Epidemiology of bacterial meningitis in IBN-EL-Khateeb hospital Baghdad 1986-1990.

number: 
639
إنجليزية
Degree: 
Imprint: 
Medicine
Author: 
Omar Abdul-Sattar
Supervisor: 
Dr.Amjad Dawood Niazi
Dr.Abdul Jabbar Abdul Abbas
year: 
1992
Abstract:

Bacterial meningitis, including meningococcal infection, posses a serious health problem in Iran. It is still causing morbidity and mort­ality, particularly during childhood. To clearify the epidemiological & clinical si­tuations of the disease & to obtain abase line data for planning of its control in Iraq, this retrospective study seek to Identify and desc­ribe the occurance and distribution of bacter­ial meningitis in the community in the terms of person, place and time. The Iraq criteria for diagnosis arid case-def­inition which is relevant to the W.H.O. crite­ria was used as acut-off point for classifica­tion. This study was conducted in Ibn-El-Khateeb hospital Baghdad in (1992). it included all bacterial meningitis cases acJ.mitted to Ibn-El-Khateeb hospital for the period 1986-1990. Local patients records, admission & discharging reco­rds, M.O.H. statistical data, C.D.C annual sta­tistical data & Baghdad health governerate's vital & medical statistical data were all used to collect the data needed for this study. The following results were obtained from this study :- 1- There were 1988 (76%), 317(12.6%) and 224(8.8%) of patients with pyogenic, meningococcal and tuberculous meningitis respectively registered for the 5-years period . 2- A change i n the pattern of occurance of meningococcal meningitis outbreaks was occured since 1976. Previously .in epidemic wave occured every 10-12year since 1940.Outbreaks began to occure every 3-6 years. 4-Outb­reak of this disease were recorded since 1976. The last one in 1989 as this study showed. It is ende­mic in the inter-epidemic periods. 3. Haemophilus influenzas and streptococcus pneumontae are common pathogens causing pyogenic menin­gitis in chidren under lyear of age. It is rarely occured in adult age-groups. The percent of the confirmed cases showed that H.Influenzae and pheumococcal meningitis has (70%) and (44%) for childr­en under 1 years of age respectively .4- meningococcal meningitis affect mainly the age group (1-4) year and (15-45) year. 5. Tuberculous meningitis is the gravest type of meningitis with a high case fatality rate reachs (27.7%)in 1990 it is ***occured in children U5 but adults aged (15-45) year were affected more than the other.age-group . 5- The case fatality rate of meningococcal mening­itis was high in children under lyear of age. The same rate for tuberculous and pyogenic meningitis was high in the age -group 46 year and over. 6. The sex ratio show amale preponderance with male/female ratio about 2/1 for all types of men­ingitis under study .*** uncommonly 7- N. meninyitidis is the only one causing epidemic among the differen bacterial pathogenea causing meningitis.Serogroup- A is predominated in Iraq,alt­hough serogruup B and W135 was Isolated in 1990. In 1989 an outbreak occured and out of the (317) total number of patients, 193 (60.8%) were recorded in(1989) with an attack rate of (3.8) per 100,000 Baghdad population. 8- Saddam City, Khahdymia, New Baghdad & Al-Dora were highly endemic area in Baghdad with meningococcal meningitis & ( 38 . 7% ) , ( 34 .5% ) and (26.9%) of casesdue to meningococcal, pyogenic and tuberculous meningitis during the 5-years period respectively were from Saddam City.9.Muthana governerate had the highest attack rate with bacterial' meningitis (i.e.pyogenic & meningococcal meningitis) reach to 37/100,000 annually . Baghdad and Arbil had 10-15/100 , 000 /year . 10-The higliest percentage of referred case from oth­er governerates to Ibn-El-Khateeb.hospital was in tubereulous meningitis cases.It was (32.2%) in comparion to (13.2%) and (13.8%) for meningococcal and pyogenic meningitis respectively .11-The percentage of un-identifed pyogenic meningit­is was fairly high (93%) . 12-Meningocooca1 meningitis has amarked seasonality. cases begin to increase in November and December,refich its peak in April then begin to decrease. 13-Appioprate case-finding and case definition , early diagnosis and prompt treatment, aproper re­cording reporting system, early isolation of the causative agent are essential points to which es­pecial attention is recommended .