TITLE:
Identified Bacteria and Virus in the Cerebrospinal Fluid of under Five Years Hospitalized Children for Clinical Meningitis at Panzi Hospital in the Eastern Part of DRC
AUTHORS:
Jeannière Tumusifu Manegabe, Muke Kitoga, Mambo Mwilo, Jonhatan Yoyu, Birindwa Muhandule Archippe
KEYWORDS:
Children, Meningitis, Multiplex Real-Time PCR Meningitis Assay Bacteria, Virus
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.5,
September
21,
2023
ABSTRACT: Background: Meningitis
remains a leading cause of death among children below 5 years of age in the
Democratic Republic of the Congo (DR Congo). Distinguishing children with
bacterial meningitis from those with viral meningitis in the emergency
department is sometimes difficult. Here we identified bacteria and virus in the
cerebral spinal fluid (CSF) of children with meningitis. Material and Methods: This is a prospective,
analytical study carried out in the Pediatrics department of Panzi Hospital in
the South-Kivu province of DR Congo. Between April 2021 and March 2022, 150 of 251 collected CSF from children aged from 1 to 59
months hospitalised due to clinical meningitis at Panzi referral university
hospital, Bukavu, Eastern DR Congo were sent to the Lancet laboratory for
bacteria identification by a multiplex real-time PCR assay for detection of the
most different viruses and bacterial species causing meningitis. Result: The
used multiplex real-time PCR assay allowed us to identify germs in 24.7% of
cases (37/150). We isolated bacteria in 25/37 (67.5%) cases, and viruses in 9/37 (24.3%) while virus and bacteria
co-infection was detected in 3/37 (8.1%). The most frequently identified bacteria were Streptococcus pneumoniae 14/37 (37.8%) followed by Haemophilus
influenzae 6/37 (16.2%). The main virus was cytomegalovirus 5/37 (3.5%).
Despite the age, the most found bacterial are common in children from rural areas and unvaccinated children.
Bacterial and virus co-infection were identified in 66.7% of children aged between 25 - 60 months, mainly
among male children, and in all children from rural areas (100%). The overall
case fatality rate was 30% and was very high among cases with co-infection
CMV-Pneumococcal (66.7%), followed by Streptococcus pneumoniae (50%). Conclusion: Meningitis remains frequent
among children aged from one to 59 months
among Bukavu Infants. We noticed that, Children with co-infection with
bacteria and viruses might need higher attention when having meningitis
symptoms, as this could lead to fatal outcomes. The introduction of molecular techniques, such as
multiplex real-time PCR, has the potential to improve diagnosis and patient
outcomes.