The epidemiology of meningitis by Streptococcus pneumoniae in a metropolitan area of Brazil, 1960-1977

Abstract

The epidemiology of meningitis caused by S. pneumoniae in the city of S. Paulo, Brazil, during the period 1960-77 is analysed. Data were obtained directly from the patients' records and registered on a pre-coded form. Cases of S. pneumoniae meningitis were confirmed by gram stain and/or culture of the cerebrospinal fluid (CSF). During the period 1960-77, there was confirmation of 1,965 cases of S. pneumoniae meningitis, giving an average rate of 1.9 per 100,000 inhabitants. Children of less than 5 years of age accounted for 52% of cases and 39% were less than 1 year old. The average rates for children below 1 year of age were 37 and 30 per 100,000 inhabitants, respectively, for the periods 1960-69 and 1970-77. The rate of incidence for the peripherial zone - 2,2 per 100,000 inhabitants - was pratically double the rate for the central area - 1.2 per 100,000 inhabitants - in the 1960's. The age standardized rates were 1.6, 1.5 and 2.0 for central, intermediate, and peripherial zones, respectivelly. In the 1970's these rates were 1.4, 1.5 and 2.0. The average case fatality rate for the period was 47% which was inversely proportional to the number of CSF leucocytes at first examination. For children less than year old, the case fatality rate was 60% for the same period.