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Aetiology and Outcomes of Suspected Infections of the Central Nervous System in Children in Mbarara, Uganda
Open accessAbstract
Infections of the central nervous system (CNS) are severe conditions, leading to neurological sequelae or death. Knowledge of the causative agents is essential to develop guidelines for case management in resource-limited settings. Between August 2009 and October 2012, we conducted a prospective descriptive study of the aetiology of suspected CNS infections in children two months to 12 years old, with fever and at least one sign of CNS involvement in Mbarara Hospital, Uganda. Children were clinically evaluated on admission and discharge, and followed-up for 6 months for neurological sequelae. Pathogens were identified from cerebrospinal fluid (CSF) and blood using microbiological and molecular methods. We enrolled 459 children. Plasmodium falciparum (36.2%) and bacteria in CSF (13.3%) or blood (3.3%) were the most detected pathogens. Viruses were found in 27 (5.9%) children. No pathogen was isolated in 207 (45.1%) children. Patterns varied by age and HIV status. Eighty-three (18.1%) children died during hospitalisation, and 23 (5.0%) during follow-up. Forty-one (13.5%) children had neurological sequelae at the last visit. While malaria remains the main aetiology in children with suspected CNS infections, no pathogen was isolated in many children. The high mortality and high rate of neurological sequelae highlight the need for efficient diagnosis.
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In a study conducted 2009-2012 on the same target population and setting, cerebral malaria was the most frequent cause of CNS infection, and non-typhoidal Salmonella was the second most frequent bacterial cause.
“In a study conducted 2009–2012, on the same target population and setting as this study, cerebral malaria was the most frequent cause of CNS infection, and, non-typhoidal Salmonella (which is currently not targeted by FA-ME) to be the second most frequent bacterial cause [41].”
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Gaudenzi, G., Kumbakumba, E., Rasti, R., Nanjebe, D., Réu, P., Nyehangane, D., Mårtensson, A., Nassejje, M., Karlsson, J., Mzee, J., et al. (2020) · JMIR Research Protocols · doi:10.2196/21430 · Cited by 9
Self-citationRasti, R., Kumbakumba, E., Nanjebe, D., Mlotshwa, P., Nassejje, M., Mzee, J., Businge, S., Akankwasa, G., Nyehangane, D., Gantelius, J., et al. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-10732-w · Cited by 8
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Metadata
- Authors
- Page, A.-L., Boum II, Y., Kemigisha, E., Salez, N., Nanjebe, D., Langendorf, C., Aberrane, S., Nyehangane, D., Nackers, F., Baron, E., Charrel, R., & Mwanga-Amumpaire, J.
- Affiliations
- Epicentre (FR)
- Mbarara University of Science and Technology (UG)
- Inserm (FR)
- Epicentre Uganda (UG)
- ORCID
- Venue
- Scientific Reports
- Published
- 2017-06-02
- Volume
- 7
- Issue
- 1
- Pages
- 2728-2728
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5457409
- OpenAlex
- W2620527942
- Cited by
- 18
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2018: 4 · 2017: 1
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Medecins Sans Frontieres Field Research (Medecins Sans Frontieres) (submittedVersion)
- Funders
- Mbarara University of Science and Technology
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Keywords
- central nervous system infection, pediatric infection, etiology, Plasmodium falciparum, malaria, bacterial meningitis, viral meningitis, HIV status, neurological sequelae, mortality, Mbarara, Uganda
- MeSH terms
- Central Nervous System Infections, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Uganda, Comorbidity, Odds Ratio, Outcome Assessment, Health Care, Disease Management
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