Reagent Strips as an Aid to Diagnosis of Neonatal Meningitis in a Resource-limited Setting

J Trop Pediatr. 2019 Feb 1;65(1):9-13. doi: 10.1093/tropej/fmy003.

Abstract

Background: Without early recognition and treatment, neonatal meningitis (NM) has a high mortality and morbidity. Although some neonates have features of NM, many do not. In many low-resource settings, the laboratory support to diagnose NM is not available, and bedside diagnostics are needed.

Methods: This retrospective study was conducted in a neonatal unit in Uganda. Clear cerebrospinal fluid samples were routinely screened for glucose, protein and leukocytes on a Combur®-10 urinalysis reagent strip. A definitive diagnosis was made using laboratory analysis. The results of the screening and definitive tests were compared.

Results: The reagent strip showed moderate sensitivity and high specificity for leukocytes ≥10×106 cells/l, high sensitivity for protein ≥100 mg/dl and high specificity for glucose <50 mg/dl.

Conclusion: The use of reagent strips has the potential to improve and hasten the diagnosis of probable NM in settings where adequate or timely laboratory support is not available.

MeSH terms

  • Cerebrospinal Fluid* / chemistry
  • Cerebrospinal Fluid* / cytology
  • Female
  • Glucose* / analysis
  • Health Resources
  • Humans
  • Infant, Newborn
  • Leukocyte Count / methods*
  • Leukocytes*
  • Mass Screening
  • Meningitis / cerebrospinal fluid
  • Meningitis / diagnosis*
  • Proteins* / analysis
  • Reagent Strips*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Time Factors
  • Uganda

Substances

  • Proteins
  • Reagent Strips
  • Glucose