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Published on: November 5, 2019
[Bacterial meningiditis in adult patients in Central African hospitals]
P Mbelesso1, A Tatangba-Bakozo, V Fikouma
1Service de neurologie, hôpital de l'Amitié, BP 3183, Bangui, République Centrafricaine. pascal.mbelesso@yahoo.fr
Abstract:
Bacterial meningitidis of the adult remain frequent and serious affections in spite of therapeutic progress. The authors report results from a retrospective study of 502 cases over 5 years. Hospital prevalence was 12.1%. These infections occur during the dry season between November and April in 75% of the cases. An important peak was observed in March, that is to say 24.5%. Patients' average age was 34.7 years old with extremes ranging from 15 to 80. The isolated micro-organisms were: the pneumococcus (45.2%), the meningococcus (14.5%), salmonella (1.6%) and the Haemophilus influenzae (1.2%). Meningitidis decapitated by a preliminary antibiotherapy represented 37,5%. Seroprevalence of the HIV infection during this work was 55.1%. Patients suffering from pneumococcus meningitis were contaminated by the HIV in 51.7% of the cases. Those suffering from meningococcus infection were infected with HIV in 52.9% of the cases. Those presenting meningitidis to Haemophilus influenzae and salmonellas had contracted the HIV respectively in 83% and 87.5% of the cases. The average duration of hospitalization was 14.2% days. The average mortality rate was 31.7% for the pneumococcus, 30. 1% for the meningococcus one. 53.4% of the patients recovered.
Insights
Bacterial meningitis remains a significant threat, with pneumococcus and meningococcus as leading causes. HIV coinfection is highly prevalent, particularly in cases of Haemophilus influenzae and Salmonella meningitis, increasing mortality risks.
Area of Science:
- Epidemiology of infectious diseases
- Bacteriology
- Public health
Context:
- Adult bacterial meningitis presents ongoing clinical challenges despite advances in treatment.
- A 5-year retrospective study analyzed 502 cases to understand prevalence, causative agents, and outcomes.
- Infections show seasonal patterns, peaking between November and April, with a notable surge in March.
Purpose:
- To investigate the epidemiological characteristics and etiological agents of bacterial meningitis in adults.
- To assess the impact of Human Immunodeficiency Virus (HIV) coinfection on meningitis cases and outcomes.
- To determine hospitalization duration and mortality rates associated with different bacterial meningitis pathogens.
Summary:
- The study identified Streptococcus pneumoniae (45.2%) and Neisseria meningitidis (14.5%) as the most common bacterial pathogens.
- Human Immunodeficiency Virus (HIV) seroprevalence was high at 55.1%, with significantly elevated rates in patients infected with Haemophilus influenzae (83%) and Salmonella (87.5%).
- Mortality rates were substantial for pneumococcal (31.7%) and meningococcal (30.1%) meningitis, with an overall recovery rate of 53.4%.
Impact:
- Findings highlight the critical need for targeted prevention and treatment strategies, especially in populations with high HIV prevalence.
- The study underscores the severe prognosis of bacterial meningitis, particularly when coinfected with HIV.
- Results provide valuable data for public health interventions and resource allocation in managing bacterial meningitis.
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