Neurologic infections in a Nigerian university teaching hospital

BACKGROUND: Neurologic infections are an important cause of morbidity and mortality especially worldwide but much more in the African continent. The frequency of the different types of neurologic infections and their mortality in this part of Nigeria is not known. OBJECTIVES: To review cases admitted into the main tertiary referral center in Rivers State of Nigeria with neurologic infections over a 10-year period and to determine the types of infections, their frequency and the mortality METHODS: Case notes of all admissions into the medical wards of UPTH, Port Harcourt between April 1993 and March 2003 were reviewed. Cases admitted with neurologic infections were extracted and analyzed for the study. RESULTS: Of the 1395 patients admitted with neurologic disorders during the study period, 311 (22.3%) had neurological infections. The M:F ratio and mean age of patients with neurolgic infections were 1.7:1 and 34.1 years respectively. The most common infections identified were meningitis 136(43.7%), tetanus 90(28.9%), Pott's disease with cord compression 30(9.6%), viral meningoencephalitis 27(8.7%) and tuberculous meningitis (TBM) 19(6.1%). The case fatality was high: meningitis 49.3%, tetanus 47.8%, Pott's disease23.3%, meningoencephalitis 44.4% and TBM 68.4% CONCLUSIONS: Preventable neurologic infections are a very important cause of morbidity and mortality in this environment. Cases presenting with suspicious neurologic infections should be referred to centers where specialized care can be institute

LES MALADIES NEUROLOGIQUES OBSERVEES EN HOSPITALISATION, SUR UNE PERIODE DE 10 ANS DANS LA REGION DU DELTA AU NIGERIA NEUROLOGIC ADMISSIONS IN THE NIGER DELTA AREA OF NIGERIA – A TEN YEAR REVIEW (English)

Background: The Niger-delta area of Nigeria constitutes about 20% of the population of the nation. The pattern of neurologic diseases in this area is not known. Objective: The study was undertaken to determine the pattern of these diseases, compare this with those elsewhere and to have a baseline for future studies. Methods: The medical records of all cases admitted with neurologic diseases in the University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt between April 1993 and March 2003 were retrospectively reviewed and the frequency of neurologic diseases, sex, age and outcome of these diseases analyzed. Results: Neurologic diseases constituted 1.5% and 33.1% of hospital and medical admissions respectively with M: F ratio of 1.4:1 and mean age of 52.6 years. The five topmost diseases were stroke (61.6%), meningitis and encephalitis (13.4%), tetanus (6.5%), spinal cord diseases (6.5%) and epilepsy (3.8%). Apart from stroke, the others were commoner in the young. Other neurologic diseases were rare causes of neurologic admissions. Neurologic deaths constituted 3.7% and 28.9% of hospital and medical deaths respectively. The common causes of neurologic deaths were stroke (65%), meningitis and encephalitis (18.7%) and tetanus (8.5%). Conclusions: Neurologic diseases are common in this part and have a similar pattern as in other parts of southern Nigeria. Stroke and CNS infections are a major cause of morbidity and mortality. This finding makes the establishment of regional stroke units; improvement of the sanitary conditions of the home and environment, widespread use of immunizations for those at risk a matter of urgent healthcare priority. Keywords: Africa, Epidemiology, Neurologic disease, Neurology, Nigeria, Stroke units, Afrique, maladies neurologiques, Nigéria, unité d\'urgence neuro-vasculaire, épidémiologie RESUME Introduction: Le Delta du Niger constitue environ 20 % environ de la population du Nigeria, et le profil des affections neurologiques de cette région n\'est pas connu. Objectif: L\'étude présentée a pour but de déterminer les aspects de ces maladies neurologiques en les comparant avec celles menées par d\'autres équipes. Le travail servira de base pour mener d\'autres études ultérieures. Méthode: Les données médicales de tous les cas admis à l\'université de Port Harcourt entre avril 1993 et mars 2003 ont été examinées rétrospectivement à partir des dossiers d\'hospitalisation. La fréquence de maladie neurologique, le sexe, l\'âge et l\'évolution ont été analysés. Résultats: Les maladies neurologiques représentent 1,5 % et 33,1 % des admissions respectivement en hospitalisation et sur l\'ensemble de la pathologie médicale. Le ratio homme / femme est de 1,4: 1 avec une moyenne d\'âge de 52,6 ans. Les cinq maladies les plus fréquemment observées ont été: les accidents vasculaires cérébraux (61,6 %, les méningites et encéphalites (13,4 %) le tétanos (6,5 %), les maladies de la moelle épinière (6,5 %) et les épilepsies (3,8 %). En dehors des accidents vasculaires cérébraux, ces affections sont communes aux jeunes. Les autres affections neurologiques sont rares. Les décès imputables à la pathologie neurologique représentaient 3,7 % et 28,9 %, respectivement au niveau hospitalier et au plan médical. La cause de décès la plus importante a été les accidents vasculaires cérébraux suivis des méningites et encéphalites (18,7 %) et tétanos (8,5 %) Conclusion: Les affections neurologiques habituellement rencontrées ont un aspect similaire à celles observées dans le sud du Nigéria. Les AVC et les affections du système nerveux sont les principales causes de morbidité et de mortalité. Ces données impliquent la mise en place d\'unités régionales d\'AVC de même que l\'amélioration des conditions sanitaires de l\'environnement et de l\'habitat et l\'élargissement des vaccinations. Mots-clefs: Afrique, maladies neurologiques, Nigéria, unité d\'urgence neuro-vasculaire, épidémiologie. Af. Jnl. Neurological Sci Vol.23(1) 200