Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study.
<h4>Background</h4>Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan.<h4>Methods</h4>We conducted a prospective observational cohort study over one year...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0265487 |
| _version_ | 1811336642319876096 |
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| author | Bilal Ahmad Rahimi Niamatullah Ishaq Ghulam Mohayuddin Mudaser Walter R Taylor |
| author_facet | Bilal Ahmad Rahimi Niamatullah Ishaq Ghulam Mohayuddin Mudaser Walter R Taylor |
| author_sort | Bilal Ahmad Rahimi |
| collection | DOAJ |
| description | <h4>Background</h4>Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan.<h4>Methods</h4>We conducted a prospective observational cohort study over one year, February 2020 to January 2021 in a tertiary care hospital in Kandahar, Afghanistan. AMB was diagnosed clinically and on lumbar puncture findings. Binary logistic regression assessed factors for death.<h4>Results</h4>A total of 393 ABM children of mean age 4.8 years were recruited. Most were males [231 (58.8%)], living in rural areas [267 (67.9%)] and in households of >10 inhabitants [294 (74.8%)]. Only 96 (24.4%) had received against both Haemophilus influenzae type b (Hib) or pneumococcal (PCV) vaccines. Children were treated with combination of ceftriaxone and ampicillin and 169/321 (52.6%) received dexamethasone. Of the 321 children with a known outcome, 69 (21.5%) died. Death was significantly associated with: not receiving dexamethasone [adjusted odds ratio (AOR) 4.9 (95% CI 2.6-9.5, p <0.001)], coma on admission [AOR 4.6 (I 2.3-9.5, p <0.001)], no PCV [AOR 2.8 (1.2-6.6, p = 0.019)] or Hib vaccine [AOR 2.8 (1.2-6.6, p = 0.019)], and being male [AOR 2.7 (1.4-5.5, p = 0.005).<h4>Conclusions</h4>ABM causes significant morbidity and mortality in Afghan children that may be improved by greater use of PCV and Hib vaccines. Adjunct dexamethasone should be evaluated formally in our setting. |
| first_indexed | 2024-04-13T17:42:34Z |
| format | Article |
| id | doaj.art-8d877e83a6054e11a6a8eb9bc23ebf5f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T17:42:34Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-8d877e83a6054e11a6a8eb9bc23ebf5f2022-12-22T02:37:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01174e026548710.1371/journal.pone.0265487Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study.Bilal Ahmad RahimiNiamatullah IshaqGhulam Mohayuddin MudaserWalter R Taylor<h4>Background</h4>Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan.<h4>Methods</h4>We conducted a prospective observational cohort study over one year, February 2020 to January 2021 in a tertiary care hospital in Kandahar, Afghanistan. AMB was diagnosed clinically and on lumbar puncture findings. Binary logistic regression assessed factors for death.<h4>Results</h4>A total of 393 ABM children of mean age 4.8 years were recruited. Most were males [231 (58.8%)], living in rural areas [267 (67.9%)] and in households of >10 inhabitants [294 (74.8%)]. Only 96 (24.4%) had received against both Haemophilus influenzae type b (Hib) or pneumococcal (PCV) vaccines. Children were treated with combination of ceftriaxone and ampicillin and 169/321 (52.6%) received dexamethasone. Of the 321 children with a known outcome, 69 (21.5%) died. Death was significantly associated with: not receiving dexamethasone [adjusted odds ratio (AOR) 4.9 (95% CI 2.6-9.5, p <0.001)], coma on admission [AOR 4.6 (I 2.3-9.5, p <0.001)], no PCV [AOR 2.8 (1.2-6.6, p = 0.019)] or Hib vaccine [AOR 2.8 (1.2-6.6, p = 0.019)], and being male [AOR 2.7 (1.4-5.5, p = 0.005).<h4>Conclusions</h4>ABM causes significant morbidity and mortality in Afghan children that may be improved by greater use of PCV and Hib vaccines. Adjunct dexamethasone should be evaluated formally in our setting.https://doi.org/10.1371/journal.pone.0265487 |
| spellingShingle | Bilal Ahmad Rahimi Niamatullah Ishaq Ghulam Mohayuddin Mudaser Walter R Taylor Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. PLoS ONE |
| title | Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. |
| title_full | Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. |
| title_fullStr | Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. |
| title_full_unstemmed | Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. |
| title_short | Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. |
| title_sort | outcome of acute bacterial meningitis among children in kandahar afghanistan a prospective observational cohort study |
| url | https://doi.org/10.1371/journal.pone.0265487 |
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