Influence of malnutrition on the course of childhood bacterial meningitis.

Abstract

BACKGROUND:

Malnutrition may be an important cofactor explaining poor outcome of childhood bacterial meningitis (BM) in developing countries. We examined its effect in Latin American children.

METHODS:

The weight-for-age z score was determined for 482 children with BM aged 2 months to 5 years. Normal weight (z score from >-1 to <+1), underweight (z score <-1) and overweight (z score >+1) children were compared on admission, in-hospital and at discharge. Using uni- and multivariate analysis, we sought for associations between malnutrition and 3 different outcomes.

RESULTS:

The mean z score was -0.41 +/- 1.54, with a normal distribution. Overall, 260 (54%) patients were of normal weight, 151 (31%) underweight, and 71 (15%) overweight. Compared with others, underweight patients had on admission a lower Glasgow coma score (P = 0.0006) and cerebrospinal fluid glucose concentration (P = 0.03), and a slower capillary filling time (P = 0.02). Their death rate was higher (P = 0.0004) and they survived with more neurological sequelae (P = 0.04), but a similar frequency of hearing impairment (P > 0.05). The odds for death increased 1.98 times by mild (95% confidence interval [CI], 1.03-3.83; P = 0.04), 2.55 times by moderate (95% CI, 1.05-6.17; P = 0.04), and 5.85 times (95% CI, 2.53-13.50; P < 0.0001) by severe underweight. Overweight was not associated with adverse outcomes (P > 0.05).

CONCLUSIONS:

Children who are underweight at the time of onset of BM have a substantially increased probability of neurological sequelae and death.

• Authors: Irmeli Roine, Gerardo Weisstaub, Heikki Peltola, LatAm Bacterial Meningitis Study Group
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 29 Issue 2 Pg. 122-5 (Feb 2010) ISSN: 1532-0987 [Electronic] United States
• PMID: 19934786 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Body Weight
• Child
• Child, Preschool
• Female
• Humans
• Incidence
• Infant
• Latin America
• Male
• Malnutrition (complications)
• Meningitis, Bacterial (complications, mortality)
• Nervous System Diseases (epidemiology, etiology)
• Treatment Outcome