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Journal of Tropical Pediatrics 1999 45(1):51-53; doi:10.1093/tropej/45.1.51
© 1999 by Oxford University Press
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Brief report. Acute bacterial meningitis in The Gambia: a four-year review of paediatric hospital admissions

A PalmerA1, M WeberA2,Z, K BojangA1, T McKayA1 and R AdegbolaA2

A1 Royal Victoria Hospital, Banjul, The Gambia A2 Medical Research Council Laboratories, Fajara, The Gambia Z Corresponding author at: Division of Child Health and Development, World Health Organization, Geneva 27, Switzerland

Over a 4 year period, 1991 to 1994, 420 patients with acute bacterial meningitis were admitted to a tertiary urban hospital in The Gambia. Organisms were isolated from the cerebrospinal fluid in 64 per cent of cases. In the neonatal period Streptococcus pneumoniae was the single most common organism isolated. Amongst infants and children the two major pathogens were Haemophilus influenzae and S. pneumoniae. . In the first year of life, children with S. pneumoniae meningitis were younger than those with H. influenzae infection (median age 3 months versus 6 months, p <0.00003) and they had a higher case fatality rate (37 per cent versus 17 per cent, p = 0.002). In view of the high case fatality rate, there is a need to review overall case management. This will include a review of more effective antibiotics, the possible role of dexamethasone, and the inclusion of efficacious vaccines against H. influenzae and S. pneumoniae disease.


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