September 16, 2010Virology JournalOpen Access

Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Aseptic meningitis (n=387). Intervention: Enterovirus infection vs. Uninfected or older children. Primary outcome: Detection of enteroviral RNA in cerebrospinal fluid (p=0.011).

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Key result

Enteroviral RNA was detected in 24% of suspected aseptic meningitis cases, with significantly higher positivity in children under 2 years old (27%) compared to those 4-12 years old (8%), predominantly driven by echoviruses E9, E11, and E30.

Population

387 children <12 years of age with suspected aseptic meningitis admitted to two major hospitals in Kuwait.

Design

Cohort

Authors

ADAjmal DalwaiKuwait University SASuhail AhmadUniversity of Washington WAW. Al‐NakibKuwait University

Discussion

Member takes

Implication

May guide age-specific testing priorities for aseptic meningitis in Kuwait; extends regional epidemiology but remains hypothesis-generating.

Study Design

Type

Observational (n=387)

Multicenter

Yes

Structured PICO

Population

387 children under 12 years of age with suspected aseptic meningitis admitted to two major hospitals in Kuwait over a 3-year period.

Outcome

Detection and genotyping of enteroviral RNA in cerebrospinal fluid.

Main Result

Absolute Event Rate: 27% vs 8%

p-value: p=0.011

Echoviruses, particularly types 9, 11, and 30, are the predominant enteroviral etiologic agents of aseptic meningitis in infants and young children in Kuwait.

Limitations

A large proportion (76%) of aseptic meningitis cases did not have an enteroviral etiology identified.
No internal control was used with each sample to rule out lack of RNA extraction or presence of PCR inhibitors.
Potential delay in reporting to the hospital after the onset of symptoms may have reduced viral load and detection.
Some cases may have been misclassified as aseptic meningitis due to prior antibiotic treatment, non-infectious etiologies, or other unexplored viral agents.
Large number (76%) of aseptic meningitis cases did not have an enteroviral etiology.
Lack of internal control with each sample to rule out PCR inhibitors or extraction failure.
Possible delay in reporting to the hospital after onset of symptoms leading to declining viral load.
Potential inclusion of cases with prior antibiotic treatment, non-infectious etiologies, or other viral agents.

Cite This Study

Dalwai et al. (2010) conducted an observational in Aseptic meningitis (n=387). Enterovirus infection vs. Uninfected or older children was evaluated on Detection of enteroviral RNA in cerebrospinal fluid (p=0.011). Enteroviral RNA was detected in 24% of suspected aseptic meningitis cases, with significantly higher positivity in children under 2 years old (27%) compared to those 4-12 years old (8%), predominantly driven by echoviruses E9, E11, and E30.

synapsesocial.com/papers/6a7a16889092edbae3f3922a https://doi.org/10.1186/1743-422x-7-236

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Implication

May guide age-specific testing priorities for aseptic meningitis in Kuwait; extends regional epidemiology but remains hypothesis-generating.

Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider