Neuroinfections in developed versus developing countries.

In recent supplement of neuroendocrinology letters, first time the authors from West and East, North and South of EU and the "Third World" present data on neuroinfections in high technology society - on nosocomial meningitis and vice versa in low technology and income countries of sub-Saharan Africa. 14 years survey of 171 cases of nosocomial paediatric meningitis is presented by Rudinsky et al. [1] and subpopulations of Acinetobacter baumannii and Pseudomonas aeruginosa [1,2] within last 20 years are briefly analyzed by Huttova et al. [2] and Ondrusova et al. [3]. All cases were complicating high technology procedures, such as neurosurgery, very low birth weight neonates after shunt implants etc. Current problems of management of nosocomial meningitis are reviewed by Bauer et al. [4] and consequence of inappropriate therapy by Huttova et al. [5]. Another high technology associated infection is septic embolisation followed by brain abscess and meningitis in patients with endocarditis after cardiac surgery (Kovac et al.) [6]. Experience from more than 600 cases is discussed in the article by Karvaj et al. [7] who outlines extremely high mortality in patients with endocarditis embolizing to central nervous system - up to 60%. The rest of papers are in contrary to problems of neuroinfections in EU and US focused on meningitis and cerebral malaria as commonest neuroinfections in the third world: 261 cases of cerebral malaria are discussed in a brief research note by Sudanese team of tropical programme in area of famine and civil war in southern Sudan (Bartkovjak and Ianetti et al.) [8]. Fungal neuroinfections complicating AIDS are of decreasing trend as reported by Njambi et al. from Kenya [9] and data from 497 cases from Uganda, Ethiopia and Burundi are presented by Benca et al. [10]. Finally an outbreak of meningococcal meningitis is reported by Benca et al. [11] from meningitis belt in Darfur and southern Sudan. We hope that the supplement may show difference in etiology, risk factors, therapy and outcome of neuroinfections (which is a burning public health and social problem in tropics) in other third world countries versus developed high-tech medical settings of US, EU and other high income countries, as presented by Benca et al. [12].