Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study
Issued Date
2022-04-01
Resource Type
eISSN
19326203
Scopus ID
2-s2.0-85127853344
Pubmed ID
35404980
Journal Title
PLoS ONE
Volume
17
Issue
4 April
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS ONE Vol.17 No.4 April (2022)
Suggested Citation
Rahimi B.A., Ishaq N., Mudaser G.M., Taylor W.R. Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study. PLoS ONE Vol.17 No.4 April (2022). doi:10.1371/journal.pone.0265487 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86542
Title
Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background 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. Methods 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. Results 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). Conclusions 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.