared with the levels in untreated animals. This response
was believed to result from the release of cell-wall or membrane active
components (endotoxin) from rapidly lysed microorganisms. Concentrations of
TNF- in the cerebrospinal fluid increased almost 10-fold during the same
period, and there was a significant increase in the concentrations of white cells,
protein, and lactate in the cerebrospinal fluid and a decrease in the glucose
concentration. This effect on TNF- activity in the cerebrospinal fluid and on

inflammation was significantly lessened if dexamethasone was given just before

ceftriaxone but not if it was given one hour later. Fischer and Tomasz
demonstrated similar release of cell-wall products with the addition of ampicillin
to pneumococci, and Tauber and coworkers observed similar results with
cefotaxime therapy in experimental models of Escherichia coli meningitis. In
addition, concentrations of free endotoxin and TNF- in the cerebrospinal fluid
have been shown to increase substantially two to six hours after the first dose of
ceftriaxone in infants with H. influenzae meningitis.
As a consequence of these recent observations in the rabbit model of meningitis
and in patients with H. influenzae meningitis, we conducted the present study,
which differed in two important ways from our two previous placebo-controlled,
double-blind trials of dexamethasone therapy. First, the initial dose of
dexamethasone or placebo was administered 15 to 20 minutes before the first
dose of antibiotic; second, opening lumbar cerebrospinal pressures were
measured at diagnosis and again either 12 or 24 hours after the beginning of
treatment.

1.

Penulis :
Beneteau, Anne

2.

Judul

:
"Childhood Meningitis Caused by Streptococcus bovis
Group: Clinical and Biologic Data During a 12-Year
Period in France."

3.

Penerbit

4.

Tahun Publish

5.

Situs

The Pediatric infectious disease journal

2015
http://journals.lww.com/pidj/Abstract/2015/02000/Chil
dhood_
Meningitis_Caused_by_Streptococcus_bovis.4.aspx
6.

Tanggal akses

7.

Isi

3 oktober 2015
ABSTRACT
Background: Bacterial meningitis (BM) is a major cause of morbidity and
mortality in children. Sporadic cases of Streptococcus bovis have been described
in neonates and infants. To assess the epidemiologic, clinical and biologic
characteristics of this meningitis, we used the French Surveillance Network for
BM in children.
Methods: Two hundred and twenty-seven pediatric wards working with 168
microbiology departments throughout France were asked to report all cases of
BM in patients <18 years. Diagnosis was based on a combination of fever,
meningeal signs and a positive cerebrospinal fluid (CSF) culture and/or a positive
polymerase chain reaction in the CSF and/or positive blood culture associated
with pleiocytosis.
Results: Among 4806 cases of BM recorded in 12 years (20012012), 23 cases
were caused by S. bovis (0.5%). All were infants. Among them, 15 cases (65.2%)
occurred in the neonatal period. The majority occurred in premature infants
(73.9%). In 21 cases, the diagnosis was based on a positive CSF culture. Blood
culture was positive in 17 children. When S. bovis subtype was identified, it was
type 2 (Streptococcus gallolyticus pasteurianus) in 80% of cases. All infants
received antibiotic therapy with parenteral penicillin and/or third-generation
cephalosporin combined with an aminoglycoside. The duration of treatment
ranged from 10 to 25 days. Of the 23 patients, 17 (73.9%) had a second lumbar
puncture and in all those cases, the CSF was sterile. No deaths or neurologic
complications were reported.
Conclusion: BM due to S. bovis is rare and primarily affects infants, particularly
premature infants. Antibiotic treatment is effective with low morbidity and
mortality.

MENINGITIS, CHILD, and OUTCOME

Diajukan untuk memenuhi salah satu tugas mata kuliah keterampilan dasar (CBT)
yang diberikan oleh dr.Rizky Perdana

Disusun oleh:
Putri Anggraini Aswad
Nurul Ayu Ade
Ryan Zein Sembada
Sharah Kharisma
Galih Nadhova I
Fitri Utami Dewi
Alifiani Rizki W
Intan Sawaliyah
Heriansyah
Nura Asri Faradilla
M. Ichsan Hidayat

(10100115013)
(10100115067)
(10100115069)
(10100115070)
(10100115071)
(10100115072)
(10100115073)
(10100115074)
(10100115075)
(10100115076)
(10100115077)

