title: Pattern, Clinical Characteristics, and Outcome of Meningitis among HIV-Infected Adults Admitted in a Tertiary Hospital in North Western Tanzania: A Cross-Sectional Study.
abstract: Background. Limited information exists on the etiologies, clinical characteristics, and outcomes of meningitis among HIV-infected patients in Africa. We conducted a study to determine the etiology, clinical characteristics, and outcomes of meningitis among HIV-infected adults. Methods. A prospective cross-sectional hospital based study was conducted among HIV-infected patients aged ≥18 years admitted to the medical wards with symptoms and signs of meningitis. Sociodemographic and clinical information were collected using a standardized data collection tool. Lumbar puncture was performed to all patients; cerebrospinal fluid samples were sent for analysis. Results. Among 60 HIV-infected adults clinically diagnosed to have meningitis, 55 had CSF profiles consistent with meningitis. Of these, 14 (25.5%) had a laboratory-confirmed etiology while 41 (74.5%) had no isolate identified. Cryptococcus neoformans was the commonest cause of meningitis occurring in 11 (18.3%) of patients followed by Mycobacterium tuberculosis (6.7%). The in-hospital mortality was 20/55 (36.4%). Independent predictors of mortality were low baseline CD4 count and turbid CSF appearance. Conclusion. Cryptococcal meningitis is the most prevalent laboratory-confirmed etiological agent among adult HIV-infected patients with suspected meningitis admitted to medical wards in Western Tanzania. Mortality rate in this population remains unacceptably high. Improving diagnostic capacity and early treatment may help to decrease the mortality rate.
authors.affiliation: Department of Medicine, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania.
authors.forename: Matobogolo M
authors.identifier: 0000-0003-4425-5964
authors.initials: MM
authors.lastname: Boaz
authors.affiliation: Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania; Department of Medicine, Bugando Medical Centre, Mwanza, Tanzania.
authors.forename: Samuel
authors.identifier: 0000-0002-2582-2081
authors.initials: S
authors.lastname: Kalluvya
authors.affiliation: Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania; Center for Global Health, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Downs
authors.affiliation: Department of Medicine, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania.
authors.forename: Bonaventura C T
authors.identifier: 0000-0002-6058-6213
authors.initials: BC
authors.lastname: Mpondo
authors.affiliation: Department of Microbiology/Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: Stephen E
authors.identifier: 0000-0002-7526-6271
authors.initials: SE
authors.lastname: Mshana