The Role of Hemophilus Influenza Type b in Pediatric Meningitis

According to the reports of World Health Organization (WHO), Hemophilus Influenza type b (HIB) is the most common cause of pediatric bacterial meningitis in Eastern Mediterranean Region of WHO, but in Mashhad as in most cities of Iran we haven’t seen it frequently. The aim of this study was to declare the real role of HIB in pediatric meningitis in Mashhad In winter 2005, after improving our techniques in sampling, transfer and processing of (CSF) and with adding Latex agglutination test to our diagnostic methods, we prospectively analyzed all of the CSF samples of Mashhad kids in a single Lab. A total of 230 CSF samples were obtained during the study period (Dec-25- 2005 to My-23-2006, 140 days). Pleocytosis of CSF (and thus meningitis) was observed in 98 (42.4%) of these samples, among them there were 9 definite cases (9.18%) of bacterial meningitis (HIB: 4, Pneumococcus: 3 Meningococcus: 1 Citrobacter: 1). The estimated incidence of HIB meningitis in children younger than 5 years was 2.31/100000 persons/year and the estimated number of Lumbar Punctures in them was 106.59/100000 persons/year. HIB is the most common cause of Bacterial Meningitis in children in Mashhad, but like other Iranian reports the Incidence of HIB meningitis is much lower than the expected level. The number of Lumbar Punctures per 100000 children per year, and the rate of positive CSF cultures is also unacceptably lower than WHO standards.