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Infection

, Volume 28, Issue 1, pp 3–7 | Cite as

The Impact of HIV on Meningitis as Seen at a South African Academic Hospital (1994 to 1998)

  • C. M. Schutte
  • C. H. Van der Meyden
  • D.S. Magazi
CLINICAL AND EPIDEMIOLOGICAL STUDIES

Summary

Background:The increase in HIV infections in South Africa is alarming. The aim of this prospective 4-year study was to evaluate the rising incidence of HIV-related admissions due to meningitis at the Pretoria Academic Hospital (PAH) adult neurology ward and to investigate the spectrum of meningitis during this time.

Patients and Methods: Adults with meningitis presenting at the PAH neurology ward from March 1994 through February 1998 were included. HIV antibody status was determined and patients were assigned to five categories: bacterial, tuberculous, viral and cryptococcal meningitis, as well as an uncertain category.

Results: Over the 4-year study period 141 patients with meningitis were seen. Of these, 44 were HIV-positive (31%), with TB meningitis occurring in 16 (36%), cryptococcal meningitis in 22 (50%) and acute bacterial meningitis in three (7%). In the first 2 years of the study, 14% of patients were HIV positive; this figure rose to 44% in the 3rd year, and 57% in the final year. The spectrum of meningitis also changed: bacterial meningitis remained relatively stable at about 25% of the total; TB meningitis almost doubled from 16% in the 1st year to 31% in the last year of the study; viral meningitis initially occurred in 8% of patients and later in 3% of cases, while cryptococcal meningitis showed the most significant increase from 6% of cases in 1994/5 to 31 and 26% respectively in the last 2 years of the study.

Conclusion: Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis at the PAH.

Key words HIV Meningitis Chronic infections 

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Copyright information

© Urban & Vogel Medien und Medizin Verlagsgesellschaft 2000

Authors and Affiliations

  • C. M. Schutte
    • 1
  • C. H. Van der Meyden
    • 1
  • D.S. Magazi
    • 1
  1. 1.Department of Neurology, University of Pretoria, Private Bag X169, Pretoria, 0001 South Africa, Phone: +27-123542390, Fax: +27-3298343, e-mail: cschutte@medic.up.ac.zaZA

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