Improving the outcome of bacterial meningitis in newborn infants in Malawi

Better treatment for babies in Malawi.

Scientific version
  • Researchers:
    Dr MacPherson Mallewa, Dr Queen Dube, Prof Elizabeth Molyneux
  • Start Date:
    01 March 2010
  • Category:
  • Location:
    Queen Elizabeth Central Hospital, Malawi-Liverpool-Wellcome Research Laboratories, College of Medicine, Blantyre, Malawi
Improving the outcome of bacterial meningitis in newborn infants in Malawi

Bacterial meningitis is 10 times more common in African countries than in the West. Many children die or are left with neurological problems. Meningitis is particularly common in infants under 2 months of age and the death rate is about 50%. There are several reasons for this; one is that the standard antibiotics used are no longer as effective as they used to be. Bacterial resistance to the standard antibiotics has increased and, worryingly, some types of infection, including the second most common form of neonatal meningitis, may only be partly treated and not eradicated by present therapy.

The standard treatments (the antibiotics Penicillin and Gentamicin) are affordable and available, but require 4 injections a day, for at least 14 days - a total of 58 injections. Many mothers are upset by the number of injections and take their children away from hospital before treatment can be completed. Our standard second choice of antibiotic is ceftriaxone, which is also available and affordable and has the advantage of being given as a daily injection. The disadvantages are that it can cause (reversible) jaundice particularly in premature babies and that it must not be given with calcium products.

This study will therefore investigate whether or not ceftriaxone is safe to use in babies under 2 months. If the results show that it is safe, it could provide an alternative treatment option to penicillin and gentamicin.

BBC Radio 4 Appeal - Jan 2011

This project featured on BBC Radio 4's weekly charity appeal and was presented by Michael Rosen, whose teenage son died in 2002.

Update - January 2013

So far the study has recruited 346 children and expect to recruit about 380.
To measure jaundice and safety of ceftriaxone, the researchers have been measuring levels of a naturally occurring substance called bilirubin. When bilirubin levels are high, it indicates that the liver is being affected. 47 children had bilirubin levels increase during treatment, but only 2 were large increases.

No children have needed treatment for the jaundice due to drugs and most children’s level of jaundice declines on treatment. 51 children had no jaundice throughout the course of treatment.   

The research team are following up the children for 6 months to note outcomes including hearing and development.

At Queen Elizabeth Central Hospital in Malawi - bit of a squeeze
At Queen Elizabeth Central Hospital in Malawi - bit of a squeeze

Costs of the project

£10 will pay for a child with meningitis to be looked after for 1 day.

£33 will pay for culture and testing of spinal fluid samples for a month.

£220 will pay for one of two nurses to work for a month.

Target amount


Donated so far


So far £0.00 has been raised for this project including these recent donations...
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