Current status and challenges in the care of patients with bacterial meningitis in the Philippines: A scoping review

• Published in: Tropical medicine & international health 2022-01, Vol.27 (1), p.38-48
• Main Authors: Ocampo, Ferron F, Espiritu, Adrian I, Jamora, Roland Dominic G
• Format: Article
• Language: English
• Subjects: Antibiotics; Bacteria; Cerebrospinal fluid; Cost analysis; Delivery of Health Care; Devolution; Epidemiology; Health care; Health care facilities; Health care policy; Health services; Health surveillance; Humans; Immunization; Literature reviews; Manpower; Meningitis; Meningitis, Bacterial - epidemiology; Meningitis, Bacterial - microbiology; Meningitis, Bacterial - prevention & control; Morbidity; National Health Programs; Neurosurgery; Patients; Philippines - epidemiology; Rehabilitation; Surveillance systems; Vaccination; Vaccines
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13704

Bacterial meningitis is associated with high morbidity and mortality if not treated early. Due to the high disease burden, there are barriers in the provision of healthcare services for these patients, especially in low- to middle-income countries, such as the Philippines. We aimed to give an overview of healthcare services delivery and identify gaps in the provision of care for patients with bacterial meningitis in the Philippines. We conducted a scoping review on the available literature on the epidemiology, research, health services delivery, diagnostics and management of Filipino patients with bacterial meningitis. A qualitative summary of the results was conducted to provide an overview of the findings. There is a paucity of epidemiological data and research on bacterial meningitis. Healthcare expenditure remains out-of-pocket, with limited coverage from the national health insurance programme. There is an inadequate number of neurologists as well as inequities in the distribution of manpower and facilities due to the devolution of the healthcare system. Diagnosis remains a challenge due to the inaccessibility of tests for CSF analysis. Costs of antibiotics, adjunctive treatment, neurosurgical interventions and rehabilitation are also prohibitive. Outbreaks can be prevented by strengthening existing surveillance systems and improving vaccination coverage against the most common causative organisms. Enormous challenges still exist with regards to health services delivery in patients with bacterial meningitis in the Philippines in terms of epidemiologic data and research, access to healthcare facilities and diagnostic tools, healthcare costs, surveillance systems and immunisation against causative pathogens.