[Epidemiological, clinical, etiological features of neuromeningeal diseases at the Fann Hospital Infectious Diseases Clinic, Dakar (Senegal)].
OBJECTIVE
This retrospective study was carried out to determine the prevalence of cerebromeningeal diseases at the Fann Teaching Hospital Infectious Diseases Clinic, in Dakar, and to describe their epidemiological, clinical, and etiological features.


METHODS
Data was collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003.


RESULTS
Four hundred seventy cases were identified (11.4% of total admissions) with a M/F sex ratio of 1.38 and a mean age of 33 years. Eighty-nine patients were infected by HIV and clinical presentations included fever (78%), meningeal syndrome (57.4%), coma (64.9%), convulsions (19%), focal neurological deficits (15.5%), and cranial nerves dysfunction (7.2%). Etiologies presented as cerebral malaria (85 cases), purulent meningitis (51 cases), neuromeningeal cryptococcosis (37 cases), tuberculous meningitis (11 cases), intracranial abscess (10 cases), toxoplasma encephalitis (4 cases), cerebrovascular attack (11 cases), and cerebromeningeal hemorrhages (3 cases). In as many as 248 cases (52.8%) no etiology could be found. The case fatality rate was 44.5% overall (209 deaths) and 68.5% among HIV-infected patients. Neurological sequels were found in 22 survivors (8.8%), consisting in focal neurological deficit (12 cases), deafness (5 cases), diplopia (2 cases), dementia (2 cases), postmeningitic encephalitis (1 case).


CONCLUSIONS
These results show the need to improve our technical capacities in our diagnostic laboratories, the prevention of opportunistic infections in the course of HIV/AIDS infection, and the involvement of various specialists in the management of cerebromeningeal diseases.
Clinique des maladies infectieuses, CHU de Fann, BP 5035 Dakar, Sénégal. soumarem@refer.sn
M
M
Soumaré
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Seydi
C T
CT
Ndour
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N
Fall
Y
Y
Dieng
A I
AI
Sow
B M
BM
Diop
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D004660:Encephalitis / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016779:Malaria, Cerebral / Q000453:epidemiology; D008297:Male; D008581:Meningitis / Q000453:epidemiology*; D016919:Meningitis, Cryptococcal / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012621:Seasons; D012675:Senegal / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D016781:Toxoplasmosis, Cerebral / Q000453:epidemiology; D020306:Tuberculosis, Central Nervous System / Q000453:epidemiology