FAKULTAS KEDOKTERAN
UNIVERSITAS ISLAM BANDUNG
2015-2016

1. Penulis

2. Judul

G. V. Ramadevi
Venkatashetty
Sardar Sulthana
M. Suhasini, V. V.
Ratnakar Reddy

:
CLINICAL PROFILE OF ACUTE
BACTERIAL
MENINIGITS AND
OUTCOME

3. Penerbit

:
Journal of Evolution of Medical and Dental
Sciences

4. Tahun Terbit

:
Januari 2015

5. Situs

:
http://jemds.com/latest-articles.php?at_id=6530

6. Tanggal Akses

:
3 Oktober 2015

7. Isi

:
ABSTRACT

OBJECTIVES: To study the clinical profile of ABM and analyse the

differences in clinical presentation among young infant, toddler, compared to
school going children. and to find out the bacteriological profile and sensitivity
pattern of ABM. MATERIALS AND METHODS: The present study is a
prospective non-randomized single arm study. Children with the diagnosis of
ABM admitted to the department of Pediatrics Govt. General Hospital, Kurnool
from January 2013 to October 2013 are included in the study. Clinical details of
all patients were recorded CSF was analysed by routine biochemical methods,
and microbiological studies on special media. The children were managed as per
the standard protocols.RESULTS: In a study period of 1 year During the study
period 74 children (1.5% of all admissions) satisfied the criteria of ABM in early
childhood;. The incidence of Acute Bacterial Meningitis was 1.45% of total
Pediatric admissions. Of the 74 cases 25 died. Mortality rate was
33.79%.mortality observed was more in less than one year of age. Chief
presentation was high fever, refusal of feeds, altered sensorium and seizures. the
final etiological diagnosis (as per LAT and/or cultures) were 32 cases are positive
for culture and sensitivity of ABM and Biochemically and Cell count wise 74
cases are positive for ABM. CSF has grown pneumococci in 8 (25%) cases,
Coagulase positive Staph. aureus in 3 (9.38%) cases, Coagulase negative Staph.
aureus in 3(15.63%) cases, Nesseria Meningitides in 3 (9.38%), Klebsiella in 4
(12.50%) cases, E coli, Enterococci and Pseudomonous in 9 (28.13%) The
outcome in the present study with respect to death is 33.78% and 45.95% of
patients Survived with complications, 20.27% of patients survived without

complications. CONCLUSION: The incidence and Mortality were significantly

high in low socio economic group. The incidence and mortality was high in lesser
age group. Mortality is very high with high CSF protein and low sugar levels.
Pneumococci and coagulase negative staphylococci are predominant causes of
morbidity and mortality associated with ABM.

1. Penulis

2. Judul

Keith Grimwood
Peter Anderson
Vicki Anderson
Lesley Tan
Terry Nolan

:
TWELVE YEAR OUTCOMES FOLLOWING
BACTERIAL MENINGITIS: FURTHER
EVIDENCE
FOR PERSISTING EFFECTS

3. Penerbit

:
www.archdischild.com

4. Tahun Publish

5. Situs

6. Tanggal Akses

7. Isi

15 Februari 2000
http://m.adc.bmj.com/content/83/2/111.full.pdf
3 Oktober 2015
ABSTRACT
AimTo determine whether intellectual and cognitive impairments
observed seven years following early childhood bacterial meningitis persist into
adolescence. MethodsBlinded neuropsychological, auditory, and behaviour
assessments were conducted in 109 (69%) subjects from an original cohort of 158
children, seven and 12 years after their meningitis, and in 96 controls. Results
Meningitis subjects remained at greater risk than controls for any disability (odds
ratio OR 4.7, confidence interval 2.2 to 9.6). Those with acute neurological
complications had more sequelae than children with uncomplicated meningitis or
controls (47% v 30% v 11.5% respectively; p < 0.001). Differences in intellectual,
academic, and high level cognitive function between subjects and controls were
maintained at the seven and 12 year assessments. In contrast, lower order skills
improved, while behaviour scores deteriorated significantly (p = 0.033).
ConclusionsMany of the deficits identified at the seven year follow up persist
12 years after an episode of bacterial meningitis.Bacterial meningitis is a severe
childhood illness. While Haemophilus influenzae type b(Hib) disease has been
virtually eliminated from North America, northern Europe, Australia, and New
Zealand,1 in developing countries it is a leading cause of bacterial meningitis,2
responsible for over 200 000 cases and more than 40 000 deaths annually.2 3
Moreover, Neisseria meningitidis and Streptococcus pneumoniae remain
important pathogens.4 Recurring epidemics of meningococcal disease,5 increased
antibiotic resistance among pneumococci,6 and failure to introduce conjugate Hib
vaccines into many developing countries means that bacterial meningitis remains
a serious global health problem. In spite of potent antibiotics and improved
management of the critically ill, there is a small and significant risk of death or

