感染症と治療ジャーナル

抽象的な

Prevalence and Factors Associated with Infectious Meningitis and Meningoencephalitis Related Deaths in People Living with HIV (PLHIV)

Daye Ka, Ndéye Maguette Fall, Khardiata Diallo-Mbaye, Fatou Binetou Thiam, Abdoulaye Dia, Rahmatoulaye Ndiaye, Madeleine Sarr, Moustapha Diop, Ndéye Fatou Ngom-gueye, Viviane Marie Pierre Cisse-Diallo, Ndéye Aissatou Lakhe, Louise Fortes-Deguenonvo, Sylvie Audrey Diop-Nyafouna, Ndéye Méry Dia-Badiane, Cheikh Tidiane

Objective: To determine the prevalence of infectious meningitis and meningoencephalitis and to identify factors associated with death in PLHIV at the Infectious and Tropical Disease Clinic located in the FANN University Hospital Centre.

Patients and methods: This was a descriptive and analytical retrospective study conducted from January 1, 2011 through December 31, 2013. It involved all hospitalized PLHIV in the department of infectious diseases of FANN suffering from meningitis and/or encephalitis.

Results: One hundred and thirty-three (133) cases of meningoencephalitis among the 1033 hospitalized PLHIV were collected, which makes 12.9% hospital prevalence. The average age was 42 years ± 10 years and the female gender was predominant. The main general signs were fever (91.7%) and overall health impairment (62.4%). The predominant functional signs were headache (58.6%) and vomiting (43.6%). 28.5% of cases had impaired consciousness and more than 2/3 of the patients had meningeal signs. Nineteen percent of the patients had cranial nerve palsy and 18% had a motor deficit. The main extra neurological signs were cough and dyspnea (57.9%). The lumbar puncture performed in 84.4% of patients showed a clear Cerebro-Spinal Fluid (CSF) in 64.5% of cases and lymphocyte in 1/3 of cases. In 27.1% of patients, the etiology of meningoencephalitis was confirmed and cryptococcosis predominated (16.5%). The lethality was 57% and more than half of the deaths occurred after the 7 days of hospitalization. The presence of headache, impaired consciousness and motor deficit were significantly associated with death.

Conclusion: The high prevalence of infectious meningoencephalitis in PLWHIV and the high lethality associated with this condition justifies the need for early management of HIV infection.