Authors:
, , , , , , , , , , , , , , , , , and
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1.
Winkler AS, Mosser P, Matuja W, Schmutzhard E, 2008. Neurological disorders in rural Africa: a systematic approach. AJNS 27: 19–29.
-
2.
Iloeje SO, 1997. Paediatric neurologic emergencies at the University of Nigeria Teaching Hospital, Enugu. West Afr J Med 16: 80–84.
-
3.
Ofovwe GE, Ibadin MO, Okunola PO, Ofoegbu B, 2005. Pattern of emergency neurologic morbidities in children. J Natl Med Assoc 97: 488–492.
-
4.
Wolrd Health Organization, 2000. Severe falciparum malaria. World Health Organization, communicable diseases cluster. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1–S90.
-
5.
Lewallen S, Harding SP, Ajewole J, Schulenburg WE, Molyneux ME, Marsh K, Usen S, White NJ, Taylor TE, 1999. A review of the spectrum of clinical ocular fundus findings in P. falciparum malaria in African children with a proposed classification and grading system. Trans R Soc Trop Med Hyg 93: 619–622.
-
6.
Lewallen S et al. 2000. Clinical-histopathological correlation of the abnormal retinal vessels in cerebral malaria. Arch Ophthalmol 118: 924–928.
-
7.
Beare NA, Taylor TE, Harding SP, Lewallen S, Molyneux ME, 2006. Malarial retinopathy: a newly established diagnostic sign in severe malaria. Am J Trop Med Hyg 75: 790–797.
-
8.
Harding SP, Lewallen S, Beare NA, Smith A, Taylor TE, Molyneux ME, 2006. Classifying and grading retinal signs in severe malaria. Trop Doct 36 (Suppl 1): 1–13.
-
9.
Agueda S, Campos T, Maia A, 2013. Prediction of bacterial meningitis based on cerebrospinal fluid pleocytosis in children. Braz J Infect Dis 17: 401–404.
-
10.
Bang AT, Bang RA, Stoll BJ, Baitule SB, Reddy HM, Deshmukh MD, 2005. Is home-based diagnosis and treatment of neonatal sepsis feasible and effective? Seven years of intervention in the Gadchiroli field trial (1996 to 2003). J Perinatol 25 (Suppl 1): 62–71.
-
11.
Phillips V, Njau J, Shang L, Kachur P, 2015. Simulations show diagnostic testing for malaria in young African children can be cost-saving or cost-effective. Health Aff (Millwood) 34: 1196–1203.
-
12.
Birbeck G, 2001. Neurologic disease in a rural Zambian hospital. Trop Doct 31: 82–85.
-
13.
Bower JH, Zenebe G, 2005. Neurologic services in the nations of Africa. Neurology 64: 412–415.
-
14.
Yansouni CP et al. 2013. Rapid diagnostic tests for central nervous system infections in central Africa. Lancet ID 13: 546–558.
-
15.
Urdea M et al. 2006. Requirements for high impact diagnostics in the developing world. Nature 444 (Suppl 1): 73–79.
-
16.
Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI, 2005. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434: 214–217.
-
17.
Craig MH, Snow RW, le Sueur D, 1999. A climate-based distribution model of malaria transmission in sub-Saharan Africa. Parasitol Today 15: 105–111.
-
18.
Yihenew G, Adamu H, Petros B, 2014. The impact of cooperative social organization on reducing the prevalence of malaria and intestinal parasite infections in Awramba, a rural community in south Gondar, Ethiopia. Interdiscip Perspect Infect Dis 6: 1–6.
-
19.
Bhatt S et al. 2015. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature 526: 207–211.
-
20.
Ulimwengu J, Funes J, Headey D, You L, 2009. Paving the Way for Development: The Impact of Road Infrastructure on Agricultural Production and Household Wealth in the Democratic Republic of Congo. In 2009 Annual Meeting, July 26–28, 2009, Washington, DC.
-
21.
