Epidemiology of adult meningitis during antiretroviral therapy scale-up in southern Africa : Results from the Botswana national meningitis survey
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Data on meningitis epidemiology in high HIV-prevalence African settings following antiretroviral therapy scale-up are lacking. We described epidemiology of adult meningitis in Botswana over a 16-year period.
METHODS: Laboratory records for adults undergoing lumbar puncture (LP) 2000-2015 were collected, with complete national data 2013-2014. Cerebrospinal fluid (CSF) findings and linked HIV-data were described, and national incidence figures estimated for 2013-2014. Temporal trends in meningitis were evaluated.
RESULTS: Of 21,560 adults evaluated, 41% (8759/21,560) had abnormal CSF findings with positive microbiological testing and/or pleocytosis; 43% (3755/8759) of these had no confirmed microbiological diagnosis. Of the 5004 microbiologically-confirmed meningitis cases, 89% (4432/5004) were cryptococcal (CM) and 8% (382/5004) pneumococcal (PM). Seventy-three percent (9525/13,033) of individuals undergoing LP with identifiers for HIV registry linkage had documented HIV-infection. Incidence of LP for meningitis evaluation in Botswana 2013-2014 was 142.6/100,000 person-years (95%CI:138.3-147.1); incidence of CM was 25.0/100,000 (95%CI:23.2-26.9), and incidence of PM was 2.7/100,000 (95%CI:2.4-3.1). In contrast to previously reported declines in CM incidence with ART roll-out, no significant temporal decline in pneumococcal or culture-negative meningitis was observed.
CONCLUSIONS: CM remained the predominant identified aetiology of meningitis despite ART scale-up. A high proportion of cases had abnormal CSF with negative microbiological evaluation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:79 |
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| Enthalten in: |
The Journal of infection - 79(2019), 3 vom: 28. Sept., Seite 212-219 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tenforde, Mark W [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 08.07.2020 Date Revised 16.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jinf.2019.06.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298694824 |
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| 100 | 1 | |a Tenforde, Mark W |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Epidemiology of adult meningitis during antiretroviral therapy scale-up in southern Africa |b Results from the Botswana national meningitis survey |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Completed 08.07.2020 | ||
| 500 | |a Date Revised 16.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Data on meningitis epidemiology in high HIV-prevalence African settings following antiretroviral therapy scale-up are lacking. We described epidemiology of adult meningitis in Botswana over a 16-year period | ||
| 520 | |a METHODS: Laboratory records for adults undergoing lumbar puncture (LP) 2000-2015 were collected, with complete national data 2013-2014. Cerebrospinal fluid (CSF) findings and linked HIV-data were described, and national incidence figures estimated for 2013-2014. Temporal trends in meningitis were evaluated | ||
| 520 | |a RESULTS: Of 21,560 adults evaluated, 41% (8759/21,560) had abnormal CSF findings with positive microbiological testing and/or pleocytosis; 43% (3755/8759) of these had no confirmed microbiological diagnosis. Of the 5004 microbiologically-confirmed meningitis cases, 89% (4432/5004) were cryptococcal (CM) and 8% (382/5004) pneumococcal (PM). Seventy-three percent (9525/13,033) of individuals undergoing LP with identifiers for HIV registry linkage had documented HIV-infection. Incidence of LP for meningitis evaluation in Botswana 2013-2014 was 142.6/100,000 person-years (95%CI:138.3-147.1); incidence of CM was 25.0/100,000 (95%CI:23.2-26.9), and incidence of PM was 2.7/100,000 (95%CI:2.4-3.1). In contrast to previously reported declines in CM incidence with ART roll-out, no significant temporal decline in pneumococcal or culture-negative meningitis was observed | ||
| 520 | |a CONCLUSIONS: CM remained the predominant identified aetiology of meningitis despite ART scale-up. A high proportion of cases had abnormal CSF with negative microbiological evaluation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Cryptococcal meningitis | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a Pneumococcal meningitis | |
| 650 | 4 | |a Sub-Saharan Africa | |
| 650 | 4 | |a TB meningitis | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 700 | 1 | |a Mokomane, Margaret |e verfasserin |4 aut | |
| 700 | 1 | |a Leeme, Tshepo |e verfasserin |4 aut | |
| 700 | 1 | |a Tlhako, Nametso |e verfasserin |4 aut | |
| 700 | 1 | |a Tsholo, Katlego |e verfasserin |4 aut | |
| 700 | 1 | |a Ramodimoosi, Chandapiwa |e verfasserin |4 aut | |
| 700 | 1 | |a Dube, Bonno |e verfasserin |4 aut | |
| 700 | 1 | |a Mokobela, Kelebeletse O |e verfasserin |4 aut | |
| 700 | 1 | |a Tawanana, Ephraim |e verfasserin |4 aut | |
| 700 | 1 | |a Chebani, Tony |e verfasserin |4 aut | |
| 700 | 1 | |a Pilatwe, Tlhagiso |e verfasserin |4 aut | |
| 700 | 1 | |a Hurt, William J |e verfasserin |4 aut | |
| 700 | 1 | |a Mitchell, Hannah K |e verfasserin |4 aut | |
| 700 | 1 | |a Molefi, Mooketsi |e verfasserin |4 aut | |
| 700 | 1 | |a Mullan, Paul C |e verfasserin |4 aut | |
| 700 | 1 | |a Guthrie, Brandon L |e verfasserin |4 aut | |
| 700 | 1 | |a Farquhar, Carey |e verfasserin |4 aut | |
| 700 | 1 | |a Steenhoff, Andrew P |e verfasserin |4 aut | |
| 700 | 1 | |a Mine, Madisa |e verfasserin |4 aut | |
| 700 | 1 | |a Jarvis, Joseph N |e verfasserin |4 aut | |
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