title: Meningitis in HIV-positive patients in sub-Saharan Africa: a review.
abstract: BACKGROUND
  Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. There is no widespread tracking of the incidence rates of causative agents among patients living with HIV, yet the aetiologies of meningitis are different than those of the general population.
  
  
  METHODS
  We reviewed the scientific literature published in PubMed to determine the incidence rates of meningitis among hospitalized people living with HIV in sub-Saharan Africa and report our findings from seven studies across sub-Saharan Africa.
  
  
  RESULTS
  We found high rates of cryptococcal meningitis (19-68%). Tuberculous meningitis was lower (1-36%), although some centres included possible cases as "other" meningitis; therefore, this may not be a true representation of the total cases. Pyogenic meningitis ranged from 6 to 30% and "other" meningitis ranged from 7 to 28% of all reported cases of meningitis. Mortality rates ranged from 25 to 68%. This review describes the most common aetiologies and provides practical diagnostic, treatment and prevention considerations as they apply to the individual living with HIV in sub-Saharan Africa.
  
  
  CONCLUSIONS
  Diagnosis is often limited, and wider availability of accurate and low-cost laboratory diagnostics is desperately needed for prompt diagnosis and initiation of appropriate treatment. Wider acceptance and adoption of available preventative modalities can decrease the incidence of potentially fatal central nervous system infections in African patients living with HIV.
authors.affiliation: Division of Infectious Diseases, University of California Los Angeles, Los Angeles, CA, USA; jveltman@mednet.ucla.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Veltman
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Claire C
authors.initials: CC
authors.lastname: Bristow
authors.affiliation: Division of Infectious Diseases, University of California Los Angeles, Los Angeles, CA, USA; Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008581:Meningitis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis
keywords: HIV/AIDS; adult; meningitis; sub-Saharan Africa