Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients.
OBJECTIVE
To determine the causative organisms and characteristics of patients presenting with features of meningitis.


METHODS
A prospective cross-sectional study.


METHODS
Two tertiary university-affiliated hospitals in Harare, Zimbabwe.


METHODS
Four-hundred and six patients clinically suspected to have meningitis.


METHODS
Causative organisms of meningitis; clinical and cerebrospinal fluid characteristics.


RESULTS
Four-hundred and six predominantly adult (95% were aged > or = 18 years) patients were suspected to have meningitis. Of the 200 patients confirmed to have meningitis, 89 (45%) had cryptococcal meningitis (CM), 54 (27%) had mononuclear meningitis (MM), 31 (16%) had pyogenic meningitis (PM), 24 (12%) had tuberculous meningitis (TBM) and 2 (1%) had undefined meningitis. HIV seropositivity was 100% in CM, 83% in MM, 81% in PM and 88% in TBM patients. In-hospital mortality rate was 38.8% for CM, 34.9% for MM, 68% for PM and 66.7% for TBM. HIV seropositivity was 80% in the 206 patients not found to have meningitis.


CONCLUSIONS
All patients suspected to have meningitis had a high HIV sero positivity irrespective of whether they were later confirmed to have meningitis or not. CM was the most common type of meningitis seen. In-hospital mortality was high irrespective of the cause of meningitis.
Department of Medicine, Medical School, University of Zimbabwe, Harare.
J G
JG
Hakim
I T
IT
Gangaidzo
R S
RS
Heyderman
J
J
Mielke
E
E
Mushangi
A
A
Taziwa
V J
VJ
Robertson
P
P
Musvaire
P R
PR
Mason
D017088:AIDS-Related Opportunistic Infections / Q000134:cerebrospinal fluid / Q000150:complications / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000209:etiology; D016919:Meningitis, Cryptococcal / Q000150:complications; D008875:Middle Aged; D011446:Prospective Studies; D014390:Tuberculosis, Meningeal / Q000150:complications; D015030:Zimbabwe