TY - JOUR
T1 - Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020
AU - for GERMS-SA
AU - Meiring, Susan
AU - Cohen, Cheryl
AU - de Gouveia, Linda
AU - Plessis, Mignon du
AU - Quan, Vanessa
AU - Kleynhans, Jackie
AU - Menezes, Colin
AU - Reubenson, Gary
AU - Dawood, Halima
AU - Nchabeleng, Maphoshane
AU - Said, Mohamed
AU - Mvelase, Nomonde
AU - Mahabeer, Prasha
AU - Chomba, Rispah
AU - Lekalakala, Ruth
AU - Nana, Trusha
AU - Chibabhai, Vindana
AU - Black, Marianne
AU - von Gottberg, Anne
N1 - Funding Information:
This work was supported by the NICD of the National Health Laboratory Service.
Funding Information:
Susan Meiring reports a grant from Sanofi Pasteur for research outside the submitted work. Anne von Gottberg and Cheryl Cohen report grants from US CDC, PATH, Wellcome Trust, Sanofi, and from South African MRC, outside the submitted work. All other authors declare that they have no commercial or other associations that may pose a conflict of interest.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/9
Y1 - 2022/9
N2 - Objectives: Providing country-specific estimates of case fatality and sequelae from bacterial meningitis (BM) is important to evaluate and monitor progress toward the World Health Organization's roadmap to “defeating meningitis by 2030”. Methods: From 2016-2020, GERMS-SA conducted enhanced surveillance at 26 hospitals across South Africa. Episodes of laboratory-confirmed BM due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis were included. Risk factors for in-hospital death and sequelae at hospital discharge among survivors were analyzed. Results: Of 12,717 invasive bacterial infections reported nationally, 39% (4980) were from enhanced surveillance sites, including 4159 pneumococcal, 640 H. influenzae, and 181 meningococcal infections. BM accounted for 32% (1319/4159) of pneumococcal, 21% (136/640) of H. influenzae, and 83% (151/181) of meningococcal invasive diseases. Clinical data were available for 91% (1455/1606) of BM: 26% (376/1455) were aged <5 years, 50% (726/1455) were female, and 62% (723/1171) with known HIV results, were HIV-infected. In-hospital case fatality was 37% (534/1455), and 24% (222/921) of survivors had adverse sequelae. Risk factors for death included altered mental status, HIV infection, and comorbidities. Risk factors for adverse sequelae included altered mental status and antimicrobial nonsusceptibility. Conclusion: BM in South Africa has a high case fatality, and adverse sequelae frequently occur among survivors. Those with comorbidities (including HIV) are at the highest risk.
AB - Objectives: Providing country-specific estimates of case fatality and sequelae from bacterial meningitis (BM) is important to evaluate and monitor progress toward the World Health Organization's roadmap to “defeating meningitis by 2030”. Methods: From 2016-2020, GERMS-SA conducted enhanced surveillance at 26 hospitals across South Africa. Episodes of laboratory-confirmed BM due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis were included. Risk factors for in-hospital death and sequelae at hospital discharge among survivors were analyzed. Results: Of 12,717 invasive bacterial infections reported nationally, 39% (4980) were from enhanced surveillance sites, including 4159 pneumococcal, 640 H. influenzae, and 181 meningococcal infections. BM accounted for 32% (1319/4159) of pneumococcal, 21% (136/640) of H. influenzae, and 83% (151/181) of meningococcal invasive diseases. Clinical data were available for 91% (1455/1606) of BM: 26% (376/1455) were aged <5 years, 50% (726/1455) were female, and 62% (723/1171) with known HIV results, were HIV-infected. In-hospital case fatality was 37% (534/1455), and 24% (222/921) of survivors had adverse sequelae. Risk factors for death included altered mental status, HIV infection, and comorbidities. Risk factors for adverse sequelae included altered mental status and antimicrobial nonsusceptibility. Conclusion: BM in South Africa has a high case fatality, and adverse sequelae frequently occur among survivors. Those with comorbidities (including HIV) are at the highest risk.
KW - Complications
KW - Haemophilus influenzae
KW - Meningitis
KW - Mortality
KW - Neisseria meningitidis
KW - Streptococcus pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=85135986199&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.07.068
DO - 10.1016/j.ijid.2022.07.068
M3 - Article
C2 - 35934172
AN - SCOPUS:85135986199
SN - 1201-9712
VL - 122
SP - 1056
EP - 1066
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -