Etiology of Pediatric Meningitis in Latin America: A Systematic Review and Meta-analysis
Ian Inestroza1, Maria Ycaza-Zurita2, Cindy Disla-Tejada3, Niels Pacheco-Barrios4, Karlos Acurio5, Blaise Bayer6, Miguel Chuquilin7
1Universidad Nacional Autónoma de Honduras, 2Columbia University Medical Center, 3Universidad Tecnológica De Santiago - UTESA, 4Harvard Medical School, 5Universidad Peruana Cayetano Heredia, 6Universidad Latina de Panama, 7Tallahassee Memorial HealthCare
Objective:
To systematically investigate the etiology of pediatric meningitis in Latin America, aiming to enhance our understanding of the region's disease burden and inform public health strategies.
Background:
While the etiology of pediatric meningitis has been extensively researched in developed countries, there remains a notable gap in understanding within Latin America. The region's unique demographic composition and epidemiological characteristics present distinct challenges and considerations in the study of meningitis etiology, making it an area that warrants further exploration.
Design/Methods:
We conducted a systematic review across MEDLINE, EMBASE, Web of Science, Scopus, Lilacs, and Scielo, targeting studies on meningitis published up to September 1st, 2023, and employing keywords and MeSH terms for our search. We focused on observational studies of patients aged 1 month to 18 years, including works in English, Spanish, or Portuguese, and aimed to identify the frequencies of bacterial, viral, and fungal meningitis etiologies. The NewCastle-Ottawa scale assessed the quality of studies, and a random-effects meta-analysis quantified meningitis types. We ensured the robustness of our findings through sensitivity and subgroup analyses, using the I2 statistic to measure heterogeneity, with I2 > 50% indicating significant variation.
Results:
Our systematic review analyzed 1,634 studies from 1957 to 2023, selecting 51 studies with 8,080 cases of pediatric meningitis in Latin America. We found a dominant bacterial etiology at 93.74% (95% CI [92.66%, 94.82%]), with Neisseria meningitidis (34.46%), Haemophilus influenzae type b (21.14%), and Streptococcus pneumoniae (16.78%) as leading causes. Viral meningitis was significantly less common at 6.26% (95% CI [6.04%, 7.52%]). No fungal infections were reported.
Conclusions:
This systematic review provides a comprehensive analysis of the etiology of meningitis in Latin American pediatric patients. The findings highlight the importance of region-specific surveillance and targeted preventive measures to combat meningitis effectively.