Novelli VP, Peters M, Dobson S, 1999. Infectious diseases. Macnab AJ, Macrae DJ, Henning R, eds. Care of the Critically Ill Child. London, United Kingdom: Churchill Livingstone, 281–298.
-
22.
Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I, 2010. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet ID 10: 317–328.
-
23.
Saez-Llorens XM, 2008. Acute bacterial meningitis beyond the neonatal period. Long S, ed. Long: Principles and Practice of Pediatric Infectious Diseases Revised Reprint, 3rd edition. Philadelphia, PA: Churchill Livingstone.
| Past two years | Past Year | Past 30 Days | |
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Pediatric Acute Severe Neurologic Illness and Injury in an Urban and a Rural Hospital in the Democratic Republic of the Congo
Taty Tshimangani
Taty Tshimangani
Hopital Pediatrique de Kalembe Lembe, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo;
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Jean Pongo
Jean Pongo
Department of Pediatrics, Universite des Sciences et des Technologie de Lodja, Lodja, Democratic Republic of the Congo;
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Joseph Bodi Mabiala
Joseph Bodi Mabiala
Department of Pediatrics, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo;
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Marcel Yotebieng
Marcel Yotebieng
Ohio State University, College of Public Health, Columbus, Ohio;
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Nicole F. O’Brien
Nicole F. O’Brien
Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio;
The Ohio State University, Columbus, Ohio
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The Ohio State University, Columbus, Ohio
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Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions. Two hundred and seventy-two children had clinical findings consistent with central nervous system infection but lacked complete diagnostic evaluation for definitive classification. Another 151 children were confirmed to have cerebral malaria (N = 109, 23% of admissions), bacterial meningitis (N = 38, 8% of admissions), tuberculous meningitis (N = 3, 0.6% of admissions), or herpes encephalitis (N = 1, 0.21% of admissions). Febrile convulsions, traumatic brain injury, and epilepsy contributed less significantly to overall hospital prevalence of ANI (3.19/1,000, 1.37/1,000, and 1.06/1,000, respectively). Overall mortality for the cohort was 21% (97/471). Neurologic sequelae were seen in another 31% of participants, with only 45% completing the study with a normal neurologic examination. This type of data is imperative to help plan effective strategies for illness and injury prevention and control, and to allow optimal use of limited resources in terms of provision of acute care and rehabilitation for these children.
Author Notes
Disclosure: Yotebieng reports grants from Eunice Kennedy Shriver National Institute of Child Health and Human Development and grants from National Institute of Allergy and Infectious Diseases, outside the submitted work.
Authors’ addresses: Taty Tshimangani, Hopital Pediatrique de Kalembe Lembe, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo, E-mail: tshimangataty@yahoo.fr. Jean Pongo, Department of Pediatrics, Universite des Sciences et des Technologie de Lodja, Lodja, Democratic Republic of the Congo, E-mail: jeanpongo01@gmail.com. Joseph Bodi Mabiala, Department of Pediatrics, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo, E-mail: bodi@yahoo.fr. Marcel Yotebieng, College of Public Health, Ohio State University, Columbus, OH, E-mail: yotebieng.2@osu.edu. Nicole F. O’Brien, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, and The Ohio State University, Columbus, OH, E-mail: nicole.obrien@nationwidechildrens.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Winkler AS, Mosser P, Matuja W, Schmutzhard E, 2008. Neurological disorders in rural Africa: a systematic approach. AJNS 27: 19–29.
-
2.
Iloeje SO, 1997. Paediatric neurologic emergencies at the University of Nigeria Teaching Hospital, Enugu. West Afr J Med 16: 80–84.
-
3.
Ofovwe GE, Ibadin MO, Okunola PO, Ofoegbu B, 2005. Pattern of emergency neurologic morbidities in children. J Natl Med Assoc 97: 488–492.
-
4.
Wolrd Health Organization, 2000. Severe falciparum malaria. World Health Organization, communicable diseases cluster. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1–S90.
