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Britz E, Perovic O, von Mollendorf C, et al. The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012. PLoS One. 2016;11(9):e0163036doi: 10.1371/journal.pone.0163036.
Britz, E., Perovic, O., von Mollendorf, C., von Gottberg, A., Iyaloo, S., Quan, V., Chetty, V., Sriruttan, C., Ismail, N. A., Nanoo, A., Musekiwa, A., Reddy, C., Viljoen, K., Cohen, C., & Govender, N. P. (2016). The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012. PloS one, 11(9), e0163036. https://doi.org/10.1371/journal.pone.0163036
Britz, Erika, et al. "The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012." PloS one vol. 11,9 (2016): e0163036. doi: https://doi.org/10.1371/journal.pone.0163036
Britz E, Perovic O, von Mollendorf C, von Gottberg A, Iyaloo S, Quan V, Chetty V, Sriruttan C, Ismail NA, Nanoo A, Musekiwa A, Reddy C, Viljoen K, Cohen C, Govender NP. The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012. PLoS One. 2016 Sep 26;11(9):e0163036. doi: 10.1371/journal.pone.0163036. eCollection 2016. PMID: 27669564; PMCID: PMC5036788.
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PLoS One. 2016 Sep 26;11(9):e0163036. doi: 10.1371/journal.pone.0163036. eCollection 2016.

The Epidemiology of Meningitis among Adults in a South African Province with a High HIV Prevalence, 2009-2012.

PloS one

Erika Britz, Olga Perovic, Claire von Mollendorf, Anne von Gottberg, Samantha Iyaloo, Vanessa Quan, Verushka Chetty, Charlotte Sriruttan, Nazir A Ismail, Ananta Nanoo, Alfred Musekiwa, Carl Reddy, Karien Viljoen, Cheryl Cohen, Nelesh P Govender

Affiliations

  1. South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, Johannesburg, South Africa.
  2. School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
  3. National Institute for Communicable Diseases, Johannesburg, South Africa.
  4. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  5. Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Pretoria, South Africa.

PMID: 27669564 PMCID: PMC5036788 DOI: 10.1371/journal.pone.0163036

Abstract

INTRODUCTION: Meningitis is a major cause of mortality in southern Africa. We aimed to describe the aetiologies and frequencies of laboratory-confirmed fungal and bacterial meningitis among adults in a South African province with an 11% HIV prevalence, over 4 years.

METHODS: We conducted a retrospective, observational study of secondary laboratory data, extracted on all cerebrospinal fluid (CSF) specimens submitted to public-sector laboratories in Gauteng province from 2009 through 2012. We calculated cause-specific incidence rates in the general and HIV-infected populations and used Poisson regression to determine if trends were significant.

RESULTS: We identified 11,891 (10.7%) incident cases of meningitis from 110,885 CSF specimens. Cryptococcal meningitis, tuberculous meningitis and pneumococcal meningitis accounted for 62.3% (n = 7,406), 24.6% (n = 2,928) and 10.1% (n = 1,197) of cases over the four-year period. The overall incidence (cases per 100,000 persons) of cryptococcal meningitis declined by 23% from 24.4 in 2009 to 18.7 in 2012 (p <0.001) and decreased by 19% among HIV-infected persons from 178.2 to 144.7 (p <0.001). Tuberculous meningitis decreased by 40% from 11.3 in 2009 to 6.8 in 2012 (p <0.001) and decreased by 36% among HIV-infected persons from 54.4 to 34.9 (p <0.001). Pneumococcal meningitis decreased by 41% from 4.2 in 2009 to 2.5 in 2012 (p <0.001) and decreased by 38% among HIV-infected persons from 28.0 to 17.5 (p <0.001). Among cases of other bacterial meningitis (248/11,891, 2.1%), Neisseria meningitidis (n = 93), Escherichia coli (n = 72) and Haemophilus influenzae (n = 20) were the most common organisms identified.

CONCLUSIONS: In this high HIV-prevalence province, cryptococcal meningitis was the leading cause of laboratory-confirmed meningitis among adults. Over a 4-year period, there was a significant decrease in incidence of cryptococcal, tuberculous and pneumococcal meningitis. This coincided with expansion of the national antiretroviral treatment programme, enhanced tuberculosis control programme and routine childhood immunisation with pneumococcal conjugate vaccines.

Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: CVM has received speaker honoraria from Pfizer. AVG has received research grant funds from P

References

  1. Am J Trop Med Hyg. 2015 Feb;92(2):274-9 - PubMed
  2. PLoS One. 2011;6(5):e20077 - PubMed
  3. Lancet. 2015 May 30;385(9983):2173-82 - PubMed
  4. AIDS Res Ther. 2012 Apr 10;9:11 - PubMed
  5. Lancet Infect Dis. 2015 Sep;15(9):1066-76 - PubMed
  6. AIDS. 2000 Jul 7;14(10):1401-7 - PubMed
  7. J Int AIDS Soc. 2014 Oct 10;17:19184 - PubMed
  8. Lancet. 2002 Oct 26;360(9342):1287-92 - PubMed
  9. J Acquir Immune Defic Syndr. 2013 Jul 1;63(3):e101-8 - PubMed
  10. AIDS. 2010 Jun 1;24(9):1351-60 - PubMed
  11. S Afr Med J. 2012 Oct 08;102(12):914-7 - PubMed
  12. J Infect Dis. 2004 Jun 1;189(11):1996-2000 - PubMed
  13. Clin Infect Dis. 2000 Jul;31(1):53-7 - PubMed
  14. Int J Tuberc Lung Dis. 2012 Jul;16(7):903-7 - PubMed
  15. N Engl J Med. 2016 Jan 14;374(2):124-34 - PubMed
  16. PLoS One. 2011;6(11):e27929 - PubMed
  17. BMC Infect Dis. 2010 Mar 15;10:67 - PubMed
  18. PLoS Med. 2013 Oct;10(10):e1001536 - PubMed
  19. Lancet Glob Health. 2015 Aug;3(8):e450-7 - PubMed
  20. Int J Infect Dis. 2006 Sep;10(5):387-95 - PubMed
  21. N Engl J Med. 2014 Nov 13;371(20):1889-99 - PubMed
  22. Int J Infect Dis. 2007 Jul;11(4):348-54 - PubMed

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