Etiologies, clinical presentation and hospital outcome of bacterial meningitis in children at the pediatric unit of the Yaounde -gyneco- obstetric and pediatric hospital

JULY, 2019

THE UNIVERSITY OF BAMENDA

FACULTY OF HEALTH SCIENCES

DEPARTMENT OF CLINICAL SCIENCES

ETIOLOGIES, CLINICAL PRESENTATION AND HOSPITAL
OUTCOME OF BACTERIAL MENINGITIS IN CHILDREN
AT THE PEDIATRIC UNIT OF THE YAOUNDE -GYNECO -
OBSTETRIC AND PEDIATRIC HOSPITAL

A Dissertation submitted to the Department of Clinical Sciences in the Faculty of Health
Sciences in partial fulfilment of the requirements for the award of a Postgraduate
Diploma (DM) in Clinical Sciences.

By

MAURANE EMMA NDJOCK MBEA
Registration Number: UBa12H034

SUPERVISOR CO-SUPERVISOR

Prof. CHIABI ANDREAS Prof. ATANGA MARY

(c) Copyright by Maurane Emma Ndjock Mbea, 2019 All Rights Reserved

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DECLARATION

I, Nlaurane Emma Ndjock Mbea, Registration N° UBaI2HO34, Department of Clinical Sciences in the Faculty of Health Sciences, University of Bamenda, hereby declare that, this work titled: "Etiologies, Clinical Presentation And Hospital Outcome Of Bacterial Meningitis In Children At The Pediatric Unit Of The Yaounde --Gyneco -- Obstetric And Pediatric Hospital" is my original work. It has not been presented in any application for a degree or any academic pursuit. 1 have sincerely acknowledged all borrowed ideas nationally and internationally through citations.

Date 4 (t'A f q-cac)
	Signature ~~ j

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DEDICATION
TO MY PARENTS
CHANTAL BAYEGUI Epse NDJOCK MBEA
AND
EMMANUEL NDJOCK MBEA
TO MY SISTER
FINKE FICTIME YAN NDJOCK MBEA

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ACKNOWLEDGEMENT

I am most grateful to:

Thesis supervisor Prof CHIABI Andreas for his outstanding teaching received during the course of the work. Professor, your rigor and constant devotion for a work perfectly done forces our admiration.

Thesis co directors Prof NGUEFACK Seraphin and Prof ATANGA Mary for their acceptance given to us in agreeing to guide us in this work. Thank you once more for your availability and dynamism.

Dean of the Faculty of Health Sciences of the University of Bamenda for her constant advice and support given to us at any given circumstances to all her students.

Pediatric Department of YGOPH for their welcome and help during our study.

Formal Dean of the Faculty of Health Sciences for his rigorous training he has given to us.

My parents Mr and Mrs Ndjock Mbea for their love, moral and financial support they have been given me throughout the realization of this work.

My family members: Mrs Finke Fictime Marie Louise for her moral and financial support, my sisters Finke yan and Bayegui Marie Louise for their prayers and moral support.

Second batch of Faculty of Health Sciences of the University of Bamenda and my friend Ngo Linwa Esther for the exceptional 7 years they have made me gone through, together in struggle and brighter days, thanks.

To all whose names are not cited, I say my most gratitude towards any form of help from you, thanks.

GOD Almighty for the inspiration, mental and physical strength and protection he gave me to be able to go through this work successfully.

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ABSTRACT

INTRODUCTION AND OBJECTIVES:

Meningitis is a term that describes the inflammation of membranes (meninges) and/or cerebrospinal fluid that surrounds and protects the brain and spinal cord. Bacterial meningitis remains a serious global health problem, with World Health Organization estimating over 1.2 million of cases worldwide each year. It still affects mostly children with significant morbidity and mortality despite the presence of vaccins. Many studies have been conducted out of Africa, in Africa and in Cameroon with an incidence of 1.54 in 2014, all emphasizing the continuous rising incidence, thus our main aim being to: determine incidence, etiologies, clinical presentations, and describe the hospital outcome of bacterial meningitis in children.

MATERIALS AND METHODS:

This was a retrospective cross sectional descriptive study done at the pediatric unit of the Yaoundé Gyneco-Obstetric and Pediatric hospital. Those included in the study were children admitted for meningitis from the 1^st of January 2014 till the 31^st of December 2018 and aged from 1 month to 15 years. The sample size of 23 was calculated from the Cochrane's formula, and there was consecutive search of files in the archives for the following information: pathogens isolated and clinical manifestation and hospital outcome of children with the disease. The data were recorded using CS PRO 7.2(census and survey processing system) soft ware and analysed using IBM SPSS 23.0(statistical package for the social sciences)

RESULTS:

The incidence of bacterial meningitis in children at the Yaoundé Gyneco -Obstetric Hospital was 0.3% and the female sex was predominant at 56% in the admissions. Streptococcus pneumoniae and Neisseria meningitidis were the most common pathogens isolated; 63% and 25% respectively. Children within the age group of < 12 months were the most affected. Fever (95.3 %) and convulsion (60.5%) were the most common presentations of meningitis at time of admission, while neck stiffness and meningeal signs (Kerning and Brudzinski's signs) were present on clinical examination at 20.9% and16.3% respectively. A mortality rate of 2.4% was recorded against cure rate of 97.6%.

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