Aetiology and Outcomes of Suspected Infections of the Central Nervous System in Children in Mbarara, Uganda

Hdl Handle:
http://hdl.handle.net/10144/618938
Title:
Aetiology and Outcomes of Suspected Infections of the Central Nervous System in Children in Mbarara, Uganda
Authors:
Page, A; Boum Ii, Y; Kemigisha, E; Salez, N; Nanjebe, D; Langendorf, C; Aberrane, S; Nyehangane, D; Nackers, F; Baron, E; Charrel, R; Mwanga-Amumpaire, J
Journal:
Scientific Reports
Abstract:
Infections of the central nervous system (CNS) are severe conditions, leading to neurological sequelae or death. Knowledge of the causative agents is essential to develop guidelines for case management in resource-limited settings. Between August 2009 and October 2012, we conducted a prospective descriptive study of the aetiology of suspected CNS infections in children two months to 12 years old, with fever and at least one sign of CNS involvement in Mbarara Hospital, Uganda. Children were clinically evaluated on admission and discharge, and followed-up for 6 months for neurological sequelae. Pathogens were identified from cerebrospinal fluid (CSF) and blood using microbiological and molecular methods. We enrolled 459 children. Plasmodium falciparum (36.2%) and bacteria in CSF (13.3%) or blood (3.3%) were the most detected pathogens. Viruses were found in 27 (5.9%) children. No pathogen was isolated in 207 (45.1%) children. Patterns varied by age and HIV status. Eighty-three (18.1%) children died during hospitalisation, and 23 (5.0%) during follow-up. Forty-one (13.5%) children had neurological sequelae at the last visit. While malaria remains the main aetiology in children with suspected CNS infections, no pathogen was isolated in many children. The high mortality and high rate of neurological sequelae highlight the need for efficient diagnosis.
Publisher:
Nature Publishing Group
Issue Date:
2-Jun-2017
URI:
http://hdl.handle.net/10144/618938
DOI:
10.1038/s41598-017-02741-w
PubMed ID:
28578421
Submitted date:
2017-06-12
Language:
en
ISSN:
2045-2322
Appears in Collections:
Paediatrics

Full metadata record

DC FieldValue Language
dc.contributor.authorPage, Aen
dc.contributor.authorBoum Ii, Yen
dc.contributor.authorKemigisha, Een
dc.contributor.authorSalez, Nen
dc.contributor.authorNanjebe, Den
dc.contributor.authorLangendorf, Cen
dc.contributor.authorAberrane, Sen
dc.contributor.authorNyehangane, Den
dc.contributor.authorNackers, Fen
dc.contributor.authorBaron, Een
dc.contributor.authorCharrel, Ren
dc.contributor.authorMwanga-Amumpaire, Jen
dc.date.accessioned2017-06-21T14:05:23Z-
dc.date.available2017-06-21T14:05:23Z-
dc.date.issued2017-06-02-
dc.date.submitted2017-06-12-
dc.identifier.citationAetiology and Outcomes of Suspected Infections of the Central Nervous System in Children in Mbarara, Uganda. 2017, 7 (1):2728 Sci Repen
dc.identifier.issn2045-2322-
dc.identifier.pmid28578421-
dc.identifier.doi10.1038/s41598-017-02741-w-
dc.identifier.urihttp://hdl.handle.net/10144/618938-
dc.description.abstractInfections of the central nervous system (CNS) are severe conditions, leading to neurological sequelae or death. Knowledge of the causative agents is essential to develop guidelines for case management in resource-limited settings. Between August 2009 and October 2012, we conducted a prospective descriptive study of the aetiology of suspected CNS infections in children two months to 12 years old, with fever and at least one sign of CNS involvement in Mbarara Hospital, Uganda. Children were clinically evaluated on admission and discharge, and followed-up for 6 months for neurological sequelae. Pathogens were identified from cerebrospinal fluid (CSF) and blood using microbiological and molecular methods. We enrolled 459 children. Plasmodium falciparum (36.2%) and bacteria in CSF (13.3%) or blood (3.3%) were the most detected pathogens. Viruses were found in 27 (5.9%) children. No pathogen was isolated in 207 (45.1%) children. Patterns varied by age and HIV status. Eighty-three (18.1%) children died during hospitalisation, and 23 (5.0%) during follow-up. Forty-one (13.5%) children had neurological sequelae at the last visit. While malaria remains the main aetiology in children with suspected CNS infections, no pathogen was isolated in many children. The high mortality and high rate of neurological sequelae highlight the need for efficient diagnosis.en
dc.language.isoenen
dc.publisherNature Publishing Groupen
dc.rightsArchived with thanks to Scientific Reportsen
dc.titleAetiology and Outcomes of Suspected Infections of the Central Nervous System in Children in Mbarara, Ugandaen
dc.identifier.journalScientific Reportsen

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