1MD- PGT, Department of Pediatric Medicine, Medical College, Kolkata
2Professor, Department of Community Medicine, NRS Medical College, Kolkata
3Associate Professor, Department of Community Medicine, Medical College, Kolkata
4Assistant Professor, Department of General Medicine, Medical College, Kolkata
*Corresponding Author: Swarnali Joardar, E-mail: swarnalijoardar@gmail.com, Phone: 9831894526, Address: 16, Dover Lane, Kolkata- 700029, West Bengal, India
Online published on 13 January, 2015.
Meningitis in children constitutes a formidable illness due to its high morbidity and mortality. The etiological agents and other associated epidemiological factors contributing to its occurrence and prognosis varies from place to place. Identification of these factors is crucial for the control of this important health problem. This record-based observational study was conducted in Medical College & Hospital Kolkata, India. The objectives of the study were to identify the socio-demographic profiles, etiological types and nutritional status of the meningitis cases admied in Pediatric Medicine department of Medical College & Hospital, Kolkata during the last three years; and to find out the duration of hospital stay, case fatality rates and seasonal variations in different types of those cases.
The available records of all the meningitis cases admied in pediatric medicine department of the Institution from January 2009 to December 2011 were studied. The variables included were age, sex, religion, residence, nutritional status, etiological type, duration of hospital stay, case fatality rate (CFR) and seasonal variation. The collected data were analyzed with appropriate statistical methods.
A total of 326 meningitis cases in the age group below twelve years comprised the study population. Among the cases 27.91% were infants and 44.17% were below three years of age. The majority of the cases were male (60.43%), Hindu (64.42%) by religion and rural (74.23%) by residence. Regarding the etiology 57.37% of the cases were tubercular and 34.66% were pyogenic. Among those who survived (224), the overall prevalence of undernutrition was 66.52%; a significantly higher proportion of undernutrition was observed in tuberculous meningitis (75.59%) compared to that among pyogenic meningitis (54.16%). For 59.06% of tuberculous and 57.32% of pyogenic cases the hospital stay was between 1–2 weeks. The overall case fatality rate (CFR) was 31.29%. Compared to viral meningitis, the CFR was significantly higher both in pyogenic and tuberculous meningitis. Some seasonal variation was also observed with two peaks in case of pyogenic and four peaks in case of tuberculous meningitis.
It can be concluded that case fatality rate was quite high in pyogenic and tuberculous meningitis even in this era of modern medicine. Higher proportion of patients from rural locations and a high proportion of undernutrition among the cases point to socio-economic impacts on the disease.
Meningitis, Undernutrition, Case fatality rate, Seasonal variation
