Etiology and risk factors of meningitis in patients admitted at a Central Hospital in Harare

Abstract

Objective: To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare. Design: Cross-sectional study. Setting: Tertiary, urban-based referral hospital. Subjects: Patients suspected of having meningitis admitted at Parirenyatwa hospital were consecutively recruited into the study until sample size accrual. Main Outcome Measures: (a) Prevalence of pathogens associated with meningitis, (b) Risk factors of meningitis. Results: Two hundred and ninety six (296) patients with clinically suspected meningitis were recruited into the study, 51.7 %( n=115) were male. Meningitis was confirmed in 20.6% (n=61) cases with the following pathogens, C. neoformans 45.9 % ( n=28); S. pneumoniae 27.9 % (n=17); tuberculosis 4.9 % ( n=3); probable viral meningitis 6.6% (n=4 and other bacteria 14.8% (n=9). Patients from crowded households were also more likely to suffer from meningitis than those from sparsely populated households (p<0.001). Conclusion: C. neoformans was the single commonest cause of microbiology positive meningitis. The use of latex agglutination increases the proportion of detected pathogens both fungal and bacterial when used in conjunction with cerebrospinal fluid (CSF) gram stain and culture. Cryptococcus neoformans and S. pneumoniae are the leading causes of meningitis in patients admitted at Parirenyatwa Hospital.