Epidemiological trends and neurological outcomes of pediatric central nervous system infections in rural part of western India

Table 1 Demographic and seasonal characteristics of pediatric central nervous system infections in children (n = 278), n (%)/mean ± SD

Variable
Mean age (years)	5.8 ± 3.2
Age < 5 years	142 (51.1)
Male sex	162 (58.3)
Monsoon/post-monsoon (July-October)	116 (41.7)
Winter (November-February)	83 (29.9)
Summer (March-June)	79 (28.4)

Table 2 Etiological spectrum of pediatric central nervous system infections

Etiology	Cases (n)	Percentage, %
Viral encephalitis	111	39.9
Bacterial meningitis	86	30.9
Tuberculous meningitis	42	15.1
Brain abscess	6	2.2
Undetermined	33	11.9
Total	278	100.0

Values represent the number of cases and their corresponding percentages of the total cohort.

Table 3 Outcomes by etiology of pediatric central nervous system infections, n (%)

Etiology	Recovered	Neurological sequelae	Deaths
Viral encephalitis	98 (88.3)	10 (9.0)	3 (2.7)
Bacterial meningitis	65 (75.6)	10 (11.6)	11 (12.8)
Tuberculous meningitis	24 (57.1)	9 (21.4)	9 (21.4)
Brain abscess	5 (83.3)	1 (16.7)	0 (0.0)
Undetermined	21 (63.6)	9 (27.3)	3 (9.1)
Total	213 (76.6)	39 (14.0)	26 (9.4)

Values represent the n (%) of children in each outcome category according to infection etiology. Percentages are based on the total within each etiological group.

Table 4 Neurological sequelae among survivors of pediatric central nervous system infections (n = 213), n (%)

Neurological sequelae	Cases
Post-infectious epilepsy	15 (7.0)
Hemiparesis	9 (4.2)
Cognitive impairment	8 (3.8)
Cerebral palsy	5 (2.3)
Spinal deformities	2 (0.9)
Total neurological sequelae	39 (18.3)

Percentages are calculated using the total number of survivors at discharge (n = 213).

Table 5 Univariate analysis of factors associated with mortality and neurological sequelae in pediatric central nervous system infections

Variable	Deaths	Neurological sequelae (%)
Age < 5 years	12.6a	16.9
Age ≥ 5 years	6.2	11.1
Male sex	8.6	13.0
Female sex	10.3	15.5
Altered sensorium present	18.9b	17.1
No altered sensorium	4.8	11.4
Seizures present	11.3	21.7a
Seizures absent	8.0	8.3

^aP < 0.05 (χ² test).

^bP < 0.01 (χ² test).

Values represent the percentage of deaths and neurological sequelae among each subgroup. Data with P > 0.05 are not indicated.

Table 6 Independent predictors of poor outcomes (death or neurological sequelae) among children with central nervous system infections

Variable	Adjusted odds ratio (95%CI)	P value
Age < 5 years	2.31 (1.10-4.89)	0.026
Altered sensorium at admission	3.84 (1.75-8.41)	0.001
Tuberculous meningitis	4.97 (1.92-12.81)	0.001
Bacterial meningitis	2.15 (0.96-4.84)	0.062
Seizures at presentation	1.39 (0.69-2.81)	0.350
Male sex	1.12 (0.53-2.33)	0.770

Multivariate binary logistic regression was performed using the backward stepwise method, including variables with P < 0.1 on univariate analysis or of clinical relevance. Odds ratios are presented with 95%CI. P < 0.05 was considered statistically significant.