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Observational Study
. 2022 Apr 11;17(4):e0265487.
doi: 10.1371/journal.pone.0265487. eCollection 2022.

Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study

Bilal Ahmad Rahimi  1   2 , Niamatullah Ishaq  3 , Ghulam Mohayuddin Mudaser  4 , Walter R Taylor  5
Affiliations
Observational Study

Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study

Bilal Ahmad Rahimi et al. PLoS One. .

Erratum in

Abstract

Background: Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan.

Methods: We conducted a prospective observational cohort study over one year, February 2020 to January 2021 in a tertiary care hospital in Kandahar, Afghanistan. AMB was diagnosed clinically and on lumbar puncture findings. Binary logistic regression assessed factors for death.

Results: A total of 393 ABM children of mean age 4.8 years were recruited. Most were males [231 (58.8%)], living in rural areas [267 (67.9%)] and in households of >10 inhabitants [294 (74.8%)]. Only 96 (24.4%) had received against both Haemophilus influenzae type b (Hib) or pneumococcal (PCV) vaccines. Children were treated with combination of ceftriaxone and ampicillin and 169/321 (52.6%) received dexamethasone. Of the 321 children with a known outcome, 69 (21.5%) died. Death was significantly associated with: not receiving dexamethasone [adjusted odds ratio (AOR) 4.9 (95% CI 2.6-9.5, p <0.001)], coma on admission [AOR 4.6 (I 2.3-9.5, p <0.001)], no PCV [AOR 2.8 (1.2-6.6, p = 0.019)] or Hib vaccine [AOR 2.8 (1.2-6.6, p = 0.019)], and being male [AOR 2.7 (1.4-5.5, p = 0.005).

Conclusions: ABM causes significant morbidity and mortality in Afghan children that may be improved by greater use of PCV and Hib vaccines. Adjunct dexamethasone should be evaluated formally in our setting.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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