The Spectrum Of Childhood Meningitis In Barbados: A Population Based Study

Objectives: To describe the epidemiologic characteristics of meningitis in children during a 12 year period, from 1994 to 2005, in Barbados, with particular emphasis on the trends in incidence and age distribution. Methods: This is a retrospective population based study of all childhood meningitis over a 12 years period. A chart review was conducted of all patients outside of the neonatal age group hospitalized at the Queen Elizabeth Hospital of Barbados with a diagnosis of meningitis from January 1994 to November 2005. Results: There were 327 cases of meningitis, 235 (71%) cases were categorized as aseptic meningitis and 92 (29%) were categorized as bacterial meningitis. The median age of children with aseptic meningitis was 3 years (Range 2 months 15 years) and the median age for patients with bacterial meningitis was 18.0 months and ranged in age from 1 months to 15 years (P < 0.05). Fifty nine percent of the cases of aseptic meningitis and 50% of the cases of bacterial meningitis occurred in boys. The annual incidence of pyogenic meningitis has varied narrowly in between 10 to 20 per 100, 000 under 16 populations, with a decline to less than 5 in 2005. The annual incidence rate of aseptic meningitis showed two epidemics with the rate peaking above 40 cases per 100, 000 under 16 population in 1997 and 2001. Through out the study period, a little over half of all meningitis in < 5 years children was pyogenic without any significant trend. Conclusions: The incidence of pyogenic meningitis in Barbados has shown a modest decline since early 2000. Aseptic meningitis is as common as pyogenic meningitis and shows seasonality during the year with epidemics every few years.