Abstract:
The study focused on the sensitivity and specificity of cerebrospinal fluid
appearance and white blood cell (WBC) count as potential laboratory screening
indicators compared to culture method. This is because Cerebrospinal fluid (CSF)
culture facilities are expensive and difficult to maintain in resource poor laboratory
settings yet this is the gold standard for diagnosis. Early signs of meningitis are
often subtle and nonspecific resulting in unacceptably high mortality and morbidity
rates in children, especially those from developing countries where rapid access to
medical attention and resources is unavailable. Diagnosing acute bacterial
meningitis in children is likely to be missed in a third of cases at district hospitals
in sub-Saharan Africa where adequate and reliable laboratory resources are lacking.
Most affected patients now survive due to antibiotic use, though many children still
die or suffer permanent neurologic sequelae as a result of bacterial meningitis. Data
was gathered from samples collected from children aged below five years admitted
at the participating hospitals between the time periods 2001 to 2008. This was
carried out retrospectively from the period 2001 to 2005 and prospectively from
2006 to 2008. A total of 32,152 samples were collected for the entire period. Of the
29,153 samples collected with reported appearance, 4.49% of them were positive
for pathogenic organisms out of which three micro-organisms were of most interest
to the surveillance; Streptococcus pneumoniae, Haemophilus influenzae and
Neisseria meningitidis that accounted for 50.7% of the positive isolates. Turbid
appearance had a sensitivity of 72% (95% CI 69 – 74) and specificity of 96%.
Clear appearance had a sensitivity of 18% (95% CI 16.1 – 20.3) and a specificity of
