{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:47:28Z","timestamp":1787928448707,"version":"build-2784847793"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Acute bacterial meningitis (ABM) is an important cause of morbidity and mortality in children but there are no published data on the treatment outcomes of ABM in Afghanistan.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a prospective observational cohort study over one year, February 2020 to January 2021 in a tertiary care hospital in Kandahar, Afghanistan. AMB was diagnosed clinically and on lumbar puncture findings. Binary logistic regression assessed factors for death.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 393 ABM children of mean age 4.8 years were recruited. Most were males [231 (58.8%)], living in rural areas [267 (67.9%)] and in households of &gt;10 inhabitants [294 (74.8%)]. Only 96 (24.4%) had received against both <jats:italic>Haemophilus influenzae<\/jats:italic> type b (Hib) or pneumococcal (PCV) vaccines. Children were treated with combination of ceftriaxone and ampicillin and 169\/321 (52.6%) received dexamethasone. Of the 321 children with a known outcome, 69 (21.5%) died. Death was significantly associated with: not receiving dexamethasone [adjusted odds ratio (AOR) 4.9 (95% CI 2.6\u20139.5, <jats:italic>p<\/jats:italic> &lt;0.001)], coma on admission [AOR 4.6 (I 2.3\u20139.5, <jats:italic>p<\/jats:italic> &lt;0.001)], no PCV [AOR 2.8 (1.2\u20136.6, <jats:italic>p<\/jats:italic> = 0.019)] or Hib vaccine [AOR 2.8 (1.2\u20136.6, <jats:italic>p<\/jats:italic> = 0.019)], and being male [AOR 2.7 (1.4\u20135.5, <jats:italic>p<\/jats:italic> = 0.005).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>ABM causes significant morbidity and mortality in Afghan children that may be improved by greater use of PCV and Hib vaccines. Adjunct dexamethasone should be evaluated formally in our setting.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265487","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T17:23:10Z","timestamp":1649697790000},"page":"e0265487","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Outcome of acute bacterial meningitis among children in Kandahar, Afghanistan: A prospective observational cohort study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-5742","authenticated-orcid":true,"given":"Bilal Ahmad","family":"Rahimi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamatullah","family":"Ishaq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam Mohayuddin","family":"Mudaser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter R.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"pone.0265487.ref001","doi-asserted-by":"crossref","first-page":"510","DOI":"10.3325\/cmj.2013.54.510","article-title":"Estimating global and regional morbidity from acute bacterial meningitis in children: assessment of the evidence","volume":"54","author":"I Luk\u0161i\u0107","year":"2013","journal-title":"Croat Med J"},{"key":"pone.0265487.ref002","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/j.1553-2712.2008.00117.x","article-title":"Children with bacterial meningitis presenting to the emergency department during the pneumococcal conjugate vaccine era","volume":"15","author":"LE Nigrovic","year":"2008","journal-title":"Acad Emerg Med"},{"key":"pone.0265487.ref003","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1056\/NEJMoa1005384","article-title":"Bacterial Meningitis in the United States, 1998\u20132007","volume":"364","author":"MC Thigpen","year":"2011","journal-title":"N Engl J Med"},{"key":"pone.0265487.ref004","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S1473-3099(10)70048-7","article-title":"Global and regional risk of disabling sequelae from bacterial meningitis: A systematic review and meta-analysis","author":"K Edmond","year":"2010","journal-title":"The Lancet Infectious Diseases. 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