Aetiology of Encephalitis and Meningitis in Children Aged 1-59 Months Admitted to the Children's Hospital, Lusaka, Zambia

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

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.

Disclosure: The authors declare no conflict of interest.

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Author Biographies

P Kalima, Lothian University Hospitals Div., Edinburg, Scotland, UK

Department of Laboratory Medicine

G Kwenda, University Teaching Hospital (UTH), Lusaka Zambia

Microbiology Laboratory

J Chipeta, University Teaching Hospitals, Children's Hospital, Lusaka

University of Zambia, School of Medicine, Department of Paediatrics & Child Health, Lusaka, Zambia

K Templeton, Lothian University Hospitals Div., Edinburg, Scotland, UK

Department of Laboratory Medicine

E. M Mpabalwani, University Teaching Hospitals, Children's Hospital, Lusaka

University of Zambia, School of Medicine, Department of Paediatrics & Child Health, Lusaka, Zambia

Published
2019-08-15
Section
Articles