Abstract:
Background: Acute Meningoencephalitis Syndrome (AMES) remains
a significant cause of morbidity and mortality in children worldwide,
with diverse infectious etiologies varying by geography and resource
availability. While vaccines have successfully reduced bacterial meningitis
due to Streptococcus pneumoniae and Haemophilus influenzae type B (Hib)
in developed regions, serotype replacement and antimicrobial resistance
pose ongoing challenges. Objective: This study aimed to determine
the frequency of infectious causes of AMES among children presenting
to a tertiary care hospital in Khyber Pakhtunkhwa, Pakistan, providing
essential epidemiological insights to guide diagnostic and preventive
strategies. Methods: A cross-sectional study was conducted in the tertiary
care hospital, Peshawar, from August 1, 2023, to January 31, 2024. 130
children aged 1–10 years with acute meningoencephalitis syndrome of
≤72 hours’ duration were enrolled. Lumbar puncture was performed for
cerebrospinal fluid (CSF) analysis, and pathogens including Streptococcus
pneumoniae, enterovirus, herpesvirus VI, Mycobacterium tuberculosis,
Escherichia coli, and Group B Streptococcus were identified. Data were
analyzed using Statistical Package for the Social Sciences version 23, with
stratification by age, gender, and duration of symptoms. Results and
conclusion: The most commonly identified pathogen was enterovirus (23.1%), followed by Group B Streptococcus (19.2%),
Escherichia coli (17.7%), and Streptococcus pneumoniae
(16.9%). Herpesvirus VI was detected in 12.3% of cases, while
Mycobacterium tuberculosis was the least frequent (3.8%).
Male patients accounted for 73.1% of cases. Age stratification
indicated higher infection rates among younger children
(1–5 years), although no statistically significant differences
were observed across age groups, gender, or symptom
duration. Viral etiologies, particularly enteroviruses, remain
the predominant cause of pediatric AMES, aligning with
global trends. However, the considerable burden of bacterial
infections underscores the continued need for improved
vaccination coverage and antimicrobial stewardship. The low
detection rate of Mycobacterium tuberculosis likely reflects
diagnostic limitations rather than its true prevalence. These
findings highlight the importance of early diagnosis, targeted
treatment strategies, and enhanced surveillance to improve
outcomes in pediatric acute meningoencephalitis syndrome
cases.
