Neonatal meningitis 1

Lead investigator

Dr D Holt

About the study

Between 1985 and 1987, the Karim Centre for Meningitis Research carried out a survey to determine the incidence of meningitis in children aged under one year. At the time, no country-wide survey existed. The incidence of neonatal meningitis was 0.32 per 1000 live births. The principal infecting bacteria were Group B haemolytic streptococci, Escherichia coli, and Listeria monocytogenes. Half of the neonates were on a regimen based on chloramphenicol, and the other half on aminoglycosides. The diagnosis was based on a positive culture from the cerebrospinal fluid (CSF), cell counts in the CSF and the clinical picture. Over 30% of the babies who survived had an identifiable neurodevelopmental problem at five years of age.

Over the intervening years, paediatric practice in the diagnosis and treatment of neonatal meningitis changed. Lumbar puncture was omitted from routine infection screens, and in some cases, when the baby had serious signs indicative of meningitis.

The first line of treatment with a combination of a penicillin and chloramphenicol or an aminoglycoside was replaced by a combination of ampicillin and a third-generation cephalosporin, and it was suggested that there was also increasing use of steroids and immunoglobulins in this age group.

This study aimed to determine the incidence, mortality, diagnostic procedures, principal infecting organisms and treatment of meningitis in the newborn period. Additionally, this may also contribute to revisions in the knowledge of the disease, its diagnosis and treatment. The children identified by the study were examined at both five and nine years of age to determine long-term morbidity after modern treatment.

Duration

July 1996 – December 1996

Published papers

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