Evaluation of IMCI Indicators of Acute Bacterial Meningitis in Central Teaching Hospital for Child


ABSTRACT:BACKGROUND:Acute bacterial meningitis [ABM] remains an important cause of death and neurological sequel in children, the clinical feature of meningitis is often nonspecific may overlap with those of other infection. Early diagnosis and appropriate treatment are perhaps the most important steps in management, but published data suggested that fewer than half of the cases of meningitis are identified at first assessment [1,2] .OBJECTIVE:Was to evaluate the clinical indicators of ABM of IMCI [integrated management of childhood illness] referral criteria of meningitis include [lethargy, unconsciousness, in ability to feed, neck stiffness, seizures] and other symptoms and sign.PATIENT AND METHODS:By prospective study done at central teaching hospital for child for one year from 1st of September 2006-31 0f August 2007,all admission were included, L p was done for 110 cases who got one or more of meningial signs and IMCI indicators and other symptoms and sign.RESULTS:From 110 cases who have one or more of IMCI indicators and other signs,75 got meningitis including 68 only who meet all referral criteria for meningitis sensitivity 90%, specifity 60%,other 13 cases got one or more of in dependent indicators of meningitis which include, lethargy , impaired consciousness, in ability to feed, neck stiffness, seizures, anterior fontanel bulging, cyanosis, others, while in dependent indicators of absence of meningitis were the absence of high fever. .CONCLUSION:Not all cases of meningitis meet all IMCI criteria but may have one or more of them and other criteria as seizure outside febril convulsion age, repeated short fit, diarrhea, and dehydration; however careful observation and assessment may be the practical way to identify most cases of meningitis