Spectrum of central nervous system infections in a tertiary health care centre in Cameroon

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Prince Eliot Sounga Bandzouzi¹  Seraphine Mojoko Eko²  Daniel Gams Massi²  Annick Mélanie Magnerou³  Marcel Roger Rodrigue Mintyene Mintyene³  Njankouo Yacouba Mapoure⁴  Salomon Mbahe⁴  Hugo Bertrand Mbatchou Ngahane⁴  Caroline Kenmegne⁴ 

[1] Department of Neurology, Marien Ngouabi University;Faculty of Health Sciences, University of Buea;Faculty of Medicine and Pharmaceutical Sciences, University of Douala;Internal Medicine Department, Douala General Hospital;

关键词: CNS infection;    HIV;    Cerebral toxoplasmosis;    Douala;    Cameroon;   

DOI  :  10.1186/s41983-022-00454-0

来源: DOAJ

【 摘 要 】

Abstract Background Central nervous system (CNS) infections are serious and debilitating diseases with significant mortality, and high prevalence in the context of human immunodeficiency virus (HIV) pandemic in Africa. However, their diagnosis remains challenging due to outdated technical platform. We aimed to determine the frequency of CNS infection and to describe the epidemiological, clinical and outcome of this at the Douala General Hospital (DGH), Cameroon. To carry out this study, we collected the medical records of patients hospitalized for CNS infections in the internal medicine department of DGH from January 2015 to December 2019. Results Among 8430 files reviewed, 336 cases of CNS infection were identified giving a frequency of CNS infection of 3.99% among which 204 files were included in the study (54.4% were male). HIV infection was found in 147 patients (72.1%) with 38.1% (n = 56) of them on regular follow-up. The most common clinical signs were fever (84.8%), headache (68.6%), meningeal syndrome (38.7%), and seizures (36.3%). Cerebral toxoplasmosis (24.5%), cryptococcal meningitis (21.1%), and acute bacterial meningitis (8.3%) were leading aetiologies. Of the 143 CSF samples, 70.6% (n = 101) were sterile. The in-hospital mortality rate was 23.5% with CNS infection of unknown cause (22.1%) be independently associated to this [OR = 2.24; 95% CI 1.04–4.80, p = 0.039]. Conclusion Clinical presentations of CNS infections are same with classical data. HIV-related opportunistic infections are the main aetiologies. About one over four patients with CNS died. Two thirds of CSF are sterile using basic laboratory assessment giving a need to identify simple tests to increase sensibility and specificity of diagnostic tools in our setting.

【 授权许可】

Unknown