severe neurological sequelae following bacterial meningitis in childhood. A meta

analysis found that 4.5% died and at least one major adverse outcome (severe
intellectual disability, epilepsy, spasticity, deafness) was present in 6.4% of
survivors.7 Inasmuch as these studies were limited to neurological examinations
and tests of general intellectual function or hearing acuity, with assessments
restricted to one or two years follow up, the long term sequelae may havebeen
underestimated. Many motor and cognitive skills are undeveloped at the time of
meningitis. Consequently, functionally important deficits may not appear until
the children are much older, attending school, and expected to think and reason
independently. Most meningitis survivors are considered to lead normal lives8
and to be little different from their siblings.9 Despite these impressions, a
prospective seven year follow up study of children surviving bacterial meningitis
and their classroom peers showed that these primary school age survivors showed
mildly decreased intellectual quotient (IQ) scores and consistently performed less
well with neuropsychological tasks, being more likely to have abnormal findings
across all categories tested.10 The pattern of results suggested that their greatest
impairment as in verbal skills and organisational capacity.11 Compared with 11%
of controls exhibiting minor disabilities, 27% of children surviving meningitis
had either neurological and behaviour disorders or cognitive impairments that
may have contributed to their poorer academic performance. The risks for these
adverse outcomes were greatest in those with meningitis during infancy and
where there had been delays in diagnosis or acute neurological complications.11
12 The present study aimed to reassess the original cohort 12 years after their
meningitis when many were early high school age. We determined whether
previously observed disabilities persisted, suggesting permanent neurological
deficits, if there was delayed acquisition of skills that improved with maturity,
and if new deficits emerged with development.

1. Penulis

2. Judul

Jillian Mongelluzzo
Zeinab Mohamad
Thomas R.
Ten Have, PhD
Samir S. Shah, MD, MSCE

:
CORTICOSTEROIDS AND MORTALITY IN
CHILDREN
WITH
BACTERIAL
MENINGITIS

3. Penerbit

:
THE JOURNAL OF THE AMERICAN MEDICAL
ASSOCIATION

4. Tahun Publish

:
7 Mei 2008

5. Situs

:
http://jama.jamanetwork.com/article.aspx?articleid
=181852

6. Tanggal Akses

:
3 Oktober 2015

7. Isi

:
ABSTRACT

Adjuvant corticosteroid therapy reduces hearing loss in children with

meningitis caused by Haemophilus influenzae type b (Hib). However, the
epidemiology of bacterial meningitis has changed dramatically following the
licensure and widespread use of vaccines against Hib in 1985 and Streptococcus
pneumoniaein 2000. The current benefit of adjuvant corticosteroids for the
treatment of bacterial meningitis in children remains unclear. Guidelines from the
Committee on Infectious Disease of the American Academy of Pediatrics
acknowledge this uncertainty and state that for infants and children aged 6 weeks
or older, adjunctive therapy with dexamethasone may be considered after
weighing the potential benefits and risks. Adjuvant corticosteroids, when used,
should be administered with or shortly before the first dose of antimicrobial
therapy.
Antimicrobial-induced bacteriolysis leads to inflammation and cerebral
edema. The beneficial effects of corticosteroids are attributed to attenuation of
this inflammatory response. Concerns over the use of corticosteroids relate to the
potential for decreased cerebrospinal fluid (CSF) penetration of antibiotics and
potential adverse effects of corticosteroids, namely gastrointestinal
bleeding. Other concerns with corticosteroid use include the potential to mask
antimicrobial failure by preventing a secondary fever.
In adults, adjuvant corticosteroids decrease mortality in patients with
bacterial meningitis, with the greatest benefit occurring in the subset of patients
with pneumococcal meningitis. In neonates and children, the effect of

