TITLE:
Spectrum of Meningitis in Adult at the Douala General Hospital
AUTHORS:
Yacouba N. Mapoure, Henry N. Luma, Dieudonné Gnonlonfoun, Paul M. Ossou-Guiet, Xaverie Biloa, Jacques N. Doumbe, Hugo Bertrand N. Mbatchou, Benjamin Clet N. Tchaleu, Julius Y. Fonsah, Albert S. Mouelle, Alfred K. Njamnshi
KEYWORDS:
Meningitis, Signs, Aetiologies, Mortality, Adults, Douala, Cameroon
JOURNAL NAME:
World Journal of Neuroscience,
Vol.4 No.2,
April
22,
2014
ABSTRACT: Objectives: Describe the clinical, aetiological and prognostic
features of infectious meningitis in adults at the Douala General Hospital
(DGH). Patients and Methods: We carried out a 5-year retrospective
cross-sectional study at the DGH, on data from the registers of the
bacteriology and biochemistry laboratories. Cases of meningitis were identified
from the results of the cerebrospinal fluid (CSF) analysis, and the patient
clinical file was obtained. Cases files of patients aged 15 years and above
were included. For each patient, sociodemographic, clinical features and
hospital mortality data were extracted. Results: During study period, 1877 CSF
analyses were recorded and 135 were enrolled for data analysis. Up to 74
patients (55%) were male and the mean age was 40.04 ± 12.5 years. The time
lapse between the onset of symptoms and consultation was 12.24 ± 11.16 days.
The main clinical signs were meningeal syndrome (96.3%), neck stiffness
(71.1%), reduced alertness (64.4%) and confusional states (55.6%). The main
aetiology was bacterial (45.19%) withStreptococcus pneumoniae(45.90%) andNeisseria meningitis(29.51%) leading. The other aetiologies were
viral (21.48%), fungal withCryptococcus neoformans(20%) and meningeal tuberculosis (13.33%). Fifty
eight patients (42.9%) had a positive HIV serology. The mean duration of
hospitalization was 9.05 ± 8.1 days, and the total in-hospital mortality was
25.18%. 117 patients (86.8%) had received antibiotherapy before diagnosis.
Conclusion: The clinical features of meningitis in the DGH are as in classical
description. However, the mortality is high and the major aetiologies appear to
be associated with HIV infection at least in part. Prospective multi-centric studies
are needed to provide more evidence for the development of staged management
guidelines in our resource-limited settings.