Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020.
Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
Volume: 122
Issue:
Year of Publication: 2022
Affiliated Institutions:
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: susan.meiring@nhls.ac.za.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa. Electronic address: cherylc@nicd.ac.za.
Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa. Electronic address: lindad@nicd.ac.za.
Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: mignond@nicd.ac.za.
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa. Electronic address: vanessaq@nicd.ac.za.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa. Electronic address: jackiel@nicd.ac.za.
Division of Infectious Diseases, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: colin.menezes@wits.ac.za.
Rahima Moosa Mother & Child Hospital, Department of Paediatrics & Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: gary.reubenson@wits.ac.za.
Department of Medicine, Pietermaritzburg Hospital Complex, Pietermaritzburg, South Africa; Caprisa, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. Electronic address: pmbiddoc@gmail.com.
Medical Microbiology Laboratory, National Health Laboratory Service, Dr George Mukhari Tertiary Hospital, Garankuwa, South Africa; Microbiology Department, Sefako Makgatho Health Sciences University, Garankuwa, South Africa. Electronic address: maphoshane.nchabeleng@smu.ac.za.
Medical Microbiology Laboratory, National Health Laboratory Service, Tswane Academic Hospital, Pretoria, South Africa; Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa. Electronic address: Mohamed.said@nhls.ac.za.
Medical Microbiology Laboratory, National Health Laboratory Service, KwaZulu-Natal Academic Complex, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. Electronic address: nomonde.dlamini@nhls.ac.za.
Medical Microbiology Laboratory, National Health Laboratory Service, KwaZulu-Natal Academic Complex, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. Electronic address: mahabeerp@ukzn.ac.za.
Division of Clinical Microbiology and Infectious Diseases, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Medical Microbiology Laboratory, National Health Laboratory Service, Helen Joseph Academic Hospital, Johannesburg, South Africa. Electronic address: rispah.chomba@nhls.ac.za.
Division of Medical Microbiology, Department of Pathology, University of Limpopo, Polokwane, South Africa; Medical Microbiology Laboratory, National Health Laboratory Service, Polokwane Academic Hospital, Polokwane, South Africa. Electronic address: mlekalakala@nhls.ac.za.
Division of Clinical Microbiology and Infectious Diseases, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Medical Microbiology Laboratory, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. Electronic address: trusha.nana@nhls.ac.za.
Division of Clinical Microbiology and Infectious Diseases, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Medical Microbiology Laboratory, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. Electronic address: vindana.chibabhai@nhls.ac.za.
Division of Clinical Microbiology and Infectious Diseases, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Medical Microbiology Laboratory, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. Electronic address: marianne.black@nhls.ac.za.
Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: annev@nicd.ac.za.
Abstract summary
Providing country-specific estimates of case fatality and sequelae from bacterial meningitis (BM) is important to evaluate and monitor progress toward the World Health Organization's roadmap to "defeating meningitis by 2030".From 2016-2020, GERMS-SA conducted enhanced surveillance at 26 hospitals across South Africa. Episodes of laboratory-confirmed BM due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis were included. Risk factors for in-hospital death and sequelae at hospital discharge among survivors were analyzed.Of 12,717 invasive bacterial infections reported nationally, 39% (4980) were from enhanced surveillance sites, including 4159 pneumococcal, 640 H. influenzae, and 181 meningococcal infections. BM accounted for 32% (1319/4159) of pneumococcal, 21% (136/640) of H. influenzae, and 83% (151/181) of meningococcal invasive diseases. Clinical data were available for 91% (1455/1606) of BM: 26% (376/1455) were aged <5 years, 50% (726/1455) were female, and 62% (723/1171) with known HIV results, were HIV-infected. In-hospital case fatality was 37% (534/1455), and 24% (222/921) of survivors had adverse sequelae. Risk factors for death included altered mental status, HIV infection, and comorbidities. Risk factors for adverse sequelae included altered mental status and antimicrobial nonsusceptibility.BM in South Africa has a high case fatality, and adverse sequelae frequently occur among survivors. Those with comorbidities (including HIV) are at the highest risk.
Authors & Co-authors:
Meiring Susan S
Cohen Cheryl C
de Gouveia Linda L
Plessis Mignon du MD
Quan Vanessa V
Kleynhans Jackie J
Menezes Colin C
Reubenson Gary G
Dawood Halima H
Nchabeleng Maphoshane M
Said Mohamed M
Mvelase Nomonde N
Mahabeer Prasha P
Chomba Rispah R
Lekalakala Ruth R
Nana Trusha T
Chibabhai Vindana V
Black Marianne M
von Gottberg Anne A
Study Outcome
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