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Original Articles

Outcome and prognostic factors of acute meningoencephalitis in children of Southern Bangladesh

Authors:

Choudhury Habibur Rasul ,

Department of Paediatrics, Khulna Medical College & Hospital, Khulna, LK
About Choudhury
Professor, Department of Paediatrics, Khulna Medical College & Hospital, Khulna
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M Ashrafuz Zaman,

Department of Microbiology, Khulna Medical College, Khulna,
About M
Assistant Professor, Department of Microbiology, Khulna Medical College, Khulna,
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M Jahangir Hossain,

International Centre for Diarrhoeal Disease Research, Bangladesh,
About M
Associate Scientist, International Centre for Diarrhoeal Disease Research, Bangladesh,
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Evana Nasrin,

Department of Paediatrics, Khulna Medical College Hospital, Khulna,
About Evana
Assistant Registrar, Department of Paediatrics, Khulna Medical College Hospital, Khulna,
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Mahmudur Rahman

Institute of Epidemiology, Disease Control & Research, Dhaka, Bangladesh
About Mahmudur

Director, Institute of Epidemiology, Disease Control & Research, Dhaka, Bangladesh

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Abstract

Objective: To estimate the outcome of acute meningoencephalitis (AME) in children and evaluate the impact of prognostic factors.

Design and setting: A prospective cross sectional study was conducted in the paediatric ward of Khulna Medical College Hospital from 2007- 2009.

Method: All admitted children, aged 1 month to 12 years, satisfying the case definition were enrolled into the study. Cerebrospinal fluid (CSF) was collected for cytology and biochemistry to categorize AME into pyogenic, viral or normal varieties. CSF was tested for common bacterial antigen and, along with serum was also tested for Japanese encephalitis virus antibodies. Patients were monitored twice daily until the final outcome.

Results: One hundred and forty children were inducted constituting 2.5% of admissions. Infants (30%) were the worst sufferers. Twenty one (15%) children with AME died which is 4 times higher than the overall mortality (3.8%) in paediatric ward (p<0.001). Among the 11 bacteria positive cases one died from S Pneumoniae. Low GCS score was associated with higher mortality (p<0.05). Eighteen (13%) cases developed neurological sequelae. Paralysis (27%) was the most frequent followed by hydrocephalus (23%) and involuntary movements (14%). Number of sequelae was significantly higher in pyogenic (44%) meningoencephalitis in comparison to non-pyogenic (14%) variants (OR=3.30, 95% CI: 1.08-10.01, p<0.05).

Conclusions: Mortality from AME was 15%. Low GCS score was associated with higher fatality.

(Key Words: Outcome; prognostic factors; meningoencephalitis; Bangladesh)

DOI: http://dx.doi.org/10.4038/sljch.v42i1.5291

How to Cite: Rasul, C.H., Zaman, M.A., Hossain, M.J., Nasrin, E. and Rahman, M., 2013. Outcome and prognostic factors of acute meningoencephalitis in children of Southern Bangladesh. Sri Lanka Journal of Child Health, 42(1), pp.27–32. DOI: http://doi.org/10.4038/sljch.v42i1.5291
Published on 13 Mar 2013.
Peer Reviewed

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