BACKGROUND: The increase in HIV infections in South Africa is alarming. The aim of this prospective 4-year study was to evaluate the rising incidence of HIV-related admissions due to meningitis at the Pretoria Academic Hospital (PAH) adult neurology ward and to investigate the spectrum of meningitis during this time. PATIENTS AND METHODS: Adults with meningitis presenting at the PAH neurology ward from March 1994 through February 1998 were included. HIV antibody status was determined and patients were assigned to five categories: bacterial, tuberculous, viral and cryptococcal meningitis, as well as an uncertain category. RESULTS: Over the 4-year study period 141 patients with meningitis were seen. Of these, 44 were HIV-positive (31%), with TB meningitis occurring in 16 (36%), cryptococcal meningitis in 22 (50%) and acute bacterial meningitis in three (7%). In the first 2 years of the study, 14% of patients were HIV positive; this figure rose to 44% in the 3rd year, and 57% in the final year. The spectrum of meningitis also changed: bacterial meningitis remained relatively stable at about 25% of the total; TB meningitis almost doubled from 16% in the 1st year to 31% in the last year of the study; viral meningitis initially occurred in 8% of patients and later in 3% of cases, while cryptococcal meningitis showed the most significant increase from 6% of cases in 1994/5 to 31 and 26% respectively in the last 2 years of the study. CONCLUSION: Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis at the PAH.
BACKGROUND: The increase in HIV infections in South Africa is alarming. The aim of this prospective 4-year study was to evaluate the rising incidence of HIV-related admissions due to meningitis at the Pretoria Academic Hospital (PAH) adult neurology ward and to investigate the spectrum of meningitis during this time. PATIENTS AND METHODS: Adults with meningitis presenting at the PAH neurology ward from March 1994 through February 1998 were included. HIV antibody status was determined and patients were assigned to five categories: bacterial, tuberculous, viral and cryptococcal meningitis, as well as an uncertain category. RESULTS: Over the 4-year study period 141 patients with meningitis were seen. Of these, 44 were HIV-positive (31%), with TB meningitis occurring in 16 (36%), cryptococcal meningitis in 22 (50%) and acute bacterial meningitis in three (7%). In the first 2 years of the study, 14% of patients were HIV positive; this figure rose to 44% in the 3rd year, and 57% in the final year. The spectrum of meningitis also changed: bacterial meningitis remained relatively stable at about 25% of the total; TB meningitis almost doubled from 16% in the 1st year to 31% in the last year of the study; viral meningitis initially occurred in 8% of patients and later in 3% of cases, while cryptococcal meningitis showed the most significant increase from 6% of cases in 1994/5 to 31 and 26% respectively in the last 2 years of the study. CONCLUSION: Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis at the PAH.
Authors: Andrew Kambugu; David B Meya; Joshua Rhein; Meagan O'Brien; Edward N Janoff; Allan R Ronald; Moses R Kamya; Harriet Mayanja-Kizza; Merle A Sande; Paul R Bohjanen; David R Boulware Journal: Clin Infect Dis Date: 2008-06-01 Impact factor: 9.079
Authors: Joseph N Jarvis; Graeme Meintjes; Anthony Williams; Yolande Brown; Tom Crede; Thomas S Harrison Journal: BMC Infect Dis Date: 2010-03-15 Impact factor: 3.090
Authors: Sitali P Simwami; Kantarawee Khayhan; Daniel A Henk; David M Aanensen; Teun Boekhout; Ferry Hagen; Annemarie E Brouwer; Thomas S Harrison; Christl A Donnelly; Matthew C Fisher Journal: PLoS Pathog Date: 2011-04-28 Impact factor: 6.823
Authors: Emma C Wall; Katharine Cartwright; Matthew Scarborough; Katherine M Ajdukiewicz; Patrick Goodson; James Mwambene; Eduard E Zijlstra; Stephen B Gordon; Neil French; Brian Faragher; Robert S Heyderman; David G Lalloo Journal: PLoS One Date: 2013-07-19 Impact factor: 3.240