-
5.
Lewallen S, Harding SP, Ajewole J, Schulenburg WE, Molyneux ME, Marsh K, Usen S, White NJ, Taylor TE, 1999. A review of the spectrum of clinical ocular fundus findings in P. falciparum malaria in African children with a proposed classification and grading system. Trans R Soc Trop Med Hyg 93: 619–622.
-
6.
Lewallen S et al. 2000. Clinical-histopathological correlation of the abnormal retinal vessels in cerebral malaria. Arch Ophthalmol 118: 924–928.
-
7.
Beare NA, Taylor TE, Harding SP, Lewallen S, Molyneux ME, 2006. Malarial retinopathy: a newly established diagnostic sign in severe malaria. Am J Trop Med Hyg 75: 790–797.
-
8.
Harding SP, Lewallen S, Beare NA, Smith A, Taylor TE, Molyneux ME, 2006. Classifying and grading retinal signs in severe malaria. Trop Doct 36 (Suppl 1): 1–13.
-
9.
Agueda S, Campos T, Maia A, 2013. Prediction of bacterial meningitis based on cerebrospinal fluid pleocytosis in children. Braz J Infect Dis 17: 401–404.
-
10.
Bang AT, Bang RA, Stoll BJ, Baitule SB, Reddy HM, Deshmukh MD, 2005. Is home-based diagnosis and treatment of neonatal sepsis feasible and effective? Seven years of intervention in the Gadchiroli field trial (1996 to 2003). J Perinatol 25 (Suppl 1): 62–71.
-
11.
Phillips V, Njau J, Shang L, Kachur P, 2015. Simulations show diagnostic testing for malaria in young African children can be cost-saving or cost-effective. Health Aff (Millwood) 34: 1196–1203.
-
12.
Birbeck G, 2001. Neurologic disease in a rural Zambian hospital. Trop Doct 31: 82–85.
-
13.
Bower JH, Zenebe G, 2005. Neurologic services in the nations of Africa. Neurology 64: 412–415.
-
14.
Yansouni CP et al. 2013. Rapid diagnostic tests for central nervous system infections in central Africa. Lancet ID 13: 546–558.
-
15.
Urdea M et al. 2006. Requirements for high impact diagnostics in the developing world. Nature 444 (Suppl 1): 73–79.
-
16.
Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI, 2005. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 434: 214–217.
-
17.
Craig MH, Snow RW, le Sueur D, 1999. A climate-based distribution model of malaria transmission in sub-Saharan Africa. Parasitol Today 15: 105–111.
-
18.
Yihenew G, Adamu H, Petros B, 2014. The impact of cooperative social organization on reducing the prevalence of malaria and intestinal parasite infections in Awramba, a rural community in south Gondar, Ethiopia. Interdiscip Perspect Infect Dis 6: 1–6.
-
19.
Bhatt S et al. 2015. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature 526: 207–211.
-
20.
Ulimwengu J, Funes J, Headey D, You L, 2009. Paving the Way for Development: The Impact of Road Infrastructure on Agricultural Production and Household Wealth in the Democratic Republic of Congo. In 2009 Annual Meeting, July 26–28, 2009, Washington, DC.
-
21.
Novelli VP, Peters M, Dobson S, 1999. Infectious diseases. Macnab AJ, Macrae DJ, Henning R, eds. Care of the Critically Ill Child. London, United Kingdom: Churchill Livingstone, 281–298.
-
22.
Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I, 2010. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet ID 10: 317–328.
-
23.
Saez-Llorens XM, 2008. Acute bacterial meningitis beyond the neonatal period. Long S, ed. Long: Principles and Practice of Pediatric Infectious Diseases Revised Reprint, 3rd edition. Philadelphia, PA: Churchill Livingstone.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 672 | 447 | 139 |
| Full Text Views | 829 | 10 | 0 |
| PDF Downloads | 162 | 15 | 2 |