Aetiology of encephalitis and meningitis in children aged 1-59 months admitted to the Children's Hospital, Lusaka, Zambia

Authors

  • A. Imamba University Teaching Hospitals, Children's Hospital, Lusaka, Zambia
  • P. Kalima Department of Laboratory Medicine, Lothian University Hospitals Div., Edinburg, Scotland, UK
  • G. Kwenda University Teaching Hospital, Microbiology Laboratory, Lusaka, Zambia
  • J. Chipeta University Teaching Hospitals, Children's Hospital, Lusaka, Zambia
  • Ruth Nakazwe University Teaching Hospital, Microbiology Laboratory, Lusaka, Zambia
  • K. Templeton Department of Laboratory Medicine, Lothian University Hospitals Div., Edinburg, Scotland, UK
  • E.M. Mpabalwani University Teaching Hospitals, Children's Hospital, Lusaka, Zambia

DOI:

https://doi.org/10.55320/mjz.46.2.107

Abstract

Background: Meningitis and encephalitis are important causes of admissions and mortality in Zambia. Apart from bacterial causes, no data is available on viral agents that cause disease at the Children's Hospital, Lusaka, Zambia. We conducted a prospective descriptive study to determine the viral and bacterial causes of encephalitis and meningitis in children aged 1-59 months.

Methods: From November 2016 to February 2018, we collected cerebrospinal fluid (CSF) samples and clinical details from children admitted to the inpatient wards with encephalitis and meningitis. Macroscopic examination, microscopy, bacterial
culture and real-time (Multiplex) PCR were performed on the CSF samples.

Results: A total of 106 patients were enrolled. The median age was 10 months and 81 (76.4%) had meningitis while 25 (23.6%) had encephalitis. One (0.9%) participant had Haemophilus influenzae detected by both culture and PCR. Two (1.9%) had Neisseria meningitidis while 5 (4.7%) had Streptococcus pneumoniae detected only by PCR. Viruses were detected in 26.4% (28/106) and 64% had meningitis. The viral agents detected were: EBV (10%); Parvovirus B19, Human herpes virus type 6, Human herpes virus type 7 and CMV at 2.8% each. A raised CSF WBC was associated with the case definition (P=0.01) of meningitis. Patients with meningitis were more likely to be alive at discharge than those with encephalitis (OR = 3.6, CI = 1.96 – 6.68, P-value <0.001).

Conclusions: Viral infections of the central nervous system (CNS) are the commonest causes of both encephalitis and meningitis at the Children's Hospital, Lusaka, Zambia.

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Published

17-08-2019

Issue

Section

Original Article

How to Cite

Aetiology of encephalitis and meningitis in children aged 1-59 months admitted to the Children’s Hospital, Lusaka, Zambia. (2019). Medical Journal of Zambia, 46(2), 81-89. https://doi.org/10.55320/mjz.46.2.107