統合腫瘍学ジャーナル

Prevalence and Rapid Diagnosis of Acute Bacterial Meningitis in Children in Bangladesh

Abstract

Heidrun Männle

An attempt was made to analyze the Cerebrospinal Fluid (CSF) profile and to isolate and identify aetiological agents from the specimens from children with suspected acute bacterial meningitis. Among total 79 samples, 65 (82.3%) were crystal clear, 9 (11.4%) were moderately turbid, 2 (2.5%) highly turbid and remaining 3 (3.8%) were high blood mixed. The total cell (leucocyte) count of the CSF was proportionate to the turbidity. In case of crystal clear CSFs, total leucocyte counts were normally ranging from 0 to 700 per mm3 with predominant lymphocytes. Moderately turbid fluid showed 200 to 2,000 cells per mm3 and highly turbid fluid and highly blood mixed showed more than 40,000 cells per mm3. In the later cases, differential counts demonstrated polymorph nuclear predominancy. In 65 cases whose CSF were crystal clear, total protein and sugar concentration ranged from 20 to 400mg/dl and 20 to 180mg/dl respectively. In turbid CSFs, total protein and sugar concentration varied from 70 to 500mg/dl and 10 to 200mg/dl respectively, while in the highly turbid CSFs, they ranged from 50 to 800mg/dl and 40 to 140mg/dl respectively. Among total 79 CSF samples, Pandeys tests were positive for 16.9% and negative for 9.2% in cases of the crystal clear. In case of moderately turbid and highly turbid CSFs, Pandeys test was positive for 88.9% and 100% cases respective. C - Reactive Protein (CRP) were positive (12mg/dl) for 3 (3.79%) samples. A total of 79 CSF was culture. There were 5 culture positive cases, which included Escherichia coli (20%), Haemophilus influenzae (20%) and Streptococcus pneumoniae (60%). Using the latex agglutination test, the detection rate was higher than that of culture. Most of meningitis positive cases showed an increased total cell counts as well as proteins concentration and decreased serum sugar concentrations. High resistant rate to cotrimoxazole was observed among the invasive isolates. On the other hand, none of these invasive strains showed resistant to ceftriaxone. A rapid diagnostic test (RDT) is a medical diagnostic test that is quick and easy to perform. RDTs are suitable for preliminary or emergency medical screening and for use in medical facilities with limited resources. They also allow point-of-care testing in primary care for things that formerly only a laboratory test could measure.