Spectrum of Meningitis in Adult at the Douala General Hospital

DOI: 10.4236/wjns.2014.42017   PDF   HTML     4,671 Downloads   5,799 Views  


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-year 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) analysis, and the patient clinical file was obtained. Cases files of patients aged 15 years and above were included. For each patient, sociodemographic, clinical features and hospital mortality data were extracted. Results: During study period, 1877 CSF analyses were recorded and 135 were enrolled for data analysis. Up to 74 patients (55%) were male and the mean age was 40.04 ± 12.5 years. The time lapse between the onset of symptoms and consultation was 12.24 ± 11.16 days. The main clinical signs were meningeal syndrome (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 Cryptococcus 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 days, 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.

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Mapoure, Y. , Luma, H. , Gnonlonfoun, D. , Ossou-Guiet, P. , Biloa, X. , Doumbe, J. , Mbatchou, H. , Tchaleu, B. , Fonsah, J. , Mouelle, A. and Njamnshi, A. (2014) Spectrum of Meningitis in Adult at the Douala General Hospital. World Journal of Neuroscience, 4, 144-151. doi: 10.4236/wjns.2014.42017.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Massenet, D., Inrombe, J. and Mevoula, D.-E. (2009) Serogroup W135 Meningitis Northern 2007-2008. Emerging Infectious Diseases, 15, 340-342. http://dx.doi.org/10.3201/eid1502.080988
[2] Massenet, D., Vohod, D., Hamadicko, H. and Caugant, D.A. (2011) Epidemic Meningococcal Meningitis, Cameroon. Emerging Infectious Diseases, 17, 2070-2072. http://dx.doi.org/10.3201/eid1711.110468
[3] Koulla, S., Mbuagbaw, J., Kuaban, C. and Kouda Zeh, A. (1997) Etiological and Outcome of Adult Bacterial Meningitis in Yaoundé, Cameroon. International Journal of Infectious Diseases, 2, 9-11.
[4] Mbuagow, J.N., Biholong and Njamnshi, A.K. (2006) Cryptococcal Meningitis and HIV in the Internal Medicine Service at the Yaoundé University Hospital, Cameroon. AJNS, 25, 13-18.
[5] Okome-Nkoumou, M. and Loembe, P.M. (1999) Les méningites bactériennes de l’adulte. étude de 85 cas observés dans l’unité des maladies infectieuses de la Fondation Jeanne Ebori, Libreville, Gabon. Bulletin de la Société de pathologie exotique, 92, 288-291.
[6] Tsiba, J.B. and Nzingoula, S. (2006) Les méningites bactériennes de l’adulte en milieu hospitalier centrafricain. Bulletin de la Société de pathologie exotique, 99, 261-263.
[7] Bergemann, A. and Karstaedt, A.S. (1996) The Spectrum of Meningitis in a Population with High Prevalence of HIV Disease. QJM, 89, 499-504. http://dx.doi.org/10.1093/qjmed/89.7.499
[8] Silber, E., Sonnenberg, P., Ho, K.C., Koornhof, H.J., Eintracht, S., Morris, L. and Saffer, D. (1999) Meningitis in a Community with a High Prevalence of Tuberculosis and HIV Infection. Journal of the Neurological Sciences, 162, 20-26. http://dx.doi.org/10.1016/S0022-510X(98)00259-7
[9] Dao, S., Goita, D., Oumar, A.A., Diarra, S., Traore, S. and Bougoudodgo, F. (2008) Aspects épidémiologiques des méningites purulentes au Mali. Médecine d'Afrique noire, 55, 514-518.
[10] Varlet, G., Bazeze, V. and N’Dri, O.K.A. (2009) Sensibilité et spécificité des signes cliniques chez l’adulte-C?te D’Ivoire. Médecine et Maladies Infectieuses, 39, 445-451. http://dx.doi.org/10.1016/j.medmal.2009.06.015
[11] Njamnshi, A.K., de P. Djientcheu, V., Bissek, A.C., Ongolo-Zogo, P., Mapoure, N.Y., Yepnjio, F.N., Sini, V., Dongmo, L., Kaptue, L.N. and Muna, W.F.T. (2003) Epidemiological and Aetiological Features of Nervous System HIVAIDS in Yaoundé: A Preliminary Study. Health Services Research Journal, 3, 18-28.
[12] Owusu, M., Nguah, S.B., Boaitey, Y.A. and Adu-Boateng, E.B. (2012) Aetiological Agents of Cerebrospinal Meningitis: A Retrospective Study from a Teaching Hospital in Ghana. Annals of Clinical Microbiology and Antimicrobials, 11, 28. http://dx.doi.org/10.1186/1476-0711-11-28
[13] Mezghani Maalej, S., Kassis, M., Mahjoubi Rhimi, F., Damak, J. and Hammami, A. (2006) Bactériologie des méningites communautaires dans la région de Sfax, Tunisie. Médecine et Maladies Infectieuses, 36, 105-110.
[14] Zimba, T.F., Nota, D.T., Langa, J.C., Leonel, C., Monteiro, G.S. and Coovadia, Y.M. (2009) The Aetiology of Acute Community Acquired Bacterial Meningitis in Children and Adults in Maputo, Mozambique. The Journal of Infection in Developing Countries, 3, 723-726.

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