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Spectrum of Meningitis in Adult at the Douala General Hospital

World Journal of Neuroscience 2014年第2期4卷 144-151页

作者： y.couba N. Mapoure Henry.N. Luma Dieudonné Gnonlonfoun Paul M. Ossou-Guiet Xaverie Biloa Jacques N. Doumbe Hugo Bertrand N. Mbatchou Benjamin Clet N. Tchaleu julius y. fonsah Albert S. Mouelle Alfred K. Njamnshi Department of Clinical Sciences Douala General Hospital Douala Cameroon Department of Clinical Sciences The University of Douala Douala Cameroon Department of Clinical Sciences Université des Montagnes Douala Cameroon Department of Neurology Brazzaville University Teaching Hospital Brazzaville Congo Department of Neurology National University Hospital Centre Cotonou Bénin Department of Neurology The University of Yaoundé I Yaoundé Cameroon Department of Neurology Yaoundé Central Hospital Yaoundé Cameroon

Objectives: Describe the clinical, aetiological and prognostic features of infectious meningitis in adults at the Douala General Hospital (DGH). Patients and Methods: We carried out a 5-y.ar retrospective cross-sectional study.at the DGH, on data from the registers of the bacteriology.and biochemistry.laboratories. Cases of meningitis were identified from the results of the cerebrospinal fluid (CSF) analy.is, and the patient clinical file was obtained. Cases files of patients aged 15 y.ars and above were included. For each patient, sociodemographic, clinical features and hospital mortality.data were extracted. Results: During study.period, 1877 CSF analy.es were recorded and 135 were enrolled for data analy.is. Up to 74 patients (55%) were male and the mean age was 40.04 ± 12.5 y.ars. The time lapse between the onset of sy.ptoms and consultation was 12.24 ± 11.16 day.. The main clinical signs were meningeal sy.drome (96.3%), neck stiffness (71.1%), reduced alertness (64.4%) and confusional states (55.6%). The main aetiology.was bacterial (45.19%) withStreptococcus pneumoniae?(45.90%) and?Neisseria meningitis?(29.51%) leading. The other aetiologies were viral (21.48%), fungal with?Cry.tococcus neoformans?(20%) and meningeal tuberculosis (13.33%). Fifty.eight patients (42.9%) had a positive HIV serology. The mean duration of hospitalization was 9.05 ± 8.1 day., and the total in-hospital mortality.was 25.18%. 117 patients (86.8%) had received antibiotherapy.before diagnosis. Conclusion: The clinical features of meningitis in the DGH are as in classical description. However, the mortality.is high and the major aetiologies appear to be associated with HIV infection at least in part. Prospective multi-centric studies are needed to provide more evidence for the development of staged management guidelines in our resource-limited settings.

关键词： Meningitis Signs Aetiologies Mortality Adults Douala Cameroon

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Stroke Epidemiology.in Douala: Three y.ars Prospective Study.in a Teaching Hospital in Cameroon

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World Journal of Neuroscience 2014年第5期4卷 406-414页

作者： y.couba N. Mapoure C. Kuate Clet B. Tchaleu Hugo B. Mbatchou Ngahane Gérard N. Mounjouopou Hamadou Ba Salomon Mbahe julius y. fonsah Gérard Bey.ha Henry.N. Luma Albert S. Mouelle Philomène K. Ndouongo Alfred K. Njamnshi Department of Clinical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Internal Medicine University of Yaoundé I Douala Cameroon Department of Neurology Yaoundé Central Hospital Yaoundé Cameroon Department of Surgery University of Douala Douala Cameroon Department of Neurology University of Health Sciences Libreville Gabon

Background and Objectives: Cerebro-vascular accident or stroke constitutes a major challenge in sub-Saharan Africa. In Cameroon, basic epidemiologic data are not routinely.available. Aims: The aim of this study.was to determine the ty.e, the associated risk factors, time to admission, the clinical presentation and the case fatality.of stroke at the Douala General Hospital (DGH) in Cameroon. Methods: A cross-sectional study.was performed from January.1, 2010 to December 31, 2012 at the neurology.and intensive care units of the DGH. All patients above 15 y.ars of age with a diagnosis of established stroke were enrolled. For each patient, socio-demographic, clinical and paraclinical data were recorded as well as the duration of hospitalization and the case fatality. Results: In all, 325 patients were enrolled with males constituting 68.1% and general mean age of 58.66 ± 13.6 y.ars. The mean initial consultation delay.was 47.36 ± 18.48 hours. The majors cerebro-vascular risk factors were hy.ertension (81.15%), chronic alcohol consumption (28.3%), diabetes mellitus (20.61%), obesity.(18.15%), cigarette smoking (16%), dy.lipidemia (8.9%) and atrial fibrillation (3.07%). Ischemic stroke accounted for 52% of cases while 48% were hemorrhagic. The mean duration of hospitalization was 8.58 ± 6.35 day. with a case fatality.rate of 26.8%. Septic conditions appeared to be the leading cause of death accounting for 35.6% of cases. Conclusion: Stroke in the DGH is associated with a high case fatality.rate and hy.ertension remains the number one risk factor. There is a clear and urgent need for public health authorities to reinforce measures for the control of modifiable stroke risk factors.

关键词： Stroke Epidemiology Risk Factors Case Fatality Douala Cameroon

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