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Green, Edward, Ndiaye, Malick, Hossain, Ilias M, Olatunji, Yekini A, Sahito, Shah M, Salaudeen, Rasheed, Badji, Henry, Manjang, Ahmed, Ceesay, Lamin, Hill, Philip C, Greenwood, Brian and Mackenzie, Grant A (2023) 'Pneumonia, Meningitis, and Septicemia in Adults and Older Children in Rural Gambia: 8 Years of Population-Based Surveillance'. Clinical Infectious Diseases, Vol 76, Issue 4, pp. 694-703.
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Abstract
Background
Representative data describing serious infections in children aged ≥5 years and adults in Africa are limited.
Methods
We conducted population-based surveillance for pneumonia, meningitis, and septicemia in a demographic surveillance area in The Gambia between 12 May 2008 and 31 December 2015. We used standardized criteria to identify, diagnose, and investigate patients aged ≥5 years using conventional microbiology and radiology.
Results
We enrolled 1638 of 1657 eligible patients and investigated 1618. Suspected pneumonia, septicemia, or meningitis was diagnosed in 1392, 135, and 111 patients, respectively. Bacterial pathogens from sterile sites were isolated from 105 (7.5%) patients with suspected pneumonia, 11 (8.1%) with suspected septicemia, and 28 (25.2%) with suspected meningitis. Streptococcus pneumoniae (n = 84), Neisseria meningitidis (n = 16), and Staphylococcus aureus (n = 15) were the most common pathogens. Twenty-eight (1.7%) patients died in hospital and 40 (4.1%) died during the 4 months after discharge. Thirty postdischarge deaths occurred in patients aged ≥10 years with suspected pneumonia. The minimum annual incidence was 133 cases per 100 000 person-years for suspected pneumonia, 13 for meningitis, 11 for septicemia, 14 for culture-positive disease, and 46 for radiological pneumonia. At least 2.7% of all deaths in the surveillance area were due to suspected pneumonia, meningitis, or septicemia.
Conclusions
Pneumonia, meningitis, and septicemia in children aged ≥5 years and adults in The Gambia are responsible for significant morbidity and mortality. Many deaths occur after hospital discharge and most cases are culture negative. Improvements in prevention, diagnosis, inpatient, and follow-up management are urgently needed.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > WA 105 Epidemiology WA Public Health > WA 30 Socioeconomic factors in public health (General) WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified) WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 240 Bacteremia. Sepsis. Toxemias WL Nervous System > WL 200 Meninges. Blood-brain barrier |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1093/cid/ciac603 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 05 Oct 2022 14:14 |
| Last Modified: | 23 Feb 2023 15:32 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/21081 |
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