Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV.
<h4>Background</h4>Meningitis remains an important cause of morbi-mortality in adults in sub-Saharan Africa. Data on the etiological investigation of meningitis in adults in Mozambique is limited and most studies were conducted in southern Mozambique. Identification of the etiology of me...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0267949 |
| _version_ | 1818193322821287936 |
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| author | Aquino Albino Nhantumbo Charlotte Elizabeth Comé Plácida Iliany Maholela Alcides Moniz Munguambe Paulino da Costa Mariana Mott Gabriella Rosa Cunha Lúcia Chambal Cícero Dias Vlademir Vicente Cantarelli Eduardo Samo Gudo |
| author_facet | Aquino Albino Nhantumbo Charlotte Elizabeth Comé Plácida Iliany Maholela Alcides Moniz Munguambe Paulino da Costa Mariana Mott Gabriella Rosa Cunha Lúcia Chambal Cícero Dias Vlademir Vicente Cantarelli Eduardo Samo Gudo |
| author_sort | Aquino Albino Nhantumbo |
| collection | DOAJ |
| description | <h4>Background</h4>Meningitis remains an important cause of morbi-mortality in adults in sub-Saharan Africa. Data on the etiological investigation of meningitis in adults in Mozambique is limited and most studies were conducted in southern Mozambique. Identification of the etiology of meningitis in adults are crucial to guide prevention and treatments strategies. In this study, we determine the burden of fungal and bacterial meningitis among adults at the three largest hospitals in Mozambique.<h4>Method</h4>We performed analysis of data from the routine sentinel surveillance system for meningitis in Mozambique from January 2016 to December 2017. Cerebrospinal fluid (CSF) samples were collected from eligible adults (≥18 years old) who met World Health Organization (WHO) case definition criteria for Meningitis. All samples were tested by cryptococcal antigen (CrAg) lateral flow assay (LFA), culture and triplex real-time polymerase chain reaction (qPCR) assay and all patients were tested for human immunodeficiency virus (HIV) using the national algorithm for HIV testing.<h4>Results</h4>Retrospective analysis of 1501 CSF samples from adults clinically suspected of meningitis revealed that 10.5% (158/1501) were positive for bacterial and fungal meningitis. Of these 158 confirmed cases, the proportion of Cryptococcal meningitis and pneumococcal meningitis was38.6% (95% CI: 31.0% to 46.7%) and 36.7% (95% CI: 29.2% to 44.7%), respectively. The other bacterial agents of meningitis identified include Neisseria meningitidis (8.9%; 14/158), Escherichia coli (6.3%; 10/158), Haemophilus influenzae (5.1%; 8/158) and S. aureus (4.4%; 7/158), which represent (24.7%; 39/158) of the total confirmed cases.<h4>Conclusion</h4>Altogether, our findings show a high burden of Cryptococcal meningitis among adults in Mozambique, especially in people living with HIV, followed by pneumococcal meningitis. Our findings suggest that rollout of CrAg Lateral Flow Assay in the health system in Mozambique for early detection of cryptococcus neoformans is necessary to improve overall patient care. |
| first_indexed | 2024-12-12T00:44:34Z |
| format | Article |
| id | doaj.art-40c34f5c12c14511bcfcc937c03d2ae9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T00:44:34Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-40c34f5c12c14511bcfcc937c03d2ae92022-12-22T00:44:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175e026794910.1371/journal.pone.0267949Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV.Aquino Albino NhantumboCharlotte Elizabeth ComéPlácida Iliany MaholelaAlcides Moniz MunguambePaulino da CostaMariana MottGabriella Rosa CunhaLúcia ChambalCícero DiasVlademir Vicente CantarelliEduardo Samo Gudo<h4>Background</h4>Meningitis remains an important cause of morbi-mortality in adults in sub-Saharan Africa. Data on the etiological investigation of meningitis in adults in Mozambique is limited and most studies were conducted in southern Mozambique. Identification of the etiology of meningitis in adults are crucial to guide prevention and treatments strategies. In this study, we determine the burden of fungal and bacterial meningitis among adults at the three largest hospitals in Mozambique.<h4>Method</h4>We performed analysis of data from the routine sentinel surveillance system for meningitis in Mozambique from January 2016 to December 2017. Cerebrospinal fluid (CSF) samples were collected from eligible adults (≥18 years old) who met World Health Organization (WHO) case definition criteria for Meningitis. All samples were tested by cryptococcal antigen (CrAg) lateral flow assay (LFA), culture and triplex real-time polymerase chain reaction (qPCR) assay and all patients were tested for human immunodeficiency virus (HIV) using the national algorithm for HIV testing.<h4>Results</h4>Retrospective analysis of 1501 CSF samples from adults clinically suspected of meningitis revealed that 10.5% (158/1501) were positive for bacterial and fungal meningitis. Of these 158 confirmed cases, the proportion of Cryptococcal meningitis and pneumococcal meningitis was38.6% (95% CI: 31.0% to 46.7%) and 36.7% (95% CI: 29.2% to 44.7%), respectively. The other bacterial agents of meningitis identified include Neisseria meningitidis (8.9%; 14/158), Escherichia coli (6.3%; 10/158), Haemophilus influenzae (5.1%; 8/158) and S. aureus (4.4%; 7/158), which represent (24.7%; 39/158) of the total confirmed cases.<h4>Conclusion</h4>Altogether, our findings show a high burden of Cryptococcal meningitis among adults in Mozambique, especially in people living with HIV, followed by pneumococcal meningitis. Our findings suggest that rollout of CrAg Lateral Flow Assay in the health system in Mozambique for early detection of cryptococcus neoformans is necessary to improve overall patient care.https://doi.org/10.1371/journal.pone.0267949 |
| spellingShingle | Aquino Albino Nhantumbo Charlotte Elizabeth Comé Plácida Iliany Maholela Alcides Moniz Munguambe Paulino da Costa Mariana Mott Gabriella Rosa Cunha Lúcia Chambal Cícero Dias Vlademir Vicente Cantarelli Eduardo Samo Gudo Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. PLoS ONE |
| title | Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. |
| title_full | Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. |
| title_fullStr | Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. |
| title_full_unstemmed | Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. |
| title_short | Etiology of meningitis among adults in three quaternary hospitals in Mozambique, 2016-2017: The role of HIV. |
| title_sort | etiology of meningitis among adults in three quaternary hospitals in mozambique 2016 2017 the role of hiv |
| url | https://doi.org/10.1371/journal.pone.0267949 |
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