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低收入和中等收入国家儿童及成人细菌性脑膜炎的流行病学与临床结局

Epidemiology and Clinical Outcomes of Bacterial Meningitis in Children and Adults in Low- and Middle-Income Countries.

作者信息

Villalpando-Carrión Salvador, Henao-Martínez Andrés F, Franco-Paredes Carlos

机构信息

Hospital Infantil de México, Federico Gómez, Doctor Marquéz No. 162, Col. Doctores, Delegación Cuauhtémoc, 06720 CDMX, Mexico City, CP, Mexico.

Anschutz Medical Center, University of Colorado, Aurora, CO, USA.

出版信息

Curr Trop Med Rep. 2024 Jun;11(2):60-67. doi: 10.1007/s40475-024-00316-0. Epub 2024 Feb 22.

Abstract

PURPOSE OF REVIEW

Despite the availability of effective vaccines against the three primary pathogens (, type b, and ) that cause bacterial meningitis, this condition remains a significant cause of morbidity, neurologic sequelae, and mortality among children and adults living in low-income and middle-income countries.

RECENT FINDINGS

Bacterial meningitis represents a significant public health challenge for national and global health systems. Since vaccine-preventable meningitis remains highly prevalent in low-income and middle-income countries, the World Health Organization (WHO) recently developed a global roadmap to defeating meningitis by 2030 and ameliorating its associated neurological sequelae.

SUMMARY

There is a need for a global approach to surveillance and prevention of bacterial meningitis. Increasing vaccination coverage with conjugate vaccines against pneumococcus and meningococcus with optimal immunization schedules are high-value healthcare interventions. Additionally, overcoming diagnostic challenges and the early institution of empirical antibiotic therapy and, when feasible, adjunctive steroid therapy constitutes the pillars of reducing the disease burden of bacterial meningitis in resource-limited settings.

摘要

综述目的

尽管已有针对引起细菌性脑膜炎的三种主要病原体(b型流感嗜血杆菌、肺炎链球菌和脑膜炎奈瑟菌)的有效疫苗,但在低收入和中等收入国家的儿童及成人中,这种疾病仍是导致发病、神经后遗症及死亡的重要原因。

最新研究结果

细菌性脑膜炎对国家和全球卫生系统而言是一项重大的公共卫生挑战。由于疫苗可预防的脑膜炎在低收入和中等收入国家仍然高度流行,世界卫生组织(WHO)最近制定了一项全球路线图,目标是到2030年战胜脑膜炎并改善其相关神经后遗症。

总结

需要采取全球方法来监测和预防细菌性脑膜炎。通过采用最佳免疫程序提高肺炎球菌和脑膜炎球菌结合疫苗的接种覆盖率是高价值的医疗保健干预措施。此外,克服诊断难题并尽早开始经验性抗生素治疗,以及在可行时采用辅助性类固醇治疗,是在资源有限的环境中减轻细菌性脑膜炎疾病负担的关键。

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Bacterial meningitis in Africa.非洲的细菌性脑膜炎。
Front Neurol. 2023 Feb 14;14:822575. doi: 10.3389/fneur.2023.822575. eCollection 2023.

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