Evaluation of Different Methods for Rapid Diagnosis of Meningitis in Assiut University Hospital

meningitis is a notifiable disease in many countries, the exact incidence rate is unknown. In 2013 meningitis resulted in 303,000 deaths - down from 464,000 deaths in 1990. In 2010 it was estimated that meningitis resulted in 420,000 deaths, excluding cryptococcal meningitis.

Bacterial meningitis occurs in about 3 people per 100,000 annually in Western countries. Population-wide studies have shown that viral meningitis is more common, at 10.9 per 100,000, and occurs more often in the summer. In Brazil, the rate of bacterial meningitis is higher, at 45.8 per 100,000 annually.Sub-Saharan Africa has been plagued by large epidemics of meningococcal meningitis for over a century,leading to it being labeled the "meningitis belt". Epidemics typically occur in the dry season (December to June), and an epidemic wave can last two to three years, dying out during the intervening rainy seasons.Attack rates of 100-800 cases per 100,000 are encountered in this area, which is poorly served by medical care. These cases are predominantly caused by meningococci.The largest epidemic ever recorded in history swept across the entire region in 1996-1997, causing over 250,000 cases and 25,000 deaths.

Meningococcal disease occurs in epidemics in areas where many people live together for the first time, such as army barracks during mobilization, college campuses and the annual Hajj pilgrimage. Although the pattern of epidemic cycles in Africa is not well understood, several factors have been associated with the development of epidemics in the meningitis belt. They include: medical conditions (immunological susceptibility of the population), demographic conditions (travel and large population displacements), socioeconomic conditions (overcrowding and poor living conditions), climatic conditions (drought and dust storms), and concurrent infections (acute respiratory infections).

There are significant differences in the local distribution of causes for bacterial meningitis. For instance, while N. meningitides groups B and C cause most disease episodes in Europe, group A is found in Asia and continues to predominate in Africa, where it causes most of the major epidemics in the meningitis belt, accounting for about 80% to 85% of documented meningococcal meningitis cases.

Infections that involve the central nervous system (CNS), such as meningitis/encephalitis (ME), are severe clinical conditions associated with high rates of morbidity and mortality as well as significant long-term sequelae . acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.The most common symptoms are fever, headache, and neck stiffness.Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding.If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs.Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. A lumbar puncture can diagnose or exclude meningitis.A needle is inserted into the spinal canal to collect a sample of cerebrospinal fluid (CSF), which envelops the brain and spinal cord. The CSF is examined in a medical laboratory.