The diagnostic accuracy of cranial ultrasound in acute baterial meningitis in infants at Mulago Hospital
| dc.creator | Nakazibwe, Sylvia | |
| dc.date | 2013-03-01T06:39:19Z | |
| dc.date | 2013-03-01T06:39:19Z | |
| dc.date | 2009-05 | |
| dc.date.accessioned | 2018-09-04T12:33:10Z | |
| dc.date.available | 2018-09-04T12:33:10Z | |
| dc.description | A thesis submitted in partial fulfillment of the requirements for the award of Master of Medicine (Radiology) Degree of Makerere University. | |
| dc.description | Introduction: Acute bacterial meningitis remains an impoliant cause of morbidity and mortality in Uganda and worldwide and a noticeable number of survivors (22-28%) are left with marked neurological sequel despite adequate treatment. Diagnosis of ABM among infants depends on signs and symptoms and CSF analysis with CSF culture as the gold-standard, however, imaging investigations like cranial-ultrasound have been found to be extremely valuable in diagnosis of ABM and its complications. Objectives: The aim of this study is to establish the diagnostic accuracy of cranial ultra sound in acute bacterial meningitis among infants admitted in Mulago hospital using CSF gramstain, protein and leucocyte count as operational gold standard. Design and Setting: A cross sectional study was conducted in acute care unit of Mulago hospital from December 2008 to April 2009. Study population: These were infants aged 0-12 months admitted with clinically suspected ABM and in whom CSF had been sent for analysis. A sample size of 227 infants was used. Recruited infants after undergoing routine lumbar puncture underwent a cranial ultrasound examination and findings were documented using a pre-coded questionnaire. Data was entered in a computer and checked for consistency and accuracy. Statistical analysis: Results were analyzed using SPSS II with the assistance of a statistician. Cross tabulation of cranial ultrasound scan findings with CSF results led to computation of sensitivity, specificity, predictive values and likelihood ratios. Univariate and bivariate analysis were conducted. Logistic regression analysis was done to determine sonographic features most predictive of ABM in infants. Results: Cranial ultrasound scan has a sensitivity of 85%; specificity of 74.1%; positive predictive value 32.9%; negative predictive value 97.2%; positive diagnostic likelihood ratio. The most common sonographic abnormalities among "proven" cases of ABM were echogenic sulci (92.6%), vcntriculomegaly (77.8%) and Parenchymal abnormalitics (62.9%). Sonographic findings most predictive of ABM among infants are echogenic sulci, ventriculitis and cerebral edema. Conclusion: Cranial ultrasound scan has a high sensitivity of 85% and high negative predictive value of 97.2% making it a very useful screening and diagnostic test for acute bacterial meningitis. Recommendation: Cranial Ultrasound scan should be considered as an initial diagnostic tool in management of acute bacterial meningitis followed by CSF analysis for confirmation ifpositive scan result is obtained. | |
| dc.identifier | ||
| dc.identifier | ||
| dc.identifier | http://hdl.handle.net/10570/1154 | |
| dc.identifier.uri | http://hdl.handle.net/10570/1154 | |
| dc.language | en | |
| dc.subject | Acute Bacterial Meningitis (ABM) | |
| dc.subject | ABM Diagnosis | |
| dc.subject | Cranial-ultrasound | |
| dc.subject | Infants | |
| dc.subject | Mulago Hospital | |
| dc.title | The diagnostic accuracy of cranial ultrasound in acute baterial meningitis in infants at Mulago Hospital | |
| dc.type | Thesis, masters |