Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020

•Despite available vaccines and antibiotics, bacterial meningitis is deadly.•In South Africa, a middle-income country, over one in three individuals with bacterial meningitis die.•A total of 24% of survivors reported sequelae, and 5% died within 2 months of hospital discharge.•HIV (particularly in i...

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Published in:International journal of infectious diseases 2022-09, Vol.122, p.1056-1066
Main Authors: Meiring, Susan, Cohen, Cheryl, de Gouveia, Linda, Plessis, Mignon du, Quan, Vanessa, Kleynhans, Jackie, Menezes, Colin, Reubenson, Gary, Dawood, Halima, Nchabeleng, Maphoshane, Said, Mohamed, Mvelase, Nomonde, Mahabeer, Prasha, Chomba, Rispah, Lekalakala, Ruth, Nana, Trusha, Chibabhai, Vindana, Black, Marianne, von Gottberg, Anne
Format: Article
Language:English
Subjects:
Complications
Haemophilus influenzae
Meningitis
Mortality
Neisseria meningitidis
Streptococcus pneumoniae
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Summary:•Despite available vaccines and antibiotics, bacterial meningitis is deadly.•In South Africa, a middle-income country, over one in three individuals with bacterial meningitis die.•A total of 24% of survivors reported sequelae, and 5% died within 2 months of hospital discharge.•HIV (particularly in individuals with low cluster of differentiation [CD4] T cell counts) was a risk factor for death. 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
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2022.07.068