Clinical findings and management of patients with meningitis with an emphasis on Haemophilus influenzae meningitis in rural Tanzania.
BACKGROUND
The spectrum of meningitis pathogens differs depending on the age of patients and the geographic region, amongst other. Although meningitis vaccination programs have led to the reduction of incidence rates, an imbalance between low- and high-income countries still exists.


METHODS
In a hospital-based study in rural northern Tanzania, we consecutively recruited patients with confirmed meningitis and described their clinical and laboratory characteristics.


RESULTS
A total of 136 patients with meningitis were included. Fever (85%), meningism (63%) and impairment of consciousness (33%) were the most frequent clinical symptoms/signs. Nearly 10% of all patients tested were positive for malaria. The majority of the patients with bacterial meningitis (39%), especially those under 5years of age, were confirmed to be infected with Haemophilus influenzae (26%), Streptococcus pneumoniae (19%) and Neisseria meningitidis (15%). Haemophilus influenzae represented the dominant causative organism in children under 2years of age.


CONCLUSIONS
Our study emphasizes the importance of recognizing warning symptoms like fever, meningism and impairment of consciousness, implementing laboratory tests to determine responsible pathogens and evaluating differential diagnoses in patients with meningitis in sub-Saharan Africa. It also shows that Haemophilus influenza meningitis is still an important cause for meningitis in the young, most probabaly due to lack of appropriate vaccination coverage.
Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany. Electronic address: corinna.storz@gmx.de.
Corinna
C
Storz
Department of Anesthesia, Klinik Kirchheim, Eugenstrasse 3, 73230 Kirchheim unter Teck, Germany. Electronic address: conny.schutz@web.de.
Cornelia
C
Schutz
Haydom Lutheran Hospital, Mbulu, Manyara, Tanzania. Electronic address: qambiye@yahoo.com.
Anthony
A
Tluway
Department of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Electronic address: matujaw@gmail.com.
William
W
Matuja
Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address: erich.schmutzhard@i-med.ac.at.
Erich
E
Schmutzhard
Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany; Haydom Lutheran Hospital, Mbulu, Manyara, Tanzania; Department of Community Medicine, Centre for Global Health, University of Oslo, Postboks 1130, Blindern, 0318 Oslo, Norway. Electronic address: andrea.winkler@tum.de.
Andrea S
AS
Winkler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D006193:Haemophilus influenzae; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008583:Meningitis, Haemophilus / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D012424:Rural Population; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
Clinical characteristics; Haemophilus influenzae; Laboratory findings; Meningitis; Sub-Saharan Africa