corticosteroids on mortality is controversial. Only 1 small clinical

trial specifically evaluated corticosteroids in neonates; however, the study was
not included in a large Cochrane review. The results of that study of neonates by
Daoud et al showed no difference in mortality between treatment and control
groups. A retrospective study of 120 children with pneumococcal meningitis
conducted between 1994 and 1999 found that adjuvant corticosteroid use was
associated with a lower odds of death in adjusted analysis.However, a subsequent
Cochrane review of randomized controlled trials from 1969 to 2006 found no
significant difference in mortality in children younger than 16 years who received
corticosteroids compared with those who did not receive corticosteroids for all
causative organisms, although the overall mortality rate was lower than
previously reported in some of the studies. Furthermore, few of these studies
were conducted in the United States.
In a multicenter randomized controlled trial conducted in Latin
America not included in the Cochrane review, adjuvant corticosteroids had no
effect on mortality in children aged 2 months to 16 years. However, the study was
performed in areas where Hib accounted for most cases of meningitis. Also, in
contrast with previous work, the study found no protection against hearing loss in
the 54 children with Hib meningitis who received adjuvant corticosteroids
compared with controls.A more recent randomized trial in Vietnam found that
adjuvant corticosteroids decreased overall mortality in those individuals with
culture-confirmed bacterial meningitis. The study included adults and
adolescents; however, the results were not stratified by age.
The goal of our study was to determine the effect of adjuvant
corticosteroid therapy on mortality and length of hospitalization in children with
bacterial meningitis treated at tertiary care children's hospitals in areas where Hib
meningitis is no longer prevalent.

1. Penulis

2. Judul

Nandita Chinchankar
Meenakshi Mane
Sheila Bhave,
Swatee Bapat
Ashish Bavdekar
Anand Pandit, K.B.
Niphadkar
Anil Dutta
Didier Leboulleux

:
DIAGNOSIS AND OUTCOME OF
ACUTE
BACTERIAL
MENINGITIS IN EARLY
CHILDHOOD

3. Penerbit

4. Tahun Publish

5. Situs

INDIAN PEDIATRICS
Oktober 2002
http://www.indianpediatrics.net/oct2002/oct-9
14-921.htm
6. Tanggal Akses

7. Isi

3 Oktober 2015
ABSTRACT
Objective:To estimate frequency of acute bacterial meningitis (ABM) in
early childhood in hospital admissions, to describe clinical and diagnostic
features, and to analyze mortality, complications and long term
sequelae. Design: Prospective study. Setting: Pediatric wards and Rehabilitation
Center of KEM Hospital, Pune. Method: Study subjects between the ages of 1
months to 5 years with ABM were recruited. Clinical details were recorded. CSF
was analysed by routine biochemical methods, antigen detection tests (Latex
agglutination LAT) and microbiological studies on special media. Management
was as per standard protocols. Survivors were followed up long term with
neurodevelopmental studies and rehabilitation programmes. Results: In a study
period of 2 years, 54 children (1.5% of all admissions) satisfied the criteria of
ABM in early childhood; 78% were below one year and 52% were under the age
of six months. Chief presentation was high fever, refusal of feeds, altered
sensorium and seizures. Meningeal signs were present in only 26%. CSF Creactive protein was positive in 41%, gram stain was positive in 67%, LAT in
78% and cultures grew causative organisms in 50% of the cases. The final

etiological diagnosis (as per LAT and/or cultures) were Streptococcus

pneumoniae 39%, Hemophilus influenzae type b 26% and others in 35%. The
others included one case of Neisseria meningitidis and 10 who were LAT
negative and culture sterile. 39% patients developed acute neurological
complications during the hospital course. 31% children with ABM died in
hospital or at home soon after discharge. Six were lost to follow up. Of the 31
children, available for long term follow up (1-3 years), 14 (45%) had no
sequelae. The remaining had significant neurodevelopmental handicaps ranging
from isolated hearing loss to severe mental retardation with multiple
disabilities. Conclusion:ABM in early childhood has a considerable mortality,
morbidity and serious long term sequelae. Neurodevelopmental follow up and
therapy should begin early. Etiological diagnosis can be enhanced by LAT and
good culture media. H. influenzae b and S. pneumoniae account for more than
60% of ABM in early childhood.
Key words: Acute bacterial meningitis, Long term Sequelae.
ACUTE bacterial meningitis (ABM) is an important disease of early
childhood, with high case fatality and risk of neurologic handicaps(1). The
community incidence of ABM in India is not known. The exact etiological
diagnosis is often not possible, because of poor culture facilities(2,3). The three
organisms commonly associated with ABM in early childhood in western
countries are Hemophilus influenzae type b, S. Pneumoniae and Neisseria
meningitidis. However, the etiology may vary in different parts of the world(1).
Many of these infections are likely to be preventable in the near future(4,5). We
have prospectively examined the hospital based frequency of ABM in early
childhood, especially in relation to its etiology. The clinical and diagnostic
features, mortality, complications and especially long term sequelae were also
analysed

