Outcome of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b in children in The Gambia
Outcome of meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae type b in children in The Gambia
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DOI：
10.1046/j.1365-3156.2000.00535.x
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发表时间：
2000-03-01
影响因子：
3.3
通讯作者：
Weber, MW
中科院分区：
文献类型：
--
作者：
Goetghebuer, T;West, TE;Weber, MW
在发展中国家，地方性儿童脑膜炎是一种严重的疾病，最常见的是由肺炎链球菌或流感嗜血杆菌B型（HiB）引起。虽然许多研究表明，在发展中国家，与这些生物体引起的脑膜炎有关的死亡率很高，但对幸存者的长期结果知之甚少。本研究的目的是评估残疾的重要性，以下肺炎球菌和Hib脑膜炎在冈比亚。1990年至1995年期间，257名0-12岁儿童因培养证实的S.肺炎（n = 134）或Hib（n = 123）脑膜炎的患者。48%的肺炎球菌脑膜炎患儿和27%的Hib脑膜炎患儿在住院期间死亡。在160名幸存者中，89名（55%）在1996年9月至1997年10月期间接受了随访。在被追踪的肺炎球菌脑膜炎患儿中，58%有临床后遗症;其中一半有严重残疾，无法正常适应社会生活。38%的Hib脑膜炎幸存者有临床后遗症，其中四分之一有严重残疾。发现的主要残疾是听力损失、智力迟钝、运动异常和癫痫。这些数据表明，尽管使用了有效的抗生素进行治疗，肺炎球菌和Hib脑膜炎仍导致许多冈比亚儿童死亡，并使许多幸存者留下严重的后遗症。冈比亚目前常规接种Hib疫苗;需要有效的肺炎球菌疫苗。
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 0-12 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.