- Title
- Predictors of acute bacterial meningitis in children from a malaria-endemic area of Papua New Guinea
- Creator
- Laman, Moses; Manning, Laurens; Greenhill, Andrew; Mare, Trevor; Michael, Audrey; Shem, Silas; Vince, John; Lagani, William; Hwaihwanje, Ilomo; Siba, Peter; Mueller, Ivo; Davis, Timothy
- Date
- 2012
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/163765
- Identifier
- vital:12934
- Identifier
-
https://doi.org/10.4269/ajtmh.2012.11-0312
- Identifier
- ISBN:0002-9637
- Abstract
- Predictors of acute bacterial meningitis (ABM) were assessed in 554 children in Papua New Guinea 0.2-10 years of age who were hospitalized with culture-proven meningitis, probable meningitis, or non-meningitic illness investigated by lumbar puncture. Forty-seven (8.5%) had proven meningitis and 36 (6.5%) had probable meningitis. Neck stiffness, Kernig's and Brudzinski's signs and, in children < 18 months of age, a bulging fontanel had positive likelihood ratios (LRs) ≥ 4.3 for proven/probable ABM. Multiple seizures and deep coma were less predictive (LR = 1.5-2.1). Single seizures and malaria parasitemia had low LRs (≤ 0.5). In logistic regression including clinical variables, Kernig's sign and deep coma were positively associated with ABM, and a single seizure was negatively associated (P ≤ 0.01). In models including microscopy, neck stiffness and deep coma were positively associated with ABM and parasitemia was negatively associated with ABM (P ≤ 0.04). In young children, a bulging fontanel added to the model (P < 0.001). Simple clinical features predict ABM in children in Papua New Guinea but malaria microscopy augments diagnostic precision.
- Relation
- American Journal of Tropical Medicine and Hygiene Vol. 86, no. 2 (2012), p. 240-245
- Rights
- Copyright © 2012 by The American Society of Tropical Medicine and Hygiene.
- Rights
- This metadata is freely available under a CCO license
- Subject
- 11 Medical and Health Sciences
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