Burden and etiology of community-acquired bacterial meningitis in a hospital in Eastern Saudi Arabia: 1993-2005.

BACKGROUND

In the Middle East, some evidence suggests marked declines in cases of H. influenzae type b infection where conjugate vaccines were introduced. This study examined the causative agents of bacterial meningitis in Saudi Arabia over time in both children and adults.

MATERIAL/

METHODS

From January 1993 to December 2005 there was a total 179 cases of meningitis, of which 63 (35.2%) were bacterial meningitis, 37 (20.7%) partially treated, and 79 (44.1%) which were considered viral in origin.

RESULTS

The annual incidence rates of bacterial meningitis were 0.48-2.8 per 100,000 population, with an overall insignificant decline over the study period (P=0.8). There were 37 males and 26 females (ratio: 1.4:1) with an age range of <1 month to 72 years and a median age of 2 years. Of the total number of patients, 22.2% (n=14) were 1-23 months and 39.7% (n=25) were 2-18 years of age. The causative organisms were Streptococcus pneumoniae (35%, n=22), Haemophilus influenzae type b (22.2%, n=14), Neisseria meningitides (15.9%, n=10), Group B streptococci (7.9%, n=5), and 19% (n=12) were other organisms. Of H. influenzae type b cases, 57% (n=8) were in children one year of age and 78.6% (n=11) were in the years 1993-1999. The rates of H. influenzae meningitis cases in the periods of 1993-1999 and 2000-2005 were 4.2 and 1.2 per 100,000 population, respectively.

CONCLUSIONS

There was a drop in the number of cases of H. influenzae type b, but it was not statistically significant, and might be related to the small sample size.