Clinical features of bacterial meningitis among hospitalised children in Kenya

Table 2 Clinical features at admission

	No meningitis (n=12,837)	Meningitis (n=98)	P value^a
Bulging fontanelle^b
Absent	4490 (98)	37 (82)	<0.001
Present	51 (1.1)	8 (18)
Missing	29 (0.6)	0 (0)
Neck stiffness
Absent	12,652 (99)	79 (81)	<0.001
Present	96 (0.8)	19 (19)
Missing	89 (0.7)	0 (0)
Cyanosis
Absent	12,702 (99)	98 (100)	0.594
Present	46 (0.3)	0 (0)
Missing	89 (0.7)	0 (0)
History of seizures within febrile convulsion age range^c
No seizures	9990 (78)	48 (49)	<0.001
Seizures within febrile convulsion age range	2187 [17]	34 (35)
Seizures outside febrile convulsion age range	573 (4.5)	16 (16)
Missing	87 (0.7)	0 (0)
Type of convulsion at any age
No seizures	9990 (78)	48 (49)	<0.001
Unknown type	81 (0.6)	2 (2.0)
Generalised^d	2354 [18]	40 (41)
Focal^e	325 (2.5)	8 (8.2)
Missing	87 (0.7)	0 (0)
Conscious level
Normal	9338 (73)	46 (47)	<0.001
Lethargic	1444 [11]	16 (16)
Agitated	159 (1.2)	2 (2.0)
Impaired consciousness^f	1807 [14]	34 (35)
Missing	89 (0.7)	0 (0)
History of fever
Absent	4070 (32)	10 (10)	<0.001
Present	8681 (68)	88 (90)
Missing	86 (0.7)	0 (0)
Axillary temperature, ⁰C
<36	717 (5.6)	4 (4.1)	0.032
36-38.9	10,080 (79)	68 (69)
≥39	2016 [16]	26 (27)
Missing	24 (0.2)	0 (0)
Malaria
Negative	10,346 (81)	84 (86)	0.201
Positive	2491 [19]	14 (14)	0.201

^aCompares children with definite meningitis (Group B, n=98) to children with no meningitis [Group A (n=10,384) + Group D (n=2453)]. Excludes children with possible meningitis (Group C, n=51)
^bCut-off age for assessment of fontanel closure was 18 months. Analysis of bulging fontanel was limited to 4615 children aged ≤18 months (45 with meningitis and 4570 without meningitis); hence, column totals are less than those of other variables on the table
^cFebrile convulsions occurring in children age between 6 months and 6 years
^dInvolving both sides of the body with associated loss of consciousness
^eFocal, involving one side of the body, and may or may not become generalised
^fBlantyre Coma Score (BCS) <4 up to 9 months and <5 at ≥9 months (Eyes: 1=watches/follows, 0=none; Cry: 2=normal, 1=moan/weak, 0=none; Motor: 2=localises stimulus, 1=withdraws, 0=other/none)

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