Neurologic complications and sequellae of infectious diseases in Uganda and Kenya: Analysis of 288 cases from two rural hospitals.

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.

Fungal neuroinfections and fungaemia: unexpected increase of mortality from invasive fungal infections in 2005-2011 in comparison to 1989-1998: analysis of 210 cases.

OBJECTIVE: In this short communication we compared the data of fungaemia cases in Slovak hospitals from 1989-1998 published in 1999-2000 with data from 2005-2011. METHODS: Risk factors, etiology and outcome of fungaemia between two periods (1989-1998 vs. 2005-2011) were compared and risk factors for death assessed by univariate analysis (CDC 2006 Statistical Package). RESULTS: In comparison to 1989-1998 when only amphotericin B and fluconazole has been used (55%), in 2005-2011 only 35.2% patients received FLU, but 26.4% received voriconazole, 22% caspofungin and anidulafungin and about 6.6% lipid formulations of Amphotericin B. In etiology, while in 1989-1998 only 37.1% (115/310) represented non-albicans Candida (NAC) and non-Candida yeasts in 2005-2011 already reached 63.7%. The significant increase of breakthrough fungaemia may be a sign of inappropriate empiric therapy.