Hussey G, Schaaf H, Hanslo D, Hitchcock J, Coetzee G, Pitout J, Malan H, Donald P
Department of Paediatrics and Child Health, University of Cape Town.
S Afr Med J. 1997 Jan;87(1):51-6.
Bacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from 1 August 1991 to 31 July 1992, was to define the magnitude of the problem of childhood bacterial meningitis in Cape Town. The study group consisted of all children, aged > 1 month to < 14 years, who presented with proven bacterial meningitis at all the hospitals in the Cape Town metropolitan area. During the year 201 cases were identified: 101 (50.2%) were due to Neisseria meningitidis, 74 (36.8%) were due to Haemophilus influenzae and 26 (12.9%) were due to Streptococcus pneumoniae. The overall incidence rate (95% confidence interval) for children less than 14 years, 5 years and 1 year was 34 (30-40), 76 (65-88) and 257 (213-309) per 100,000 children, respectively. The rate was highest in black infants, 416 (316-545)/100,000. This was 2 times greater than the rate in coloured infants and about 4.5 times greater than the rate in white infants. The median age of all the children was 10 months. The ages of children with haemophilus and pneumococcal meningitis were similar, 9 and 7.5 months respectively (P = 0.43), while children with meningococcal meningitis were significantly older (22 months) than the others (P < 0.01). The overall case fatality rate was 5%, and 12.9% of survivors had significant neurological sequelae (disability) on discharge.
在南非，细菌性脑膜炎是儿童发病和死亡的主要原因。然而，缺乏对于合理的公共卫生干预至关重要的全面区域或国家流行病学数据。这项为期1年的前瞻性研究（从1991年8月1日至1992年7月31日）的目的是确定开普敦儿童细菌性脑膜炎问题的严重程度。研究组包括在开普敦都会区所有医院就诊且确诊为细菌性脑膜炎的所有年龄大于1个月至小于14岁的儿童。在这一年中，共确诊201例：101例（50.2%）由脑膜炎奈瑟菌引起，74例（36.8%）由流感嗜血杆菌引起，26例（12.9%）由肺炎链球菌引起。14岁以下、5岁及1岁儿童的总体发病率（95%置信区间）分别为每10万名儿童34例（30 - 40例）、76例（65 - 88例）和257例（213 - 309例）。黑人婴儿的发病率最高，为416例（316 - 545例）/10万。这是有色人种婴儿发病率的2倍，约为白人婴儿发病率的4.5倍。所有儿童的中位年龄为10个月。流感嗜血杆菌性和肺炎链球菌性脑膜炎患儿的年龄相似，分别为9个月和7.5个月（P = 0.43），而脑膜炎奈瑟菌性脑膜炎患儿的年龄（22个月）明显大于其他患儿（P < 0.01）。总体病死率为5%，12.9%的幸存者出院时伴有严重神经后遗症（残疾）。
