Epidemiology and Outcome of Acute Bacterial Meningitis Among Children in Saudi Haospital Hajjah, Northwest Territories of Yemen

This is a retrospective descriptive study carried out in Saudi Hospital Hajjah between July 2016 and December 2017: The aim of this study is to assess the etiology and outcome of acute bacterial meningitis among children in Saudi Hospital Hajjah. We included in this study all children aged one month or more to 12 years who had symptoms and signs suggested acute bacterial meningitis confirmed by lumber puncture of cerebrospinal fluid for cells, biochemistry and culture. The data of all patients were retrieved from the hospital records and patient`s charts. These data included age, clinical presentation, etiologic microorganism and outcome. A total of 196 patients who had confirmed bacterial meningitis was recorded. Of these, 71 patients (36.2%) were aged under 12 months, 25% aged between 1-2 years old, 17.9% between 3-5 years and 20.9% > 5 years. Cerebrospinal fluid culture was positive among 94.9% of patients. Among the positive isolates, 43.5% were having Nesseria meningitidis , 34.9% Streptococcus pneumonia , 18.2% Hemophillus influenza type b , 2.7% group B Streptococci and 0.5% E.coli . There were 19 patients died giving the case fatality rate as 9.7%. Of those, 47.3% had aged less than 12 months, 31.5% aged 1-2 years, one child (5.2%) aged 4 years and 3 cases (15.8%) were > 5 years. Eleven cases of deaths (57.9%) had s. pneumonia infections. There were 24 patients (12.2%) of survivors developed neurological complications. This study demonstrates that there is no change in the epidemiology of the main causes of acute bacterial meningitis among children compared to that reported prior to introduction Hib and pneumococcal vaccines indicating a limited coverage of vaccination in the Northwest Territories of Yemen. The case fatality rate noted in this study is relatively low, but aggressive efforts by the health care system both to vaccinate and to early treat infected children, meningitis incidence and mortality will decline.