Altered consciousness in Ugandan hospital admissions

An awareness of diseases causing altered mental status (AMS) in particular localities could greatly facilitate patient management. This cross-sectional study evaluated 100 consecutive patients with AMS admitted to a hospital in Uganda. Patients were assessed by the Confusion Assessment Method. History, examination, available laboratory tests and patients' response to treatment were used to identify aetiologies. Our study included 58 males and 42 females: 82% were 16-50 years old and 38% were HIV-infected. The most common cause of AMS was infection (51.3%), with cerebral malaria and meningitis predominating. The aetiology was unidentified in 12%. The in-hospital mortality rate was 44%, with HIV infection being positively associated. As infections and metabolic derangements, the most common causes of AMS in our setting, are mostly treatable with a relatively favourable outcome, critical evaluation, early intervention and improved investigative capacity would greatly improve patient outcome.