ABSTRACT
OBJECTIVE: Infections involving the central nervous system have very serious consequences and affect thousands of people in Africa. Despite the availability of new antibiotics and vaccines, neuroinfections act as dangerous and life-threatening conditions. The most frequent neuroinfections which are of the greatest importance for public health systems are viral diseases (such as HIV, encephalitis, poliomyelitis, rabies), bacterial diseases (bacterial meningitis, neurological complications of leprosy and tuberculosis) and parasitic infections (cerebral malaria, sleeping sickness, trypanosomiasis, schistosomiasis, toxoplasmosis etc.). METHODS: A descriptive study to assess the occurrence of neuroinfections in two rural hospitals in Sudan (Mapuordit in Yirol and Gordim in Aweil) was performed in two periods of two years: (i) 2005-2006 and (ii) 2010-2011. We obtained data on patients from Mapuordit and from Gordim by studying their medical records. RESULTS: Several cases of neuroinfections were observed during both periods; those were represented by tetanus, meningococcal meningitis, leprosy with neuropathy (altogether 442 patients) in Mapuordit. Also in Gordim, severe neuroinfections such as cerebral malaria were very rare (1 case), as well as tetanus (1 case), meningococcal meningitis (8 cases) and sleeping sickness (9 cases). However, the incidence of neuroinfections decreased from 44/1000 in 2005-2006 to 2/1000 in 2010-2011. CONCLUSIONS: Decreased incidence of serious neuroinfections (cerebral malaria, sleeping sickness, meningococcal meningitis) in Sudan may be related to improvement of effective therapeutic options, represented by (i) intermittent preventive therapy (IPT) for malaria, (ii) by suppression of sleeping sickness vectors and (iii) by better accessibility of antibiotics.
ABSTRACT
OBJECTIVE: Many infections occurring in area of Sub-Saharan Africa are associated with more or less serious neurologic symptoms or complications. The aim of this study was to assess the incidence of selected infectious diseases in the equatorial part of Uganda and Kenya and to monitor potential neurological complications of these infections. METHODS: The study was performed for May - August 2008. Patients suffering from cerebral malaria, AIDS, meningitis, typhoid, tuberculosis (TB), syphilis, leprosy, and trypanosomiasis patients were enrolled. Besides of standard examination, lumbar puncture (LP) and cerebrospinal fluid (CSF) examination was performed, and the occurrence of neurological disorders and sequellae was recorded and assessed. RESULTS: Altogether 288 patients with neurological manifestation were enrolled. Malaria was the most prevalent disease in this study (102 cases, 35.42%), followed by typhoid (47 cases, 16.2%) and meningitis (38 cases, 13.2%). Leprosy and trypanosomiasis were only rarely detected (2.3% and 1.4%, respectively). CONCLUSION: In malaria and HIV hyper-endemic area of rural Uganda, cerebral malaria is the leading tropical neuroinfection. Also, meningitis is still frequent probably due to insufficient access to vaccination.
ABSTRACT
OBJECTIVE: Severe malaria represents less than 10% of all malaria cases and is associated with significant mortality. The aim of this case series was to review severe malaria cases in travelers within the last 10 years in Slovakia. METHODS: All cases of severe malaria in travelers reported within last 10 years from the Inpatient Department in Slovakia to the Slovak Tropical Institute (STI) are reviewed. Only those traveling as tourist to Sub-Saharan Africa were included. RESULTS: During the last 10 years, eight (n=8) cases of cerebral malaria were reported, of which only one died (12.5%). Seven of all 8 cases had deep coma (87.5%), 4 (50%) required ventilator support, 4 (50%) required dialysis, 5 (62.5%) had liver failure and 6 (75%) had severe acidosis. CONCLUSION: Severe malarial cases were rarely detected among travelers returning to Slovakia within last 10 years. In survivors usually no sequellae remained. One patient treated with quinine alone died.
ABSTRACT
OBJECTIVE: Majority of malaria cases in hyper-endemic areas have seasonal variations. The aim of this short research note is to refer and assess seasonal variability and mortality of malaria in Ngogwe in southeast Uganda in 2011/2012 season. METHODS: We analyzed clinical records of patients admitted to Buikwe-Ngogwe Hospital in the period from July 1, 2011 to August 25, 2012 to assess seasonality of malaria. RESULTS: Altogether, 23,675 patients were admitted to Buikwe-Ngogwe Hospital due to fever illness and 14,940 malaria-positive samples were obtained (63.1%) from these patients. We have observed significantly higher number of malaria cases in December compared to period of June - November (p<0.01). Mortality rate was only 0.48%. CONCLUSION: Interestingly, we have observed seasonal variability in malaria occurrence in Ngogwe, Southeast Uganda, which is, not correlating with rainy season but with movement of population to the areas closer to Lake Victoria. However, despite of high prevalence, mortality of this disease remained low. The reasons for low mortality are probably a good access to health care facility and adaptation of artemisinin-based combinational therapy for documented malaria.
