Epidemiology of bacterial meningitis among children in Brazil, 1997-1998

Weiss, Débora Pl; Coplan, Paul; Guess, Harry A.

doi:10.1590/s0034-89102001000300006

Cited by 21 publications

(21 citation statements)

References 15 publications

(22 reference statements)

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“…Considering the absolute frequency of the cases, the highest ratio was observed in males of the 1-4-years age group in MG, which agrees with the findings of other studies [24][25][26] . Possible explanations for the high proportion of male cases are the facts that men have a tendency of taking less care of their health, expose themselves to a higher amount of risky situations, and seek the help of health care services less often than women.…”

Section: Ethical Considerationssupporting

confidence: 92%

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Epidemiological profile of meningococcal disease in the State of Minas Gerais and in the Central, North, and Triângulo Mineiro regions, Brazil, during 2000-2009

Nascimento

Miranzi

Scatena

2012

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: Infection by Neisseria meningitidis, termed as meningococcal disease, can cause meningococcal meningitis and septicemia with or without meningitis. Meningococcal disease is endemic in Brazil and has a high potential to cause large-scale epidemics; therefore, it requires the immediate notification of cases to the Information System for Notifiable Diseases (SINAN) in Brazil. The aim of this study was to describe an epidemiological profile using data from notified and confirmed cases in the State of Minas Gerais, Brazil, from January 2000 to December 2009, obtained from the investigation records of individuals with meningitis registered with SINAN. METHODS: This was a retrospective, population-based study. Descriptive analysis of the data was made using the simple and relative frequencies of the categorical variables in the investigation records. RESULTS: There were 1,688 confirmed patients in Minas Gerais of which 45.5% lived in the Central, North, and Triângulo Mineiro regions. The highest frequencies of cases were in the 1-4-years age group (26.3%), males (54.7%), caucasian (36.4%), and lived in an urban area (80%). In the patients with specified education, 650 (60.9%) patients had secondary education. Serogrouping of meningococci had been performed in 500 (29.6%) patients by age and gender; 285 (57%) belonged to serogroup C, 67 (13.4%) were in the 1-to 4-years age group, and 168 (33.6%) were male. CONCLUSIONS: The epidemiological profiles of patients in the Central, North, and Triângulo Mineiro regions were not significantly different from the profile of patients in Minas Gerais.

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Section: Ethical Considerationssupporting

confidence: 92%

“…The elevated percentage of cases with non-specified etiology reflects problems in the care process, i.e., in collecting, transporting, and/ or processing of cerebrospinal fluid samples, which corroborates the findings of other studies 25,32 .…”

Section: Ethical Considerationssupporting

confidence: 88%

Epidemiological profile of meningococcal disease in the State of Minas Gerais and in the Central, North, and Triângulo Mineiro regions, Brazil, during 2000-2009

Nascimento

Miranzi

Scatena

2012

Rev. Soc. Bras. Med. Trop.

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“…The mortality rate was 11.1% (Table 2), and N. meningitidis type B was the cause of all of the deaths. The high rate of failure to determine the etiological agent at GTH is consistent with other Brazilian reports, which range from 46.8 to 55.5% 3,6 . Although only 6.5% of the patients in the current study reported previous use of antibiotics, which is most likely an underestimation, the low bacterial culture rate is probably greatly affected by the previous use of antibiotics 5 .…”

supporting

confidence: 90%

Epidemiological profile of acute bacterial meningitis in the state of Rio Grande do Norte, Brazil

