Epidemiological Study and Associated Risk Factors for Developing Bacterial Meningitis in Children of Odisha, India

Abstract

Background: Bacterial meningitis is a leading cause of high childhood transience. It is the foremost cause of fatality in pediatric age group of 0-5 years in India accounting 0.5 to 2.6% of hospital admissions with CFR 16-30%. Based on above scenario, the study was undertaken to address the prevalence, etiology, social determinants of health factors of bacterial meningitis among under five children Odisha, India. Methods: A cross sectional study comprising of children under five years of age admitted to tertiary care hospital and teaching institutions in Cuttack with suspected clinical diagnosis of bacterial meningitis during April, 2012 to September 2013. About 634 children enrolled into the study after getting appropriate consent from parents or their legal guardians. Lumbar puncture was done and CSF was sent for biochemical analysis, cell counts, staining, culture, latex agglutination test (LAT) and real time polymerase chain reaction (RT PCR). Results: About 61 children (10.4%) were confirmed with diagnosis of bacterial meningitis by either culture, latex or RT PCR.  Male children (74.7%) were significantly more prone to bacterial meningitis than females (24.3%). The common isolated pathogens were Streptococcus pneumonia, Haemophilus influenza type b, E. coli, Pseudomonas aeruginosa, Klebseilla pneumoniae and Staphylococcus aureus. Streptococcus pneumoniae was observed to be most common pathogen (57.6%) followed by Haemophilus influenzae type b (26.2%). The risk factors analyzed showed statistically significant association (p<0.01) with low household income, mother’s education, overcrowding (more than 3 persons in a single room), smoking and poor ventilation of household. Conclusion: Strengthening early detection of bacteria meningitis by rapid diagnostic test like LATEX, RT PCR and prompt treatment of emergent case at the household level, improvement in mother’s education and awareness, transportation to local hospital and facility for treatment and care should be utmost priority in the present scenario. It is crucial to assess the burden of bacterial meningitis with its etiology is in this region as  vaccines are yet to be introduced in the child vaccine program.