Prevalencia de meningitis neumocócica en niños españoles

Casado Floresa, J.

doi:10.1016/S1695-4033(02)77757-6

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Objetivo

Conocer la prevalencia de la meningitis neumocócica en niños españoles.

Material y métodos

Estudio multicéntrico retrospectivo realizado en 5 comunidades autónomas, CC.AA. (Cataluña, Galicia, Madrid, Navarra y País Vasco) entre enero de 1998 y diciembre de 2000. Se incluyeron todos los pacientes entre 0 y 14 años con meningitis neumocócica (aislamiento de Streptococcus pneumoniae u objetivación de diplococos Gram1 en LCR y LCR con más de 20 células), diagnosticados en la totalidad de los hospitales de las CC.AA. estudiadas. La población infantil de 0-14 años asciende en estas CC.AA. a 2.327.079 habitantes.

Resultados

Se detectaron 107 casos, 64 varones y 43 mujeres, mediana de edad 1,19 años (P25 -0,57; P75 -3,34). La incidencia fue mayor en los primeros 2 años de vida 72/107 (67 %). La prevalencia anual global en las 5 CC.AA. en estos primeros 24 meses de vida fue de 8,26/100.000 niños menores de 2 años (intervalo de confianza [IC] del 95 %, 3,45-15,76). El mayor número de casos se detectó en Cataluña y Madrid pero la mayor prevalencia global ajustada año fue en el País Vasco con 15,52 casos/100.000 niños menores de 2 años (IC 95 %, 8,39-24,74). En los primeros meses de la vida la prevalencia fue muy elevada en todas las CC.AA., especialmente en el País Vasco con 22,76 casos/100.000 lactantes menores de 12 meses (IC 95 %, 14,58-34,5). En los primeros 5 años de vida la prevalencia año/100.000 niños fue la siguiente: Cataluña 3,21 (IC 95 %, 1,31-5,11), Galicia 2,65 (IC 95 %, 0,35-5,64), Madrid 3,49 (1,36-5,61), Navarra 3,36 (IC 95 %, 5,08-11,81), País Vasco 5,63 (IC 95 %, 1,08-10,18).

Conclusiones

La prevalencia de la meningitis neumocócica en niños de diferentes CC.AA. es elevada, mayor en el País Vasco y en menores de 2 años de edad. Esta prevalencia es similar a la de otros países europeos y Estados Unidos.

Palabras clave:

Pneumococcal meningitis

Meningitis prevalence

Invasive pneumococcal disease

Meningitis in Spain

Bacterial meningitis

Objective

To determine the prevalence of pneumococcal meningitis in the pediatric population in Spain.

Material and methods

Retrospective multicenter study performed in five autonomous communities (Catalonia, Galicia, Madrid, Navarre and the Basque Country) between January 1998 and December 2000. All patients aged between 0 and 14 years old with a diagnosis of pneumococcal meningitis (Streptococcus pneumoniae isolation or presence of Gram-positive diplococcus in the cerebrospinal fluid (CSF) and CSF with more than 20 cells) in all the hospitals of the five autonomous communities were included in the study. The pediatric population in these communities aged between 0 and 14 years old was 2,327,079.

Results

We detected 107 cases in 64 boys and 43 girls with a mean age of 1.19 years old (p 25-0.57; p 75-3.34). The incidence was higher in the first 2 years of life [72/107 (67 %)]. The overall annual prevalence in the five autonomous communities in the first 24 months of life was 8.26 per 100,000 children aged under 2 years (95 % CI: 3.45-15.76). The highest number of cases was detected in Catalonia and Madrid but the highest annual prevalence was found in the Basque Country with 15.52 cases per 100,000 children younger than 2 years old (95% CI: 8.38-24.74). In the first 12 months of life the prevalence was high in all the autonomous communities, especially in the Basque Country with 22.76 cases per 100,000 newborn infants aged under 12 months (95 % CI 14.58-34.5). In the first 5 years of life the annual global adjusted prevalence per 100,000 children was as follows: Catalonia 3.21 (95 % CI: 1.31-5.11), Galicia 2.65 (95 % CI: -0.35-5.64), Madrid 3.49 (95 % CI: 1.36-5.61), Navarre 3.36 (95 % CI -5,08-11,81), the Basque Country 5.63 (95 % CI: 1.08-10.18).

Conclusion

The prevalence of pneumococcal meningitis in children from different autonomous communities is high and is greatest in the Basque Country and in children aged under 2 years. This prevalence is similar to that of other European countries and the USA.

Key words:

Meningitis neumocócica

Prevalencia de meningitis

Enfermedad neumocócica invasora

Meningitis en España

Meningitis bacteriana

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