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Researchers in Liverpool conduct steroid trials to combat meningitis in Africa
A major international research study funded by the charity Meningitis Research Foundation has today reported on treatments to combat meningitis.
Meningitis affects ten of thousands of people every year in the developing countries of Africa. Compared to Europe the death rate of those affected is much higher. In Malawi, where doctors and scientists from Liverpool and Malawi conducted the trial, 56% of people who get meningitis die, compared to around 10% in the UK.
In meningitis, damage and death are due to inflammation triggered by bacterial toxins. By relieving inflammation, steroids could reduce damage from meningitis and improve chances of survival. In Europe, steroids have been shown to improve survival in patients with meningitis.
The researchers set out to see whether steroids would be effective in a developing country, particularly one with a high incidence of HIV. One of the main advantages of steroids in a developing world setting is that they are safe, accessible and relatively inexpensive.
A further key aim of the project was to find out whether the antibiotic ceftriaxone is effective when injected into a muscle rather than a vein.
The study, published today in the New England Journal of Medicine, found no benefit from steroid therapy, but ceftriaxone proved to be as effective when injected into muscles as into a vein. This has important implications as the most basic and vital element in treating meningitis is to give effective antibiotics as quickly as possible. Recently, ceftriaxone has become affordable in Africa. In industrialised countries it is administered intravenously, but in Malawi this is only possible in a limited number of hospitals, which many people can't get to, so it is not practical. Intramuscular injection of ceftriaxone requires less equipment and expertise, and is therefore feasible in local health centres and hospitals.
The researchers are continuing to explore avenues to bring relief to the problems of meningitis in Africa. In a new project, also funded by Meningitis Research Foundation, they are now testing the effects of glycerol, which has been shown to reduce deaths in children with meningitis in South America. The researchers are investigating whether glycerol has the same beneficial results with adults in Malawi, as it would prove an affordable way to tackle meningitis, not least because glycerol could be produced locally.
Media Contacts: Dr Matthew Scarborough, Clinical Lecturer in Microbiology and Infectious Diseases, Nuffield Department of Clinical Laboratory Sciences, University of Oxford - 01865 741166 or 07872436461
Julia Warren, Meningitis Research Foundation - 01454 281811 or 07711 057875
Read more about this project:
Research Archive for the public - A trial of steroids and intra-muscular injection of antibiotics in adults with bacterial meningitis
Research Archive for the scientific community - Dexamethasone adjuvant therapy and intramuscular ceftriaxone in adult bacterial meningitis in Malawi
Notes to Editor :
- Meningitis Research Foundation currently funds 18 research projects. Since it was founded in 1989, the charity has awarded 118 research grants, leading to many advances in the prevention, detection and treatment of meningitis and septicaemia.
- Meningitis Research Foundation operates a Freefone 24 hour helpline - 080 8800 3344 - providing information on meningitis and septicaemia to the general public and health professionals.
Symptoms of meningitis:
Fever; vomiting; severe headache; rash (not present in all cases); stiff neck*; dislike of bright lights*; very sleepy/vacant/difficult to wake; confused/delirious; seizures (fits) may also be seen. (*Unusual in young children.)
Symptoms of septicaemia (blood poisoning form of the disease):
Fever; vomiting; limb/joint/muscle pain (sometimes stomach pain/diarrhoea); pale or mottled skin; cold hands and feet; shivering; breathing fast/breathless; rash (anywhere on the body); very sleepy/vacant/difficult to wake; confused/delirious.
Other symptoms in babies include: tense or bulging fontanelle (soft spot); refusing to feed; being irritable when picked up with a high pitched or moaning cry; a stiff body with jerky movements or else floppy and lifeless.