Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.
BACKGROUND
Infectious diseases of the central nervous system (CNS) remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.


METHODS
We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.


RESULTS
We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52%) of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24%) and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%). Mycobacterium tuberculosis was confirmed in 34/617 (6%) adult patients and 11/624 (2%) paediatric patients. The acute case fatality rate (CFR) during hospital admission was 73/617 (12%) in adults and to 42/624 (7%) in children.


CONCLUSIONS
Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.
Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
Nghia
N
Ho Dang Trung
Tu
T
Le Thi Phuong
Marcel
M
Wolbers
Hoang
H
Nguyen Van Minh
Vinh
V
Nguyen Thanh
Minh Pham
MP
Van
Nga Tran Vu
NT
Thieu
Tan Le
TL
Van
Diep To
DT
Song
Phuong Le
PL
Thi
Thao Nguyen
TN
Thi Phuong
Cong Bui
CB
Van
Vu
V
Tang
Tuan Hoang
TH
Ngoc Anh
Dong
D
Nguyen
Tien Phan
TP
Trung
Lien Nguyen
LN
Thi Nam
Hao Tran
HT
Kiem
Tam Nguyen
TN
Thi Thanh
James
J
Campbell
Maxine
M
Caws
Jeremy
J
Day
Menno D
MD
de Jong
Chau Nguyen
CN
Van Vinh
H Rogier
HR
Van Doorn
Hien Tran
HT
Tinh
Jeremy
J
Farrar
Constance
C
Schultsz
D000328:Adult; D002494:Central Nervous System Infections / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology; D008587:Meningitis, Viral / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult