Clinical spectrum, etiology, and outcome of neurological disorders in the rural hospital of Mosango, the Democratic Republic of Congo

Deby Mukendi, Jean-Roger Lilo Kalo, Alain Mpanya, Luigi Minikulu, Tharcisse Kayembe, Pascal Lutumba, Barbara Barbé, Philippe Gillet, Jan Jacobs, Harry Van Loen, Cedric P Yansouni, François Chappuis, Raffaella Ravinetto, Kristien Verdonck, Marleen Boelaert, Andrea S Winkler, Emmanuel Bottieau

Research output: Contribution to journalA1: Web of Science-article

Abstract

There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.

Original languageEnglish
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume97
Issue number5
Pages (from-to)1454-1460
Number of pages7
ISSN0002-9637
DOIs
Publication statusPublished - 2017
Externally publishedYes

Keywords

  • Journal Article

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