1. Penulis

2. Judul

Rianne Oostenbrink
Marille Maas
Karel G. M. Moons
Henritte A. Moll

:
SEQUELAE AFTER BACTERIAL MENINGITIS
IN CHILDHOOD

3. Penerbit

:
SCANDINAVIAN JOURNAL OF INFECTIOUS
DISEASES

4. Tahun Publish

5. Situs

08 Jul 2009
http://www.tandfonline.com/doi/pdf/10.1080/0036
5540110080179?redirect=1#.VhE46jEkSSo
6. Tanggal Akses

:
3 Oktober 2015

7. Isi

:
ABSTRACT

The neurological outcome of bacterial meningitis in children was evaluated

retrospectively. Data were obtained from a large study on children aged between
1 month and 15 y who initially visited the emergency department of Sophia
Children's Hospital, Rotterdam, The Netherlands with meningeal signs. This
study presents data from 103 patients in whom bacterial meningitis was
diagnosed. Neisseria meningitidis was the dominant pathogen of meningitis. We
found a 2% case-fatality rate in children with bacterial meningitis and a 13% rate
of sequelae among survivors: 7% hearing impairment and 7% neurological
sequelae. Children with bacterial meningitis caused by Streptococcus
pneumoniae and those with acute focal neurological symptoms tended to have the
worst prognosis.

1. Penulis

2. Judul

Tessa Goetghebuer,
T. Eoin West,
Vanessa Wermenbol,
Anna Louise Cadbury,
Paul Milligan,
Nellie Lloyd-Evans,
Richard A. Adegbola,
E. Kim Mulholland,
Brian M. Greenwood and
Martin W. Weber

:
OUTCOME OF MENINGITIS CAUSED
BY STREPTOCOCCUS
PNEUMONIAE ANDHAEMOPHILUS I
NFLUENZAE TYPE B IN CHILDREN IN
THE GAMBIA

3. Penerbit

:
The European Journal Tropical Medicine &
International Health

4. Tahun Publish :
25 Desember 2001
5. Situs

:
http://onlinelibrary.wiley.com/doi/10.1046/j.13
65-3156.2000.00535.x/abstract

6. Tanggal Akses

:
3 Oktober 2015

7. Isi

:
ABSTRACT

In developing countries, endemic childhood meningitis is a severe

disease caused most commonly by Streptococcus pneumoniae or Haemophilus
influenzae type b (Hib). Although many studies have shown that fatality rates
associated with meningitis caused by these organisms are high in developing
countries, little is known about the long-term outcome of survivors. The purpose
of this study was to assess the importance of disabilities following pneumococcal
and Hib meningitis in The Gambia. 257 children aged 012 years hospitalized
between 1990 and 1995 with culture-proven S. pneumoniae (n = 134) or Hib (n =
123) meningitis were included retrospectively in the study. 48% of children with

pneumococcal meningitis and 27% of children with Hib meningitis died whilst in
hospital. Of the 160 survivors, 89 (55%) were followed up between September
1996 and October 1997. Of the children with pneumococcal meningitis that were
traced, 58% had clinical sequelae; half of them had major disabilities preventing
normal adaptation to social life. 38% of survivors of Hib meningitis had clinical
sequelae, a quarter of whom had major disabilities. Major handicaps found were
hearing loss, mental retardation, motor abnormalities and seizures. These data
show that despite treatment with effective antibiotics, pneumococcal and Hib
meningitis kill many Gambian children and leave many survivors with severe
sequelae. Hib vaccination is now given routinely in The Gambia; an effective
pneumococcal vaccine is needed.