TABLE 1

Studies That Met Inclusion Criteria for Accuracy of Clinical Features Suggestive of Bacterial Meningitis in Children

StudyQuality LevelQuality QUADAS Score, of 14CountrySettingTesterPopulation Study Prevalence, n (%)aAge and Age SubgroupInclusion CriteriaNo. of Index TestsDescription of Index Tests
Akpede et al8 (1992)212Benin, NigeriaPediatric EDUnknown522 (4.2)1 mo to 6 y; subgroups: 1–6 mo, 6 mo to 2 y, 2–6 ySeizure and fever8Insufficient description
Akpede and Sykes9 (1993)210Benin, NigeriaPediatric EDUnknown92 (15)6–14 ySeizure and fever9Insufficient description
Akpede 10 (1995)212Maiduguri, NigeriaPediatric EDUnknown341 (19)1 mo to 15 yFever and seizure or “acutely ill”15Insufficient description
Lembo and Marchant14 (1991)211.5Cleveland, OHED/acute care clinic of hospitalManaging physician160 (6)6 mo (median)Fever and “could have meningitis”2 groups of 4 signs and 4 symptomsInsufficient description
Lehmann et al13 (1999)213Goroka, Papua, New GuineaBase hospitalPediatrician642 (18)1 mo to 5 ySuspected meningitis14Insufficient description
Walsh-Kelly et al16 (1992)113WisconsinPediatric EDPediatric emergency physicians547 (10)1 wk to 17 y (mean: 30 mo); subgroups: 0–6 mo, 7–12 mo, 13–18 mo, >18 moAll children undergoing LP8Well-defined index tests
Weber et al17 (2002)113Banjul, the GambiaPediatric hospitalAttending physicians322 (16)2–33 moSuspected invasive bacterial disease and member of vaccine trial26Insufficient description
Berkley et al11 (2001)113Kilifi, KenyaDistrict hospitalResearch clinician906 (5)1 mo to 13 yAdmitted children with suspected meningitis3Insufficient description
Berkley et al12 (2004)113Kilifi, KenyaDistrict hospitalClinical officers and pediatric residents999 (9)3–40 mo (median: 22 mo)All pediatric admissions with any signs of meningitis, impaired consciousness and prostration, and seizures (other than simple febrile)30Insufficient description
Sigaúque et al15 (2008)212Manhica, MozambiqueDistrict hospitalTrained medical officer475 (15)0–15 y (13% neonatal)Admitted children with neurologic signs compatible with meningitis9Insufficient description
  • ED indicates emergency department.

  • a N population with both LP results and index-test results available.