Silva

Pinheiro

Coutinho

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Acute bacterial meningitis (ABM) is a public health problem worldwide and, in Brazil, in the 1990s, an average of 28,000 cases of meningitis were reported annually 1 . In an etiological survey in northeastern Brazil in the 1980s, Bryan et al 2 reported that N. meningitides (meningococcus) was the most prevalent ABM pathogen, followed by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (pneumococcus) 2 . However, after the introduction of the anti-Hib conjugated vaccine to the public vaccination program in 1999, there was a significant decrease in the incidence of cases of ABM due to H. influenzae in Brazil 3 .Because of the high mortality rate and long-term sequels, fast and accurate diagnosis and appropriate treatment of ABM are fundamental for a good outcome 4 . The initial antibiotic regimen is usually empirical, and therefore, knowledge of the epidemiological profile of ABM in the community could lead to the best therapeutic choice 5 .In the present study, we describe the epidemiological profile of ABM at Giselda Trigueiro Hospital (GTH), a reference center for infectious diseases in the State of Rio Grande do Norte, Brazil, between 2005 and 2008. We are not aware of any previous study on the epidemiology of ABM in this Brazilian state.This study consisted of a descriptive retrospective survey of the cases of ABM that were attended at GTH between 2005 and 2008. During the period of this study, the hospital could not afford a pediatric ward, and children were sent to pediatric hospitals after diagnosis and initial treatment.Information on age, sex, home location (rural or urban area), laboratory results, criteria for diagnostic confirmation, previous use of antibiotics and outcome were collected from the official records of the Brazilian compulsory notification system (SINAN), which were available in the hospital' s epidemiology department. The data were analyzed through SPSS (Statistical Package for the Social Sciences), version 13.0.The diagnoses of cases with clinical signs and symptoms of ABM were confirmed in accordance with at least one of the following criteria: 1) cerebrospinal fluid (CSF) culture; 2) CSF Gram stain; 3) blood culture or blood Gram stain; 4) latex agglutination test on CSF; and 5) CSF presenting pleocytosis (> 500 cells/mm 3 ), predominantly polymorphonuclear neutrophils, protein level > 40mg/dl and glucose level < 40mg/dl. Two cases did not fit the above criteria and their diagnosis were confirmed post-mortem by means of autopsy.Blood and CSF were seeded in chocolate agar enriched with 5% sheep blood. The latex agglutination test was used to identify polysaccharide antigens from N. meningitides, S. pneumoniae and Hib in CSF. Gram's method consisted of a primary stain with crystal violet, followed by the addition of iodine, rapid decolorization with acetone, and staining with basic fuchsin.The antibiotic susceptibility of the S. pneumoniae was identified by means of the disk diffusion method, in accordance with the definitions of the National Committee for Clini...

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“…The risk of Hib meningitis found for the pre-vaccine period was similar to that observed in Campinas, southeastern Brazil (17x10 5 ), and is comparable to those found in European countries such as Austria, Spain, and England. 9,14 The impact of the Hib vaccination has also been evaluated in other Brazilian regions. In Curitiba, southern Brazil, the incidence of meningitis dropped from 35.5 to 9.7x10 5 (72% reduction), one year after the introduction of the vaccine.…”

Section: Discussionmentioning

confidence: 99%

Impacto da vacinação contra o Haemophilus influenzae b na redução de meningites, Goiás

et al. 2004

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ObjectiveTo assess the impact of the Haemophilus influenzae b (Hib) conjugate vaccine in reducing the incidence of meningitis among children under five years old. Methods A 'before-after' design was used to compare Hib meningitis incidence rates in the pre-vaccine (July 1995 -June 1999) and post-vaccine (July 1999 -June 2001 periods in the state of Goiás, central Brazil . Bacterial meningitis case definition was based on World Health Organization criteria. Incidence rates of S. pneumoniae and N. meningitidis were used for comparison purposes. Chi-squared and Student's t tests were used for statistical analysis. P-values below 0.05 were considered as statistically significant. Results 979 children with acute bacterial meningitis were detected throughout the entire period. The incidence rate of Hib meningitis decreased from 10.8 (x10 5 ) in the pre-vaccine period to 2.3 (x10 5 ) in the 2 nd year post vaccination, leading to a risk reduction of 78%, targeted to the 7-23 months age group (p<0.05). A total of 65 cases of Hib meningitis were prevented. An increase in S. pneumoniae meningitis was observed. Vaccine failure was detected in one child. Conclusions This study showed that mass immunization with Hib conjugate vaccine brought about an expressive decline in childhood Hib meningitis in Goiás soon after the first year. Notwithstanding, an enhancement of surveillance using high-accuracy tools is essential to: (i) detect a possible reemergence of Hib; (ii) identify vaccine failure, and (iii) monitor changes in the H. influenzae serotype profile over time.

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Epidemiology of bacterial meningitis among children in Brazil, 1997-1998

Cited by 21 publications

References 15 publications

Epidemiological profile of meningococcal disease in the State of Minas Gerais and in the Central, North, and Triângulo Mineiro regions, Brazil, during 2000-2009

Epidemiological profile of meningococcal disease in the State of Minas Gerais and in the Central, North, and Triângulo Mineiro regions, Brazil, during 2000-2009

Epidemiological profile of acute bacterial meningitis in the state of Rio Grande do Norte, Brazil

Impacto da vacinação contra o Haemophilus influenzae b na redução de meningites, Goiás

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