Predictors of Bacterial Meningitis in Resource-Limited Contexts An Angolan Case 英文参考文献.docVIP

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Predictors of Bacterial Meningitis in Resource-Limited Contexts An Angolan Case 英文参考文献.doc

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Predictors of Bacterial Meningitis in Resource-Limited Contexts An Angolan Case 英文参考文献

PredictorsofBacterialMeningitisinResource-Limited Contexts:AnAngolanCase CristinaLussiana1*,SofiaVandaLo?aClemente2,IvanAlejandroPulidoTarquino1,IsabelPaulo2 1InfectiousDiseasesLaboratory,HospitalDivinaProvidencia,Luanda,Angola,2HospitalDivinaProvidencia,Luanda,Angola Abstract Background:Despitethegreatmorbidityandmortalitythatchildhoodbacterialmeningitis(BM)isexperiencinginAfrica, diagnosis of BM in resource-limited contexts is still a challenge. Several algorithms and clinical predictors have been proposedtohelpphysiciansindecision-makingbutalotofthesemarkersusedvariablesthatarecalculableonlyinwell- equippedlaboratories.Predictorsoralgorithmbasedonparametersthatcanbeeasilyperformedinbasiclaboratoriescan helpsignificantlyinBMdiagnosis,eveninresource-limitedsettings,ruralhospitalsorhealthcenters. Results: This retrospective studyexamined 145cerebral-spinal fluid (CSF)specimens from children from2 monthsto14 years.CSFspecimensweredividedintotwogroups,accordingtothepresenceornotofaclinicaldiagnosisofBM.Foreach specimen, CSF aspect, CSF white blood cells (WBC) count, CSF glucose and protein concentration were analyzed and statisticalanalysiswereperformed.CSFWBCcount$10/mlisnomoreavaluablepredictorofBM.CSFproteinconcentration $50mg/dlhasabettersensitivityforBMdiagnosisandwhenusedwithCSFglucoseconcentration#40mg/dl,canhelpto diagnosecorrectlyalmostalltheBMcases.AnalgorithmincludingCSFproteinconcentration,glucoseconcentrationand WBCcounthasbeenproposedtoruleoutBMandtocorrectlydiagnoseit. Conclusions: In resource-limited health centers, the availability of a combination of easy-to-obtain parameters can significantlyhelpphysiciansinBMdiagnosis.ThepromptidentificationofaBMcasecanberapidtreatedortransferredto adequatestructuresandcanmodifytheoutcomeinthepatient. Citation:LussianaC,Lo?aClementeSV,PulidoTarquinoIA,PauloI(2011)PredictorsofBacterialMeningitisinResource-LimitedContexts:AnAngolanCase.PLoS ONE6(10):e25706.doi:10.1371/journal.pone.0025706 Editor:ChaoyangXue,Univers