Community Medicine Abstracts - College of Medicine and Health ...

Project No. 156 (B-1999/0)Clinico-Epidemiological Study of Meningitis, Hepatitis A and Mumps in Al AinMedical DistrictStudent Authors: Rabah Ali Mohammed, Munira Ali MohamedFaculty Supervisors: Dr. M.M. Hossain, Dr. G. Nicol, Dr. P. BadrinathAbstract:Objectives To determine incidence and seasonality of meningitis, HAV and mumps.Also, to study the sociodemographic pattern of each disease. Some specific objectivesinclude to analyse the clinical presentation, CT investigation, and antibiotic sensitivitypattern of meningitis cases. To determine geographic clustering of HAV. Finally, todetermine vaccination status of mumps cases less than 5 years.Methods The study was conducted in Al Ain City and covers the period January 1990to October 1999 (meningitis), November 1998 to October 1999 (Hepatitis A) andJanuary 1998 to November 1999 (mumps). The sociodemographic data (e.g. age,sex. nationality, and residence) were recorded from the notification forms. Otherclinical and laboratory data regarding meningitis cases were obtained from theirmedical records in the hospitals. Population denominators were estimated from theDepartment of Preventive medicine to calculate the incidence rate.Results Meningitis showed undulating pattern with a decline in the last two years.Males were more commonly infected than females (62.9% vs 37.1%). Meningitis dueto Haemophilus influenza (Hib) is the commonest type of meningitis (44.4%). Allcases of Hib Meningitis were less than six years old. Almost one third of casesdeveloped seizures and deafness (30.7% and 27% consequently). Significantassociation was found between time of presentation and development of neurologicalcomplications (X2=4.8, p-value=0.028). CT findings seemed to predict patients whowill develop neurological sequalae (X2=14, p-value=0.00). Finally, both Hib andStreptococcal pneumonia (S. pneumonia) were 100% sensitive to third generationcephalosporines and vancomycin. The number of reported cases of HAV ranges from123 in 1990 to 325 in Oct. 1999. Most of the reported cases (75%) are less than 12years of age. The majority of cases are UAE nationals (77.7%). Prevalence of HAV ismore in the rural areas (66%). There is geographical clustering of HAV as 54% ofcases were from Al Yahar. Peak incidence occurred from Jan-Mar (48.1%). Theincidence of mumps cases have decreased since 1990. Males are more commonlyinfected than females (62.5% vs 37.5%). UAE nationals are the most vulnerablegroup (56.7%). Most cases fall between 6-12 years of age (40.9%). More than onethird of cases (36.9%) were vaccinated, and nearly one fifth of cases (17.5%) werechildren less than 15 months.Conclusion The results indicate public education about meningitis to avoid latepresentation and permanent disability. Patients with CT findings need to be closelymonitored and followed up for expected neurological complications. Majority of HAVcases occur in UAE citizens with rural preponderance. Majority of mumps cases occurin children and there appears to be a reversal in the declining trend of cases.