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

III.1) STUDY DESIGN

This was a retrospective- descriptive cross sectional study. III.2) DURATION OF THE STUDY

The study went on from the 1^st December 2018 till the 31^st May 2019, a period of 6 months.

III.3) STUDY SETTING

This study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric hospital (YGOPH) at the pediatric unit. This unit is composed of 3 sub units which are; Hospitalisation 1 and 2 of infants and young children; External consultation with vaccination; and Neonatalogy.Hospitalisation 1 has 6 rooms and hospitalisation 2 has 7 rooms with one isolation room for contagious diseases. The unit is also made up of instruments such as oxygen extractors (4), aspirators (2) and resuscitators (2).

The service has an administration made of (1) head of service and (2) deputy head of services ; medical doctors (12) that is paediatricians (9) and general practitioners (3); State nurses (20) ; assistant nurses , and cleaners.

III.4) SAMPLING

There was recruitment of files from a period of 1^st of January 2014 to the 31^st of December 2018 of children admitted at YGOPH who fulfilled the inclusion criteria.

III.5) STUDY POPULATION

Children from 1 month of age to 15 years admitted at the paediatric unit of YGOPH within the study period.

III.5.1) INCLUSION CRITERIA

- Patients from 1 month of age to 15 years admitted for bacterial meningitis at YGOPH

- Patients who had bacterial examination of CSF with identification of the pathogen by culture or soluble antigen

- Patients who had their WBC above 10 cells/mm3.

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III.5.2) EXCLUSION CRITERIA

- Patients in whom bacterial meningitis has not been confirmed through examination of csf by culture or soluble antigen

- Any file with incomplete information III.6) SAMPLE SIZE

N=

d²

The sample size will be calculated using the Cochran's formula: (??1-??:??)^??P(1-P)

Where:

- Z1 - á: 2= is the standard normal variate at 5% type I error (p<0,005),

- P= expected proportion in the population based on previous studies or pilot studies, for this study, the proportion from NGUEFACK of 1.54%, 2014 was used [3].

-d= Absolute error or precision.

For our study the numerical application of the above formula was used:

Z1 - á: 2=1.96; P=0.0514%; d=5%. Then N=1.96*1.96*0.0154(1-

0.0154)/0.05*0.05=23.29

After plugging in all the information in the equation, we get a minimum of 23files to collect and use.

III.7) MATERIALS

? Materials of data collection and analysis

o Registered files from the paediatric unit

o A laptop

o Microsoft^® Office Excel 2016 and CS PRO 7.2 software for data analysis and Microsoft^® Office Word 2016 to keyboard the thesis.

o A 8 GB flash disk

o A 4 GB flash disk

o

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Office equipment

o Questionnaire for data collection

o Ballpoint ink-pens, pencils, correction fluid and eraser. ? Human resources:

o The investigator

o Supervisor and co supervisors

o Collaborators (service of archives, paramedical and medical personnel)

III.8) METHODS

III.8.1) ADMINISTRATIVE AUTHORIZATIONS AND ETHICAL CLEARANCE

Ethical clearance was obtained from the Ethical Committee of the Faculty of Health Sciences of the University of Bamenda. Authorization to carry-out the study at the YGOPH was obtained from the Director General of YGOPH.

The recruited information's from the questionnaires was held secret by the investigator in order to maintain data confidentiality taken throughout the study, and was definitely destroyed through burning after the data was analyzed and results confirmed.